EXAMPLE PROVIDED
BY: Bridges for Families Birth to 3 Program
IFSP Revision
Checklist
Points to Remember:
- A revision to an
IFSP can happen at any time.
- A revision would
be:
- adding or subtracting
a service
- changing frequency,
intensity or duration of a service
- changing location
of a service
- changing a
service provider
- adding outcome(s)
- Revisions are made
in consultation with the full team using a consensus process. No one person
makes the decision. There does not have to be a meeting. This consensus process
can occur at various times in various ways until a consensus is reached (phone,
face to face, email, meeting, etc.)
- A revision differs
from an update. An update of the IFSP involves more extensive review of the
plan including the Look At Me pages, review of all outcomes, assessment of
strengths/challenges/changes, etc.
Areas of the IFSP
that Must Be Completed for a Revision:
- Fill in the date
of the revision on the Family Info Page under the current IFSP.
- Complete new Outcome
Pages, if new outcomes were developed (desired outcome; how will we know we
have made progress.)
- Make changes to
the Summary of Services Page, if there were changes to provider, service,
frequency, duration, intensity, location
- SC and parent (at
a minimum) date and initial the Summary of Services page. (SC can date and
initial for the parent if the parent gives consent by phone: e.g. JR/BJR per
phone call.)
- Complete a new
Total Cost of Plan Page for any changes to the number of visits per week.
(Parent signature required, too.)
Things To Do Back
at the Office:
Tag with a paperclip
each page of the IFSP where anything new has been written to signal the office
staff for data entry and copying.
Only revisions adding
a service or changing a provider need to be emailed as a request to the Program
Coordinator. However, if the frequency of a service is increasing and the current
provider is not able to accommodate that frequency, then a service request must
be submitted to the Program Coordinator so that the provider can be changed.
Email request for
service(s) to Program Coordinator including the child’s name, insurance, service
requested, frequency requested, location of service (be specific- e.g. off of
Buckeye Rd, east of Stoughton Rd) and any additional information or requests
such as a particular provider preference, whether an interpreter is needed,
best days and times of day for visit, etc.
Submit the IFSP for
review while waiting for a provider to be assigned.
Hold the IFSP until
a provider is assigned then fill in that information, including the start date,
on the Summary of Services page and the Total Cost of Plan page.
Contact family to
give them name and phone number of provider, once assigned.
Contact provider
to call family to schedule visits. Share information as applicable.
Send any pertinent
written information to the provider (e.g., evaluation report, other medical
reports, IFSP or pages of the IFSP). No release of information is needed for
Bridges staff or outside providers who have a signed agreement to provide services
for Bridges.
Submit the revised
IFSP to Program Coordinator for review.
Once reviewed, the
revised IFSP will be given to office staff who will enter revised IFSP information
into the database.
Office staff will
copy the paper clipped pages of the revised IFSP for the family and give them
to the provider or send it to the family.
Office staff will
copy the paper clipped pages of the revised IFSP and send them to any outside
provider(s).
Office staff will
file the original of the revised IFSP in the chart.