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COVID-19 Advisory: Guide to Documenting COVID-19 Related Suspension or Termination of Services


It is our role to properly educate families about the realities and risks of catching COVID-19. However, there will be inevitable instances when some families may choose to temporarily suspend services or evaluations, or even close their case due to fear of infection. On the other hand, some families will actually be affected by COVID-19.


As proof that life goes on, audits will proceed as scheduled for all of us in Early Intervention regardless. This document provides guidance regarding the responsibilities of service coordinators, evaluators, interventionists and provider agencies for documenting family decisions related to COVID-19. Please read through the section that applies to you.


We are still expected to meet regulatory requirements and timelines and therefore it is important to know how to document delays, suspensions or closures related to COVID-19. And, therefore, the reason for the suspension or closure should be documented in the appropriate paperwork and NYEIS sections, specifying whether:


  1. the family is only concerned about COVID-19, or,

  2. is directly affected by it (someone in the household has fever, cough, or trouble breathing AND has traveled outside the US or had contact with a person who is suspected or confirmed to have infection with COVID-19 in the past 14 days).


Note: If the child is in foster care, the SC should notify the foster care agency case planner and/or education specialist of any changes to the child’s EI status or services.


Service Coordinators


Note: Service Coordinators are expected to meet all regulatory requirements regarding activities and timelines. COVID-19 does not suspend any of these requirements. However, the steps below outline the steps to document family reasons for delay that are due to COVID-19 which may impact regulatory timelines.


If the family delays or terminates the EI process after referral: As required in the NYC Closure Policy, the SC must make three consecutive documented attempts to re-engage the family. If at that time the family elects to not continue the process, the SC should submit a closure form with the reason for closure (family is concerned about COVID-19, or family is directly affected by COVID-19) clearly indicated. This reason for closure should also be documented in their notes. The SC should encourage the family to re-refer their child at a later date (NYC P&P Manual Chapter 6-J Case Closure). Following closure, the SC should follow up with the family within 2 months to re-refer the child (NYC P&P 1-A.1 Referral).


If the family delays or terminates the evaluation process: As required in the NYC Choice of Evaluation Site Policy (NYC P&P 3-B.1 Choice of Evaluation Site), if there is a delay in the evaluation process which will result in late submission of the Multidisciplinary Evaluation (more than 30 days post referral), the SC should complete the “Delay in Evaluation” form indicating that the family is concerned about COVID-19, or is directly affected by COVID-19, and should also document the reason in the SC notes. If the parent/guardian continues to delay the process or is unresponsive, the SC must make three consecutive documented attempts to re-engage the family. If at that time the family elects to not continue the process the SC should submit a closure form with the reason for closure (family is concerned about COVID-19, or family is directly affected by COVID-19) clearly indicated. This reason for closure should also be documented in their notes. Following closure, the SC should follow up with the family within 2 months to re-refer the child (NYC P&P 1-A.1 Referral).


If the family delays the IFSP meeting: When the family decides to delay the IFSP meeting, the SC should record the reason for delay (family is concerned about COVID-19, or family is directly affected by COVID-19) in their notes and in the Integrated Case notes. When the meeting is convened, the SC should select IFSP delay reason “3 – Family cancelled”. In the IFSP Comments section, the SC should record the reason for the delay (family is concerned about COVID-19, or family is directly affected by COVID-19).


If after three unsuccessful documented attempts to schedule the IFSP meeting the family elects to not continue the process: The SC should submit a closure form with the reason for closure (family is concerned about COVID-19, or family is directly affected by COVID-19) clearly indicated.


In scheduling any IFSP meeting, the SC must coordinate with the Regional Office to ensure that all options to schedule the IFSP at a time and place convenient to the family have been considered.


If the family seeks to delay the start of services at the IFSP meeting: On the service authorization(s), under OSEP Service Delay, “4 – Family – delayed response/consent” should be selected. In the IFSP Comments section, the SC should record the reason for the delay (family is concerned about COVID-19, or family is directly affected by COVID-19).


If the family suspends services: The SC should document the parent’s decision and the reason for suspension (family is concerned about COVID-19, or family is directly affected by COVID-19) in their notes. The SC must follow the procedures outlined in the Family Vacation Policy and follow up with the family on an agreed-upon date to resume services (NYC P&P Manual Chapter 6E- Family Vacation). Please note that in all cases of family suspension of services, the parent/guardian must be informed that the same service provider may not be available to resume care.


If the family closes their case: As required in the NYC Closure Policy, the SC must make three consecutive documented attempts to re-engage the family. If at that time the family elects to not continue the process, the SC should submit a closure form with the reason for closure (family is concerned about COVID-19, or family is directly affected by COVID-19) clearly indicated. This reason for closure should also be documented in their notes. SC should encourage the family to re-refer their child at a later date. (NYC P&P Manual Chapter 6-J Case Closure)


Evaluators


If an evaluation is cancelled due to family concerns about COVID-19, evaluators should immediately notify their agency and the family’s SC about the cancellation, including the reason (family is concerned about COVID-19, or family is directly affected by COVID-19).


Interventionists/Service Providers


Families concerned about COVID-19 may choose to cancel a session, suspend services or terminate services. In all of these cases, the interventionist must create a session note to document the missed, suspended or terminated session(s), with the reason (family is concerned about COVID-19, or family is directly affected by COVID-19) clearly indicated. All sessions may be documented on a single note.

If services are suspended: If the family identifies a date to resume services, that date should be included in the session note.


If services are terminated: The interventionist should immediately notify their agency and the child’s SC, including telling them that COVID-19 was the family’s reason for termination.


The make-up policy remains in effect. (NYC P&P Manual Chapter 6-D NYC EIP Make-up Policy). However, if the reason for canceling sessions is due to the fact that the family is directly affected by COVID-19 (anyone in the household has fever, cough, or trouble breathing AND has traveled outside the US or had contact with a person who is suspected or confirmed to have infection with COVID-19 in the past 14 days), the Regional Office will consider authorizing make-up sessions or amending service plans, based on the individual needs of the family. In addition, for children or families who required a 14-day quarantine period, make-up sessions would be delivered within 14 days of the end of the quarantine period.


Provider Agencies


Provider agencies should document any instances including the dates when:

SCs, evaluators or interventionists identify COVID-19 as their own reason for declining or dropping cases

families identify COVID-19 as their reason for suspending or terminating services or closing their case.


Provider agencies should take special care to document if the family is directly affected by COVID-19.


References


BEI reminds everyone to review and adhere to policies, procedures, and guidance described in:


  • https://www1.nyc.gov/site/doh/health/health-topics/coronavirus.page

  • The New York State Department of Health, Bureau of Early Intervention’s Health and Safety Standards for The Early Intervention Program and Frequently Asked Questions Guidance Document.

  • The New York City Early Intervention Program’s Policy and Procedure Manual 2019.


For questions regarding any of the information in this document, please contact the New York City Technical Assistance Unit at EITA@health.nyc.gov.


Provide Services Responsibly


Please review and use information in this email. The best cure to panic and fear is knowledge. Our goal is to keep providing services as long as it is safe to do so and there are no directives from NYC or NYS to stop.


Do not listen to rumors, we should trust the information provided to us at this time. For more information we started a blog which can be found here Also, we highly recommend that you forward this email to other SCs, to providers and parents.


Don't forget parents! They also need knowledge to give them a sense of control and hopefully also to prevent panic and unnecessary cancellations! We will keep on providing information as they come in and anybody interested, specially parents, can sign-up here



IMPORTANT NOTE: This email is based on emails directly from NYC Early Intervention and has been modified only to improve readability.

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