Module One: Lesson Three
The Local Early Steps must maintain a record for each eligible, enrolled infant and toddler and family. The record will contain, at a minimum, all required consent for release of information and consent for treatment forms, including but not limited to the following:
- Consent for Evaluation (DH-CMS Form 1064)
- Prior Notice Letters (DH-CMS Form 1065)
- Consent for Release of Information
- Consent for Use of Insurance, if appropriate (DH-CMS Form 1066)
- Log of Access to Confidential Record (DH-CMS Form 1063)
- All required Early Steps Data forms and other data documentation
- Individualized Family Support Plan(s) (Initial and all updates)
- Progress Notes, consultation reports from the team providing assessments and services
- Service Coordination/Targeted Case Management Notes
- Relevant Correspondence
- Additional documentation such as court order granting legal guardianship, documentation of resident alien status, and documentation of insurance, as appropriate.
- Fiscal records and service payment documentation, including documentation of service provision by community service providers.
The Local Early Steps must maintain a record of the evaluation conducted on each referred infant and toddler who is determined ineligible for Early Steps by the eligibility evaluation team. This record will include the team evaluation and conclusions and documentation of notification to the parents of the team's determination and provision of information concerning the parent's rights if they do not agree with the eligibility determination.
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