Data Elements - ECTA Center
New Jersey Early Intervention System
General Supervision Data Review Matrix
|Data Elements |Data Source |Service Coordination Units|Targeted Evaluation |EIP Agencies |Regional Early |Lead Agency |
| | | |Team | |Intervention Collaborative|(DHSS-EIS) |
|New referral information submitted to REIC within 2 |P |SPOE Paperwork |Weekly | | |Paper Review | |
|business days. | | | | | | | |
|Assignment of Service Coordinator |C |SPOE Paperwork | | | |Paper Review |Annual |
| | |SPOE Data | | | | | |
|Primary Referral Sources Report |P |SPOE Data SPOE Report | | | |Six Months |Annual Performance |
| | | | | | | |Report |
|Children Pending IFSP |P |SPOE Data SPOE Report |Weekly | | |Monthly |Quarterly |
|(Referrals in process) | | | | | | | |
|Referrals that exceed 45 days to Initial IFSP Meeting. |C |SPOE Data | | | |Quarterly |Annual |
|Timely delivery of IFSP Services. (30 days) |C |SPOE Data |Paper Review | |Paper Review |Paper Review |Six Months |
|Consent to release information (if applicable). |C |Self-Assessment |Monthly Record Review |Monthly Record Review | |Annual Review |Annual Review |
| | | |Annual Report |Annual Report | | | |
|Family Rights Booklet – documentation in the progress |C |Self-Assessment |Monthly Record Review | |Monthly Record Review |Annual Review |Annual Review |
|note that family was given booklet and information was | | |Annual Report | |Annual Report | | |
|discussed. | | | | | | | |
|Written parental consent for Evaluation/Assessment. |C |Self-Assessment |Monthly Record Review |Monthly Record Review |Monthly Record Review |Annual Review |Annual Review |
| | | |Annual Report |Annual Report |Annual Report | | |
|Documentation that family information meeting was |P |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
|conducted or that the family declined. | | |Annual Report | | | | |
|Family Cost Participation documentation is current. |P |SPOE Data |Monthly Record Review | | |Paper review |Quarterly |
| | |Self-Assessment |Annual Report | | | | |
|IFSPs demonstrate a fit between evaluation summary and |P |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
|IFSP outcomes. | | |Annual Report | | | | |
|Evaluation report contains description and age levels for|C |Self-Assessment |Monthly Record Review |Monthly Record Review |Monthly Record Review |Annual Review |Annual Review |
|all areas of development including cognitive, physical | | |Annual Report |Annual Report |Annual Report | | |
|including vision and hearing, communication, social or | | | | | | | |
|emotional, and adaptive. | | | | | | | |
|Written Prior Notice of the IFSP Meeting |C |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
| | | |Annual Report | | | | |
|Concerns, priorities and resources are reflected in the |P |Self-Assessment |Monthly Record Review |Monthly Record Review |Monthly Record Review |Annual Review |Annual Review |
|outcomes and activities on the IFSP. | | |Annual Report |Annual Report |Annual Report | | |
|Services relate to the outcomes for the child and family.|P |SPOE Paperwork |Monthly Record Review |Monthly Record Review |Monthly Record Review |Paper Review |Annual Review |
| | |Self-Assessment |Annual Report |Annual Report |Annual Report |Annual Review | |
|Individual Child Authorization Report |P |SPOE Data |Review prior to and at | | | |Procedural Safeguards |
| | | |IFSP Meeting | | | |Inquiry |
|IFSP services in natural Environments (Settings) |P |SPOE Data | | | | |Federal Child Count |
| | | | | | | |Annual Performance |
| | | | | | | |Rpt. |
|Justification present on IFSP when service setting is |C |SPOE Paperwork | | | |Paper Review | |
|other than natural environments | |(IFSP service page) | | | | | |
|Lapse of Service By Child Report |P |SPOE Data |Review month in advance | | | | |
|Timely six month IFSP periodic reviews |C |SPOE Data | | | | |Six Months |
|Timely Annual IFSP |C |SPOE Data | | | | |Six Months |
|Children turning Age Three by LEA for DOE |P |SPOE Data | | | | |Quarterly |
| | | | | | | |CMO |
|Transition to Preschool booklet was given and reviewed |P |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
|with the parents within the designated timeframes | | |Annual Report | | | | |
|Documentation of invitation to local school district to |C |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
|participate in a Transition Planning Conference. | | |Annual Report | | | | |
|The IFSP documents individualized plans for transition. |C |Self-Assessment |Monthly Record Review |Monthly Record Review | |Annual Review |Annual Review |
| | | |Annual Report |Annual Report | | | |
|Documentation of attempt to convene a transition planning|C |Self-Assessment |Monthly Record Review | | |Annual Review |Annual Review |
|conference for children that are not transitioning to | | |Annual Report | | | | |
|Part B to discuss appropriate services. | | | | | | | |
|Transition Planning Conference conducted at least 90 days|C |SPOE Data | | | | |Annual |
|prior to age three. | | | | | | | |
|Exit Reasons |P |SPOE Paperwork | | | |Paper Review |Federal Annual Child |
| | |SPOE Data | | | | |Count |
|Formal Dispute Resolution Report |P |Procedural Safeguards | | | | |Quarterly |
| | |Database | | | | | |
|Informal Procedural Safeguards Report |P |Procedural Safeguards | | | | |Quarterly |
| | |Database | | | | | |
| | | | | | | | |
|% Birth to 1 year old w/ an IFSP |P |SPOE Data | | | |Child Find Follow-up |Annual Performance |
| | |Census Data | | | | |Report |
|% Birth to 3 years w/ an IFSP |P |SPOE Data | | | |Child Find Follow-up |Annual Performance |
| | |Census Data | | | | |Report |
|Average age at Referral |P |SPOE Data | | | | |Annual Performance |
| | | | | | | |Report |
|Primary Languages |P |SPOE Data | | | | |Six Months |
|CONTRACT COMPLIANCE |
|Service Coordination Caseloads |CC |SPOE Data |Annual & ongoing update | | |Ongoing Data Entry and |Annual Contract |
| | |Grant Contract |reporting | | |Cleaning |Renewal |
| | |Personnel | | | | |Ongoing Notification |
| | |Consultation Notification | | | | |Review |
| | |Form | | | | | |
|EIP agencies comply with minimum FTE requirements and |CC |LOA Initial Practitioner |Monthly | |Ongoing Service Matrix | |Annually |
|Practitioners. | |Enrollment | | |Updates | | |
| | |Service Matrix | | | | | |
| | |EIP Assignment E-mail | | | | | |
| | |Lists | | | | | |
|Agency complies with practitioner requirements for a mix |CC |Practitioner Enrollment & | |Ongoing |Ongoing | |Initial Enrollment |
|of specialties. | |Terminations | | | | |Annually |
| | |Service Matrix | | | | | |
|Expenditure reports are submitted timely and accurately. |CC |Expenditure Reports |Quarterly | | |Quarterly |Quarterly |
| | |Contract & Fiscal Unit | | | | | |
| | |Tracking | | | | | |
|Funds From Other Sources Survey |CC |Grant Contract |Annually |Annually |Annually |Annually |Annually |
| | |Expenditure Reports | | | | | |
| | |FOS Survey | | | | | |
|Comprehensive EIP serves as individual child’s EIP Home. |CC |SPOE Report | | |Ongoing | |Annually |
| | |EIP Home | | | | | |
|Change of agency information provided timely. |CC |NJEIS Database Directory |Ongoing & at least |Ongoing |Ongoing |Ongoing |Ongoing |
| | |Report |annually | | | | |
|Self-assessment submitted timely and completely. |CC |Tracking Report | | | |Annually |Annually |
|Service Coordination Service Encounter Verification Logs |CC |CMO Trend Reporting |Monthly | | | |Quarterly |
|are submitted timely and accurately to the CMO for | |SPOE Report | | | | | |
|Medicaid Billing. | | | | | | | |
|CSPD CONTRACT COMPLIANCE |
|Practitioner Credentials |CC |Covansys | | | | |Initial Practitioner |
| | |EIP Agency | | | | |Enrollment |
|Agency Training Requirements |CC |CSPD Database | | | | |Initial |
|Practitioner Training Requirements |CC |CSPD Database | | | | |Ongoing |
|Procedural Safeguards |
|Procedural Safeguards Reports | |Informal | | | | |Quarterly |
| | |Formal | | | | | |
| | |SICC | | | | | |
|Incident Reports | | | | | | | |
|Mediations/Hearings | | | | | | | |
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