ITCVA Resource Library
Click on menu items below to expand each section. If a preferred document is missing, please let us know!
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Version Control Table UPDATED 2021-07-09
Chapter 1 - Mission, Purpose & Key Principles
Chapter 2 - State Infrastructure
Chapter 3 - Referral
Chapter 4 - Intake
Chapter 5 - Eligibility Determination
Chapter 6 - Assessment for Service Planning
Chapter 7 - IFSP Development UPDATED 2021-07-09
Chapter 8 - IFSP Implementation and Review
Chapter 9 - The Early Intervention Record
Chapter 10 - Dispute Resolution
Chapter 11 - Finance & Billing UPDATED 2021-07-09
Chapter 12 - Personnel UPDATED 2021-07-09
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Procedural Safeguards Documents
Notice of Child and Family Rights and Safeguards Including Facts About Family Cost Share (PDF) - Updated 2024-01
Strengthening Partnerships (PDF) - Updated 2024-04
Procedural Safeguards Forms and Templates
Confirmation of Scheduled Meetings/Activities (1048) PDF | DOC
Family Cost Share Appeal (1230) UPDATED 2021-07-09 PDF | DOC
Family Cost Share Fee Scale (3143) PDF
Notice and Consent to Determine Eligibility (3145) PDF | DOC
Notice and Consent for Assessment for Service Planning (3152) PDF | DOC
Notice to DMAS: Family Declining to Bill Private Insurance (3141) PDF | DOC
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Activity Notes
Eligibility Determination
ICDF
IFSP
IFSP (Individualized Family Service Plan) (TRAC-IT Version 2022-09) | DOCX
IFSP Summary Letter (3223A) DOC
IFSP Review Summary Letter (3223B) DOC
Memorandum of Agreement
State MOA with Guidance for Local Systems DOCX
Physician Certification
Physician Certification w/ Health Indicator Questions (3227) PDF | DOC
Physician Communication re: Health Indicator Questions (3228) PDF | DOC
Referral
Screening
Service Coordination
Surrogate Parents
Texting
Permission for Texting (0011) PDF
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Please refer to the Quicklinks section on the Child Outcomes & Functional Assessment page of our website. Thank you.
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Family Outcomes and the Family Survey: Improving Experiences and Outcomes for Families in Early Intervention
Family Survey 2023
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Coaching in Action Checklist PDF
Coaching in Action Checklist: Tips & Clarifications PDF
Fidelity Assessment FAQs PDF
Fidelity Assessment Implementation At-A-Glance PDF
Local Coaching Fidelity Assessment Report ANY YEAR
Preparing for Fidelity Assessment: A Webinar for Observers and Supervisors LINK
Preparing for Fidelity Assessment: A Webinar for Providers LINK
Video Recording Guidelines PDF
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General Monitoring and Supervision
Local System Manager (LSM) Handbook PDF UPDATED 2021-10
ITOTS Reports for Local System Monitoring PDF
Quarterly Data Verification Reports: What? Why? How? PDF
Quality Record Review Tool PDF
Child and Family Outcomes
Toolkit for Analysis of Child and Family Outcomes PDF
Relationship of Quality Practices to Child and Family Outcome Measurement Results VIRGINIA PDF | NATIONAL PDF
Compliance Indicators
IND 01 (Timely Initiation of Services) - Tracking Timeliness of Service Delivery EXCEL
IND 07 (45-Day Timeline) - Tips for Monitoring Compliance PDF
IND 08 (Transition) - Tips for Monitoring Compliance PDF
Fiscal Monitoring and Oversight
Data Entry and Notification Requirements for the Medicaid EI Benefit YouTube
How to Complete Your Initial Fiscal Form YouTube
How to Complete Your Mid-Year and End-of-Year Fiscal Form YouTube
How to Complete Your Federal Balance Report PDF
How to Make a Budget Revision YouTube
How to Complete the Therapy Provider Report YouTube
Improvement Planning
ITCVA Improvement Plan Template DOCX
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These documents outline steps local system managers, supervisors, and fiscal officers can take to orient themselves to the Infant & Toddler Connection of Virginia's early intervention system and administration.
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Developed by/for Virginia
Public Awareness Order Form PDF
ITCVA Poster (ENGLISH & SPANISH) PDF
Public Awareness Materials Printing Instructions PDF
ITCVA Logo PNG
Virginia Best Practice Protocol for Hospitals Referring to ITCVA PDF
On Your Way - Skill-Building Worksheets for Families and Caregivers PDF
Other Materials and Resources
CDC Developmental Milestones Brochure PDF
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Over the years a number of core EI documents (e.g., procedural safeguards forms, the IFSP, etc.) have been translated into a number of languages. Use the links below to download ZIP files of the documents available in each language.