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Supporting Ohio’s Service Coordinators System of Payments May 2018
Supporting Ohio’s Service
Coordinators
System of
Payments
May 2018
System of Payments Process
SC Collects
financial
information
and
determines
if parent is
unable to
pay
Screening,
Evaluation,
Assessment
IFSP
Completed
Services
identified to
meet
outcomes
If services
not provided
by CBDD OR
family using
private
insurance,
SC helps
parent make
POLR
application
45 Days
POLR application as needed
SC monitors
units; when 55
units almost
exhausted,
facilitates IFSP
review and re-
determines if
parent is
unable to pay
Ability to Pay DeterminationForm (EI 1701)
Ability to Pay DeterminationForm (EI 1701)
Ability to Pay DeterminationForm (EI 1701)
Payment for Early
Intervention Services(EI 1702)
Forms
Name Number
Ability to Pay Determination Form EI 1701
Payment for Early Intervention Services
Application
EI 1702
Extraordinary Medical Expenses (EME)
Worksheet
EI 1703
Extraordinary Medical Expenses (EME)
Tracking
EI 1704
http://ohioearlyintervention.org/forms
Resources
System of Payments Rule
http://ohioearlyintervention.org/federal-and-state-regulations
Next Call: Dates/Topic
July 2018IFSP
Outcomes
