If a family does not want services with PIC at any time BEFORE an initial IFSP happens then the child is exited with the status of “DECLINED” in Raintree.
Providers
If the family declines services prior to the initial IFSP, then exit the child via the comm log with category. By signing off on this comm log note, admin will get a auto-task and exit this child accordingly. If the family is initiating the decline prior to the eligibility meeting, we do NOT need signature forms.
- If the family declines enrollment AT the Eligibility Determination/Initial IFSP, then they will need to sign the Eligibility Determination and PWN signature forms. The family can decline services on the form even after the provider has sent the forms out.
Admin
- CHANGE STATUS TO “DECLINED” IN PATIENT DEMOGRAPHICS TAB
- IN PATIENT DEMOGRAPHICS TAB CHANGE CHILD’S STATUS DATE TO MATCH EXIT DATE FROM WHEN FAMILY DECLINED SERVICES
- IN “VISIT HISTORY” TAB CLOSE ROLE RECORD IF APPLICABLE WITH EXIT DATE
IN “ADMIN” TAB CHECK THAT ALL PACKET SIGNATURES ARE COMPLETE. IF ANY FORMS ARE UNSIGNED, CLOSE OUT WITH VERBAL CONSENT AND MAKE A COMM LOG NOTE WITH THE REASON FORMS ARE CLOSED WITH VC.
Example: "7/9/25 Intake signature forms closed with verbal consent since family declined services as of 7/15/25 (see comm log note).
- MAKE A NOTE OF EXIT REASON/EXIT DATE IN THE STATE DATABASE TASK
- IN “ADMIN” TAB SEND REFERRAL FEEDBACK FORM TO REFERRAL SOURCE TO LET THEM KNOW OF STATUS