June 2008 Indiana Personnel Guide Page 1 of 29
Early Intervention
Personnel
Guide
June 2008
June 2008 Indiana Personnel Guide Page 2 of 29
Table of Contents
Overview 3
Early Intervention Services 3
Early Intervention Roles 4
Enrolled Providers Must Meet Established Criteria 5
Table 1: Entry Level Qualifications for Early Intervention Personnel 7
Professional Conduct Guidelines 12
Early Intervention Personnel Credentialing Process 13
Provider Update and Attestation Statement 14
Competency Areas for Direct Service Providers 15
Current Summary of Activities 18
Portfolio Activities and Credit Points 18
Supported Documentation 19
Current Summary of Activity for Direct Service Providers (Initial) 20
Continual Professional Development for Associates and Specialists (Annual) 21
Initial Credentialing Summary of Activity for Service Coordinators 22
Current Summary of Activity for Service Coordinators (Annual) 23
Attachment A 24
Provider Enrollment Checklist with Established First Steps Facility 25
Provider Enrollment Checklist with New First Steps Facility 26
Independent Provider Enrollment Checklist 27
Provider Annual Re-Credentialing Checklist 28
SPOE Service Coordinator Enrollment Checklist 29
Helpful information:
Provider forms are located on the First Steps web page under Service Matrix/Provider Enrollment
Provider Agreements: https://www.infirststeps.com/matrix/docs/enrollment.asp
Provider Enrollment Update Form: https://www.infirststeps.com/matrix/docs/maintenance.asp
First Steps Web Address: Firststepsweb@fssa.in.gov
Indiana First Steps: www.firststeps.in.gov
Online Matrix: www.infirststeps.com
Early childhood Training Calendar: http://earlychildhoodmeetingplace.indiana.edu
UTS Training Calendar: www.utsprokids.org
June 2008 Indiana Personnel Guide Page 3 of 29
Overview
Each state participating in Part C of the Individuals with Disabilities Education Act (IDEA) must
establish qualifications to assure that persons providing early intervention services are adequately
prepared and trained as defined in 34 CFR 303.361. Indiana’s personnel standards are based on the
belief that the needs of the state will best be met by a balance between high standards and the
flexibility of individual providers to engage in personally meaningful professional development
activities. The standards therefore are intended to be flexible and inclusive, rather than exclusive,
with high standards being supported by training.
The term “early intervention” refers to required services provided to eligible infants and toddlers
with special needs and their families through the First Steps Early Intervention System. These
requirements apply to all individuals enrolled and reimbursed as providers of any early intervention
service through the First Steps Early Intervention System. Persons providing the following services
as delineated in each child’s Individualized Family Service Plan (IFSP) must meet the early
intervention personnel standards:
Early Intervention Services
Individualized Early Intervention Services are services determined through the evaluation and
assessment process designed to meet the developmental needs of each eligible child and the needs
of the family related to enhancing the child’s development. Individualized services, as defined in 34
CFR 303.12(d), include the following:
1. Audiology Services
2. Developmental Therapy (Special Instruction)
3. Specialized Individual and Family Counseling/Psychological Services
4. Health Services
5. Medical Services (Diagnostic/Evaluative Purposes Only)
6. Nursing Services
7. Nutrition Services
8. Occupational Therapy
9. Physical Therapy
10. Psychological Services
11. Social Work Services
12. Speech/Language Pathology
13. Vision Services
14. Assistive Technology/Services
15. Service Coordination
16. Transportation
17. Other Early Intervention Services
June 2008 Indiana Personnel Guide Page 4 of 29
Early Intervention Roles
It is imperative that individuals with a variety of educational and experiential backgrounds be
utilized to provide early intervention services. Early Intervention Service Providers and Service
Coordinators can best be described utilizing three distinct roles:
Early Intervention Support
Persons who provide support services such as transportation and interpreter services, but are not
directly involved in the implementation of early intervention services.
Early Intervention Associate
Persons possessing a high school diploma or GED with formal specialized training beyond the
secondary level may enroll as an early intervention associate. Individuals must meet the
requirements of their discipline (as described in Table 1) to provide services as an associate.
Associates assist in the design and provision of direct services to children and families under the
direct supervision of an early intervention specialist from the area/discipline in which they are
providing services (as described in Table 1). Early Intervention Associates include Developmental
Therapy Associates, Nurses (Licensed Practical Nurses), Occupational Therapy Assistants, Physical
Therapy Assistants, and Speech Pathology/Audiology Aides.
Early Intervention Specialist
Persons who meet entry level requirements for a specialization in their discipline as defined in Table
1. Specialists design and implement early intervention services and may supervise early
intervention associates within the area/discipline of their credential. Specialists practicing in the
First Steps Early Intervention System include Audiologists, Developmental Therapy Specialists,
Marriage and Family Therapists, Nurses (Registered Nurses), Nutritionists, Occupational Therapists,
Orientation/Mobility Specialists, Pediatric Nurse Practitioners, Physicians, Physical Therapists,
Psychologists, School Psychologists, Service Coordinators, Social Workers, Speech/Language
Pathologists and Vision.
THERE WILL BE NO WAIVERS OF THE PERSONNEL STANDARDS SET IN THIS
DOCUMENT EXCEPT AS REQUIRED UNDER CFR 303.361(g).
Providers who feel that their professional training should be considered as appropriate to
provide early intervention services should forward that information to the First Steps Website:
Firststepsweb@fssa.in.gov
All new enrollees and enrolled providers changing payee status must meet the new
standards.
June 2008 Indiana Personnel Guide Page 5 of 29
Enrolled Providers Must Meet Established Criteria
Personnel standards for early intervention providers are divided into four criteria:
1) An individual must meet minimum entry standards for the role of specialist, associate, or
support staff in their discipline. This means that they have completed required academic training
and meet state approved or recognized certification, licensing, registration, or other comparable
requirements for their discipline. See Table 1 of this document for discipline specific requirements.
Documentation of minimum qualifications must be submitted as part of provider enrollment, as well
as proof of liability insurance and a criminal history background inquiry conducted within the past 12
months.
2) All potential providers must complete the Direct Service Provider Orientation before enrolling
as a provider in First Steps. This is a distance learning experience that lets you work at your own
pace. You have 45 days from the date of registration to submit all activities. Each participant will
have three chances to pass this distant learning experience. If you do not pass with an 80% or
higher score, you will not be allowed to enroll as a provider in First Steps even if you meet other
minimum requirements.
3) All persons providing early intervention services must complete additional training as required
for their role in the early intervention system. Support persons may be required to complete and
pass supplemental training related to infants and toddlers with disabilities.
All Indiana early intervention providers are required to complete mandatory state training and
educational activities. To continually meet the needs of the providers and early intervention system,
training requirement may be modified from year to year. Current requirements may be found in
Attachment A. This training is required in order to meet credentialing requirements. Credentialing
assures families that each enrolled provider has met additional qualifications related specifically to
the provision of pediatric services within the framework of the First Steps Early Intervention System.
As part of the credentialing process all associate and specialist personnel are required to document
credit points earned through portfolio activities. These credit points are earned in competency areas
that represent bodies of knowledge and/or skills that are considered critical to the implementation
of quality early intervention services across all disciplines. Please refer to the Early Intervention
Credentialing Process in this guide (page 13).
Registration for First Steps Orientation and the state required training are coordinated through
the Unified Training System (UTS). You may access UTS by going directly to UTS Training
calendar at www.utsprokids.org or find training through:
http://earlychildhoodmeetingplace.indiana.edu
After initial credentialing, all enrolled associate and specialist level providers must document in their
personnel file a minimum of three credit points each year of portfolio activities related to continual
professional development in the competency areas. Supporting documentation of a provider’s
Continual Professional Development for Direct Service Providers Annual Credentialing must be
maintained in a personnel file.
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4) Direct Supervision for Developmental Therapists must include at a minimum:
A. Supervisor must be working in the First Steps program, carry a caseload, and have at
least one (1) year experience before becoming a supervisor.
B. Monthly face to face meetings with supervisor to review clinical notes, treatment plan,
and intervention strategies
C. Documentation of face to face meeting
June 2008 Indiana Personnel Guide Page 7 of 29
Table 1: Entry Level Qualifications for Early Intervention Personnel
Audiologist: Licensed through the Indiana Speech-Language Pathology and Audiology board as set
forth in IC 25-35.6 and further defined in 880 IC 1-1; or those in the Clinical Fellowship Year (CFY)
working toward licensure under the supervision of a licensed Audiologist who must submit the
name, address and copy of license of supervisor at time of enrollment. Certificate of completion for
orientation to the First Steps Early Intervention System (DSP 101) through the Unified Training
System (UTS) must be submitted at the time of enrollment. Completion of annual mandatory
training is required (See Attachment A). Must credential at the specialist level within 2 years of
enrollment and complete Continual Professional Development annually.
Audiologist Aide: Meets the minimum qualifications which the Indiana Speech Language
Pathology board establishes for Audiology aides. Must work under the direct supervision of an
enrolled licensed audiologist as referenced in IC 25-36.6 and 880 IAC 1-1 and submit the name,
address, and a copy of the license of their supervisor at the time of enrollment. Certificate of
completion for orientation to the First Steps Early Intervention System (DSP 101) through the
Unified Training System (UTS) must be submitted at the time of enrollment. A Completion of annual
mandatory training is required (See Attachment A). Must credential at the associate level within 2
years of enrollment and complete Continual Professional Development annually.
Developmental Therapy Specialist: Baccalaureate and/or Masters and/or Doctorate degree in
special education, deaf education, elementary education, early childhood education, child
development, or early intervention. Those enrollees lacking early intervention experience may enroll
at the specialist level but must work for 12 months under the direct supervision of an enrolled
credentialed developmental therapy specialist (see page 5, number 3) and submit name and
address of supervisor at time of enrollment. Certificate of completion of Orientation to the First
Steps Early Intervention System (DSP 101) through the Unified Training System (UTS) must be
submitted at the time of enrollment. Completion of annual mandatory training is required (See
Attachment A). Must credential at the specialist level within 2 years of enrollment and complete
Continual Professional Development annually.
Developmental Therapy Associate: High School diploma or GED and Associate degree in child
development, early childhood education or the completion of equivalent field-based training (i.e.
Child Development Associate and/or Healthy Families Training). Licensed Practical Nurses may also
enroll as a Developmental Therapy Associate. Individuals enrolling at this level must work under the
direct supervision of an enrolled credentialed developmental therapy specialist (see page 5, number
3) and submit name and address of supervisor at time of enrollment. Certificate of completion for
orientation to the First Steps Early Intervention System (DSP 101) through the Unified Training
System (UTS) must be submitted at the time of enrollment. Completion of annual mandatory
training is required (See Attachment A). Must credential at the associate level within 2 years of
enrollment and complete Continual Professional Development annually.
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Marriage and Family Therapist: Specialized individual and family counseling related to the child’s
disability may be provided by a Certified Marriage and Family Therapist (CMFT) certified under IC
25-23.6 and 839 IAC
1. Supervision, as used in IC 25-23.6.8 and 839 IAC 1, means face to face contact between the
supervisor and the supervisee for the purpose of assisting the supervisee in the process of learning
the skills of marriage and family therapy practice. Certificate of completion for orientation to the
First Steps Early Intervention System (DSP 101) through the Unified Training System (UTS) must be
submitted at the time of enrollment. Completion of annual mandatory training is required (See
Attachment A). Must credential at the specialist level within 2 years of enrollment and complete
Continual Professional Development annually.
Nurse (Registered): Licensed as a Registered Nurse by the Indiana Nursing Board. Certificate of
completion for orientation to the First Steps Early Intervention System (DSP 101) through the
Unified Training System (UTS) must be submitted at the time of enrollment. Completion of annual
mandatory training is required (See Attachment A). Must credential at the specialist level within 2
years of enrollment and complete Continual Professional Development annually.
Nurse Practitioner (Certified Pediatric Nurse Practitioner):
Licensed as a Registered Nurse by the Indiana Nursing Board and nationally certified as a Pediatric
Nurse Practitioner. Certificate of completion for orientation to the First Steps Early Intervention
System (DSP 101) through the Unified Training System (UTS) must be submitted at the time of
enrollment. Completion of annual mandatory training is required (See Attachment A). Must
credential at the specialist level within 2 years of enrollment and complete Continual Professional
Development annually.
Nurse (Licensed Practical Nurse): Licensed as a Licensed Practical Nurse by the Indiana Nursing
Board. Must work under the direct supervision of a credentialed registered nurse and submit the
name, address, and a copy of the license of their supervisor at the time of enrollment. Certificate of
completion for orientation to the First Steps Early Intervention System (DSP 101) through the
Unified Training System (UTS) must be submitted at the time of enrollment. Completion of annual
mandatory training is required (See Attachment A). Must credential at the associate level within 2
years of enrollment and complete Continual Professional Development annually.
Nutritionist: Certified as a Registered Dietitian by the Indiana Certification Dietitians Board.
Certificate of completion for orientation to the First Steps Early Intervention System (DSP 101)
through the Unified Training System (UTS) must be submitted at the time of enrollment. Completion
of annual mandatory training is required (See Attachment A). Must credential at the specialist level
within 2 years of enrollment and complete Continual Professional Development annually.
Occupational Therapist: Registered with the American Occupational Therapy Association and
certified by the Medical Licensing Board of Indiana as an Occupational Therapist; or those with a
temporary license working under the supervision of a licensed Occupational Therapist who must
submit the name, address and copy of license of supervisor at time of enrollment. Certificate of
completion for orientation to the First Steps Early Intervention System (DSP 101) through the
Unified Training System (UTS) must be submitted at the time of enrollment. Completion of annual
mandatory training is required (See Attachment A). Must credential at the specialist level within 2
years of enrollment and complete Continual Professional Development annually.
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Occupational Therapy Assistant: Registered with the American Occupational Therapy
Association and certified by the Medical Licensing Board of Indiana as an Occupational Therapy
Assistant by the Indiana Occupational Therapy Committee. Must work under the direct supervision
of an enrolled Occupational Therapist as referenced in IC 25-23.5.5 and 844 IAC 10-5.5, and submit
the name, address, and a copy of the license of their supervisor at the time of enrollment.
Certificate of completion for orientation to the First Steps Early Intervention System (DSP 101)
through the Unified Training System (UTS) must be submitted at the time of enrollment. Completion
of annual mandatory training is required (See Attachment A). Must credential at the associate level
within 2 years of enrollment and complete Continual Professional Development annually.
Orientation/Mobility Specialists: Certification as an Orientation/Mobility Specialist from the
Association for Education and Rehabilitation of the Blind and Visually Impaired. Certificate of
completion required for orientation to the First Steps Early Intervention System (DSP 101) through
the Unified Training System (UTS) must be submitted at the time of enrollment. Completion of
annual mandatory training is required (See Attachment A). Must credential at the specialist level
within 2 years of enrollment and complete Continual Professional Development annually.
Physical Therapist: Registered with the American Physical Therapy Association and licensed by
the Medical Licensing Board of Indiana as a physical therapist; or those with a temporary license
working under the supervision of a licensed Physical Therapist who must submit the name, address
and copy of license of supervisor at time of enrollment. Certificate of completion for orientation to
the First Steps Early Intervention System (DSP 101) through the Unified Training System (UTS)
must be submitted at the time of enrollment. Completion of annual mandatory training is required
(See Attachment A). Must credential at the specialist level within 2 years of enrollment and
complete Continual Professional Development annually.
Physical Therapy Assistant: Registered with the American Physical Therapy Association and
licensed by the Medical Licensing Board of Indiana as a Physical Therapy Assistant. Must work under
the direct supervision of an enrolled licensed Physical Therapist as referenced in IC 25-27-1 and 844
IAC 6 and submit the name, address, and a copy of the license of their supervisor at the time of
enrollment. Certificate of completion for orientation to the First Steps Early Intervention System
(DSP 101) through the Unified Training System (UTS) must be submitted at the time of enrollment.
Completion of annual mandatory training is required (See Attachment A). Must credential at the
associate level within 2 years of enrollment and complete Continual Professional Development
annually.
Physician: Licensed by the Indiana Medical Licensing Board as a Doctor of Medicine or Osteopathic
Physician. Certificate of completion for physician’s orientation to the First Steps Early Intervention
System through the Unified Training System (UTS) must be submitted at the time of enrollment.
Credentialing is not required.
June 2008 Indiana Personnel Guide Page 10 of 29
Psychologist: Specialized individual and family counseling or psychological treatment which
includes psychological counseling with the child and/or family, centering on the child’s
developmental needs, must be provided by a psychologist who is:
1. Licensed by the Health Professions Bureau (HSPP, IC 25-33-1 through IC 25-33-18). This would
include Psychologists who do not have the HSPP endorsement and are currently practicing under
the supervision of a health service provider in psychology for the purpose of qualifying for the
endorsement, or a psychologist who holds a limited license issued under IC 25-33-1-18 and
practices within the scope of the psychologist’s limited license
Or
2. Licensed by the Professional Standards Board (Indiana School Psychologist with Private Practice
Endorsement, IC 20-1-1.9-1 through IC 20-1-1.9-6), practicing within the scope of the school
psychologist’s license and endorsement.
Certificate of completion for orientation to the First Steps Early Intervention System (SC 101)
through the Unified Training System (UTS) must be submitted at the time of enrollment. Completion
of annual mandatory training is required (See Attachment A). Must credential at the specialist level
within 2 years of enrollment and complete Continual Professional Development annually.
Service Coordinator: A Baccalaureate degree with 12 months of case management or early
intervention experience; or a Baccalaureate degree with a minimum of 30 related academic credit
hours with 12 months of supervised case management or early intervention experience. Certificate
of completion for orientation to the First Steps Early Intervention System (SC 101) through the
Unified Training System (UTS) must be obtained prior to providing services.
Individuals who meet the degree requirement but have not practiced as a service coordinator/case
manager must work for 12 months under direct supervision.
Or
High School Diploma or GED and:
• Associate degree/equivalent training (e.g. Child Development Associate and/or Healthy Families
Training) in one of the thirteen service disciplines (see page 3); or an Associate degree with a
minimum of 15 related academic credit hours.
Or
• An immediate (parent/sibling) family member of a child with special needs.
Or
• A community member of an underserved population.
Each of the three options requires a certificate of completion for orientation to the First Steps Early
Intervention System (DSP 101) through the Unified Training System (UTS). The second and third
option will be required to provide documentation that supports their qualifications under those
options.
Service Coordinator must work under direct supervision of the SPOE. Must credential at the
specialist level within 2 years of enrollment and complete Continual Professional Development
annually according to the SPOE credentialing date set by the State and CRO.
Please Note: The above educational requirements for Service Coordinator are recommended
guidelines. The SPOE fiscal agent has the final hiring decision. Once hired, all Service
Coordinators must meet credentialing requirements and complete additional required
Service Coordination training. All Service Coordinators must receive supervision
through the SPOE. (Initial and Annual Credentialing grids can be found on Pages 20 and 21 with
specific requirements for all Service Coordinators.)
June 2008 Indiana Personnel Guide Page 11 of 29
Social Worker: Social work services, which include clinical interventions such as individual/family
counseling, must be provided by a licensed clinical social worker (LCSW) licensed under IC 25-23.6,
or a (MSW) level social worker working toward licensure who must submit the name, address and
copy of license of supervisor at time of enrollment. Certificate of completion for orientation to the
First Steps Early Intervention System (DSP 101) through the Unified Training System (UTS) must be
submitted at the time of enrollment. Completion of annual mandatory training is required (See
Attachment A). Must credential at the specialist level within 2 years of enrollment and complete
Continual Professional Development annually.
Speech Pathologist: Licensed as a Speech Pathologist by the Indiana Speech Pathology and
Audiology Board; or those who have registered with the State of Indiana for the Clinical Fellowship
Year (CFY) working toward licensure under the supervision of a licensed Speech Pathologist who
must submit the name, address and copy of license of supervisor at time of enrollment. Certificate
of completion for orientation to the First Steps Early Intervention System (DSP 101) through the
Unified Training System (UTS) must be submitted at the time of enrollment. Completion of annual
mandatory training is required (See Attachment A). Must credential at the specialist level within 2
years of enrollment and complete Continual Professional Development annually.
Speech Pathologist Aide: Must have a letter of accreditation from the Indiana Speech-Language
Pathology and Audiology Board and work under the direct supervision of a licensed Speech
Pathologist who has been approved by the board to supervise and aide as proved by IC 25-35.6.
Must work under the direct supervision of an enrolled credentialed Speech Pathology Specialist, and
submit the name, address, and copy of license of their supervisor at the time of enrollment. More
detail regarding the development of a supervisory plan, documentation, and required activities is
found in 880 IAC 1-2-4, Speech-Language Pathology and Audiology Board. Certificate of completion
for orientation to the First Steps Early Intervention System (DSP 101) through the Unified Training
System (UTS) must be submitted at the time of enrollment. Completion of annual mandatory
training is required (See Attachment A). Must credential at the associate level within 2 years of
enrollment and complete Continual Professional Development annually.
Transportation Provider: Documentation of a valid Indiana driver’s license and proof of insurance
is required for all parents providing transportation.
Vision Specialist: Vision services shall be conducted by personnel who meet state approved or
recognized certification, licensing, registration, or other comparable requirements for the discipline.
Certificate of completion for orientation to the First Steps Early Intervention System (DSP 101)
through the Unified Training System (UTS) must be submitted at the time of enrollment Completion
of annual mandatory training is required (See Attachment A). Must credential at the specialist level
within 2 years of enrollment and complete Continual Professional Development annually.
June 2008 Indiana Personnel Guide Page 12 of 29
Professional Conduct Guidelines
Each provider must adhere to a Professional Conduct guidelines set forth by the State of Indiana
Family and Social Services Agency/Division of Disability and Rehabilitative Services/Bureau of Child
Development Services:
Professional Conduct
In order to maintain the highest standards and quality of care, the Division of Disability and
Rehabilitative Services/Bureau of Child Development Services is outlining minimum standards of
practice. Providers are expected to maintain the utmost professional behavior while representing the
First Steps system.
• Providers are expected to meet and maintain all licensing, credentialing and ethical codes as
established by individual licensing agencies as well as through First Steps.
• Services will only be provided when skilled intervention is necessary.
• Service’s may only be provided with the parent or other primary caregiver present and
actively involved.
• Services provided must be designed to assist the child or family in addressing outcomes as
outlined in the IFSP.
• Services should be provided as established on the IFSP and as scheduled with the
parent/caregiver.
• Providers are required to notify parents/caregivers in advance of missed or late sessions. If
advance notice is not possible due to unforeseen circumstances, immediate notification is
required. Lack of notification of missed or late sessions, similar to a no-call, no-show, may be
grounds for termination of the provider agreement.
• Providers (including the Service Coordinator) may not bring children/minors or other
individuals not directly involved in the provision of care of the child, to early intervention
services or the residence of the child or family. Doing so would be considered a breach in
confidentiality and would interfere with the provider’s ability to perform their job. Parents
may not be requested to waive this policy. With prior consent of the family, therapy students
gaining required practical experience, and who are supervised by the specialist level
therapist, are excluded from this provision.
• No provider in the system may solicit business from parents or caregivers.
• Providers may not solicit business for their agency, other providers, spouse or immediate
family.
• Providers may not sell or market products while representing First Steps.
• Providers may not lobby to families within the system, while representing First Steps.
• Conduct and attitudes must portray the values of the First Steps system and that of family
centered care. Services shall be family-centered, inclusive and culturally competent.
• Providers must maintain professional relationships and boundaries with families served within
the First Steps system. Providers may not provide services to members of their immediate
family or individuals in which a professional relationship would be compromised.
• Providers must maintain professional conduct with providers, lead agency (including State
Program Consultants), lead education agency staff, administrators, and First Steps
Stakeholders.
June 2008 Indiana Personnel Guide Page 13 of 29
Early Intervention Personnel Credentialing Process
Early intervention specialists and associates as listed in this personnel guide, Table 1, must obtain
an early intervention credential within two years of enrollment with the Early Intervention
enrollment contractor. Annually, providers must submit certification of a criminal history
check conducted within the year, current insurance information, and *copy of a current
licensure (if applicable) with submission of Provider Update and Attestation Statement
A provider may apply for their early intervention credential once the following has been completed:
● 15 points for an Early Intervention Specialist
● Or 10 points for an Early intervention Associate
You will receive either an Early Intervention Credential that matches your request, or a letter
requesting clarification or additional documentation.
Please note: Although you may only enroll as either a service provider or a service coordinator,
you may apply simultaneously for a credential in any discipline for which you qualify. Please use a
separate cover sheet and a current summary of activity sheet for each credential request.
*Licensed Providers:
A copy of your specialty Indiana professional license must be in your personnel file at the
CRO by the expiration date of the license along with a copy of the verification showing the
exact expiration date to maintain enrollment status through First Steps.
Do not submit this packet until you have completed the credentialing requirements. Except for a copy of your current
license, proof of insurance, and criminal history inquiry. Please do not submit supporting documentation at time of
credential/re-credential. The Division conducts random audits. If you are audited, you will receive a letter informing
you of the procedures for the audit. Only submit supporting documentation to your credential if you are audited or if
otherwise requested by the division. Please keep all of your Continuing Education records and other required
documents for 5 years.
June 2008 Indiana Personnel Guide Page 14 of 29
Attestation Statement
Name: ______________________________________________ Date___________________
Address: _________________________________________________________________________
_________________________________________________________________________________
Phone: _______________________ Fax: ________________________ Rendering #______________
E-mail address: _____________________________________________ NPI #____________________
I am applying as an: 􀂅 Early Intervention Associate 􀂅 Early Intervention Specialist
1. I am applying for my initial credentialing in the following area/discipline:
Audiology Nutrition Social Work
Developmental Therapy Occupational Therapy Speech Language Pathology
Individual and Family Counseling Physical Therapy Vision Services
Medical Psychology Other (Please identify)
Nursing Service Coordination _______________________
2. First Year Attestation Page (Annual Update)
3. I am completing my annual re-credentialing
Date of Provider Forum attended: _______________________________
Completed Training Times: ____________________________________
Please complete the following information and attach supporting documents:
License#:________________________________________Expiration Date: ______________
*Please include a copy of your license.
Insurance Information Insurance Agency: __________________________________________
Phone: ________________________________________________________________________
Policy#:_______________________________________Expiration Date: _________________
*Please include a copy of your policy.
Date of Current Criminal History Inquiry**: _________________________
*Please include of copy of the inquiry. Must be completed through Indiana State Police If you live in one state and
provide services in a neighboring state, you must submit one through each state. City and County inquiries will not
be accepted.
**If a violation is noted on the criminal history report, the report must be submitted with the application packet to the provider enrollment
agency. Go to www.in.gov (Click on Law and Justice then on Limited Criminal History Search on right side.)
I hereby swear or affirm under the penalties of disenrollment that I understand and have met the
continuing education requirements for renewal and have answered the questions true to the best of
my knowledge.
Signature Date
Submit to: EDS Provider Enrollment
P.O. Box 7263
Indianapolis, IN 46207-7263
Do not submit this packet until you have completed the credentialing requirements. Except for a copy of your current license, proof of
insurance, and criminal history inquiry. Please do not submit supporting documentation at time of credential/re-credential. The Division
conducts random audits. If you are audited, you will receive a letter informing you of the procedures for the audit. Only submit supporting
documentation to your credential if you are audited or if otherwise requested by the division. Please keep all of your Continuing Education
records and other required documents for 5 years.
June 2008 Indiana Personnel Guide Page 15 of 29
Competency Areas for Direct Service Providers
The following competency areas represent bodies of knowledge and/or skills considered critical across all
early intervention disciplines:
Foundations of Early Intervention: Information and experience that promote understanding
about the history of early intervention, underlying philosophies of early intervention including
family centered practices, Individualized Family Service Plans, team process skills, and early
intervention service coordination. Providers will demonstrate:
1. a basic knowledge of relevant federal and state legislation and related public agency
policy
2. understanding of standards and rules and their impact on services and families
3. the ability to implement procedural safeguards to ensure delivery of appropriate services
4. a basic knowledge of the history and philosophy of early intervention
5. knowledge of Indiana’s First Steps system/procedures, i.e. SPOE, CRO, LPCC, service
delivery, service coordination
6. knowledge of research in the area of early intervention practice and efficacy
7. the ability to describe the purpose, importance and limitations of early identification,
screening and evaluation, including the issues of bias and testing
8. understanding of early intervention theories and their implications
Infant and Toddler Typical and Atypical Development: Information and experience that
promote an understanding of typical and atypical physical, cognitive, social/emotional and
communication development of infants and toddlers. Providers will demonstrate:
1. understanding of content and range within child developmental domains
2. understanding of etiology and characteristics of common developmental disabilities
3. understanding of the potential impact of a disability’s characteristics on a child’s needs
4. understanding of child development theories and their implications
5. the ability to describe the common risk factors for developmental dysfunction
Infant/Toddler and Family Assessments: Information and experience that promote an
understanding of the techniques and procedures for family-centered infant and toddler evaluation
and assessment. Also includes activities that promote an understanding of the process by which
families may be supported to identify their strengths, concerns and priorities. Providers will be
able to:
1. identify valid and reliable state approved screening and evaluation procedures and
instruments
2. identify valid and reliable state approved screening and evaluation tools appropriate to
age, population, and physical environment
3. demonstrate ability to discuss with parents the purpose of selected screening and
evaluation procedures, as well as due process and procedural safeguards as they apply to
identification, screening, and evaluation
4. demonstrate the ability to administer and score a variety of approved screening and
evaluation tools which measure development across the range of developmental domains
5. demonstrate competence in interpreting results of screening and evaluation in terms of a
child’s functional capabilities
6. demonstrate competence in gathering information through family interview as a
component of the screening and evaluation of the infant and toddler, and the
identification of family concerns, priorities and resources
June 2008 Indiana Personnel Guide Page 16 of 29
7. demonstrate the ability to communicate with parents in a clear, concise, respectful and
sensitive manner the results of screening and evaluation activities and subsequent
recommendations, taking into account parental response to the information given
8. demonstrate competence in adapting the environment in which the screening and
evaluation take place, using specialists when appropriate
9. demonstrate competence in referral processes and procedures to other professionals and
community resources when indicated by results of screening and evaluation
10. demonstrate ability to coordinate and participate in team meetings
Early Intervention Service Delivery Strategies: Activities that promote familiarity with research,
current trends, and best practices related to the provision of discipline specific early intervention services
to young children with special needs. Providers will design, implement and evaluate appropriate services
for a child within a collaborative relationship with parents/caregivers and community providers and
demonstrate:
1. the ability to facilitate appropriate and stimulating learning opportunities that will enhance
children’s learning and positive behaviors
2. the ability to effectively communicate with children (including access to alternative
communication systems when appropriate)
3. the ability to integrate therapeutic practices into learning environments in ways that
support learning and encourage autonomy in children (i.e., integration of medical routines
written or parents/caregiver by medical staff; integration of augmentative communication
strategies; integrations of therapeutic activities)
4. positive social interactions with children
5. the ability to develop an IFSP based on assessment information, to implement and
evaluate progress on IFSP goals through a variety of strategies in homes and community
settings
6. the ability to embed goals/objectives into daily activities/routines at home and other
natural environments
7. the ability to problem solve with the family around issues of a child’s management of
behaviors and environmental stimuli
8. the ability to teach parents/caregivers how to implement specific programs, routines and
procedures with a child
9. the ability to use adaptive techniques/equipment as directed to promote acquisition of
skills and active participation in age appropriate activities
10. developing competence in conducting home visits to serve as a source of support and a
resource to families
11. competence in developing an IFSP in partnership with team members consistent with
state standards and federal guidelines
Family Partnership and Support Strategies: Activities that promote an understanding and
recognition of the family as the major long-term influence in a child’s life, and support strategies for
families acknowledging their diversity and individual hopes and plans for their child. Providers will
demonstrate:
1. the ability to apply family guided services and work in partnership with families, mutually
exploring options, soliciting input about what they want for their child, and respecting
choices
2. the understanding about family relationships, including working with siblings, and how a
disability can affect those relationships
3. respect, understanding and responsiveness to the family within the context of their
culture, ethnicity and unique family circumstances, i.e., parents with developmental
disabilities, foster parents, grandparents as parents, teen parents, gay/lesbian parents
4. leadership in supporting parents as they advocate for their children
June 2008 Indiana Personnel Guide Page 17 of 29
5. an understanding of their role in sharing information with families, including philosophies
of various services, in a timely manner and communicates effectively with them
6. active involvement of families in the design and implementation of policies and/or
procedures which reflect a value of family guided services
7. a flexible menu of involvement/participation/support opportunities for families regarding
the identification, implementation and evaluation of child and family outcomes/goals
8. the ability to assist families in assessing information and gaining skills to functions
successfully within their community
9. recognition of and respect for the coping strategies that the family demonstrates
10. understanding of adult learning styles and basic skills in teaching adults
11. competence in conducting family interviews using attending and listening skills
12. knowledge of characteristics of adult mental health problems and their impact on the
parent-infant relationship (e.g., substance abuse, domestic violence, psychiatric
diagnoses)
13. knowledge of the effects of environmental risk factors on the parent-infant relationship
(e.g., homelessness, poverty, stress)
Team Relationship Skills: Activities that promote positive team communication in a manner that
ensures an unduplicated, family-centered, comprehensive, coordinated, community-based system of
services. Team relationships will be in concert with the identified concerns, priorities and preferences of
the family. Providers will demonstrate:
1. effective communication with a variety of audiences, i.e. families, EI providers,
community providers, using jargon-free terminology to provide essential EI information
2. skills to function as a direct service provider and consultant to other disciplines and
agencies
3. understanding of related service providers and community providers, their rules,
regulations and requirements, and act with the ability to network to advocate and create
increased options for the child and family
4. understanding of different team formats, i.e. multidisciplinary, transdisciplinary, their
strengths and limitations
5. the ability to use good communication skills and productive problem solving strategies as
a collaborative team member
6. the ability to negotiate divergent team expectations and resolve conflicts/crises
Indiana’s early intervention program updates: Participation in state required trainings such as
quarterly Training Times and any other training the State deems mandatory by all First Steps providers.
(See Attachment A)
June 2008 Indiana Personnel Guide Page 18 of 29
Current Summary of Activity
Documentation of training and skill development in competency areas is done through a Current
Summary of Activity sheet which documents where a provider assigns credit points earned to each of the
competency areas. Although flexibility is provided to tailor learning experiences that are critical to the
professional growth of each individual provider, a minimum of one credit point must be earned
and documented in each competency areas for Initial Credentialing.
Portfolio Activities and Credit Points
The Current Summary of Activity form is completed using a portfolio approach for documenting
training and skill development. The following portfolio activities may be used to earn credit points:
Activity Credit Point Equivalent Maximum Points
Experience *1 Year = 1 Point 5
Birth-Three
*You must prorate if you work only part time in First Steps.
• 1-10 hours per week- .25 points
• 11-20 hours per week-.5 points
• 21-30 hours per week- .75 points
• 31-40 hours per week- 1.0 point
In-service 10 Contact Hours = 1 Point
Activities 1 Contact Hour= .10 Points 5
Academic 1 Academic Credit = 1 Point Unlimited points for coursework
Coursework completed less than 10 year prior to
application date, or 5 points for coursework 10 years or older.
Other Proposed Tasks 1 Task = 1 Point 5
State required training 10 Contact Hours = 1 Point
1 Contact Hour = 10 Point
Training Times .2 points Total of .8 points per year
Experience must be directly related to the provision of early intervention services for children birth
to three. One year of experience may be counted for each calendar year that an individual works
providing early intervention services. You must prorate if working less than full-time.
Service Coordinators and Service Providers may also count relevant experience as a family member
of a child with special needs or a community member of an underserved population.
In-service credits may be earned through attendance at conferences, workshops, seminars, and
other similar activities sponsored by each county’s First Steps, Indiana’s Unified Training System,
national, state, and local professional organizations and other training entities. The relationship of
the in-service training to early intervention competency areas should be documented through
written training goals and learning objectives. Personnel may document only those activities
occurring within the last ten (10) years which were directly related to their individual professional
development related to the competency areas. Training offered within an employing agency that
focuses only on agency issues may not be used for credit points.
June 2008 Indiana Personnel Guide Page 19 of 29
Academic coursework must be earned through formal study at an accredited post-secondary
institution. Course descriptions and syllabi should reflect a cohesive body of knowledge related to
one or more of the early intervention competency areas. Instructional activities must provide the
equivalent of at least ten contact hours per unit of academic credit offered. A five-point maximum
applies to coursework completed ten (10) years prior to the date of submission of the credentialing
application. Unlimited points utilized for coursework completed less than 10 years form date of
submission of the credentialing application.
Other Proposed Tasks include activities specific to early intervention and children, birth to three
years, such as: independent study, research, conference presentations and teaching activities,
development of professional products, submission of articles to professional journals and other
special projects leading to increased professionalism. These tasks are worth one credentialing
point.
You may also read books and watch videos relevant to Birth to Three and claim the amount of time
used to complete the task and apply it towards your credentialing. You are required to write a onepage
report summary and keep as supporting documentation. Supporting documentation to verify
the activity must be kept on file with the provider for a period of 5 years. These activities are only
worth the actual time spent completing the task.
State required training includes activities such as quarterly Training Times or other training the
state deems mandatory by all First Steps providers. (See Attachment A.)
Supporting Documentation
Experience: A resume must be kept on file with the provider outlining experience pertaining to the
birth to three, early intervention population in the field in which the provider is credentialing.
In-service Credits: Certificate of attendance or agenda outlining topics relating to early
intervention and the birth to three population in which the provider is credentialing.
Academic Coursework: A copy of the provider’s transcript
Other Proposed Task: Documentation must include a detailed task description and supporting
documentation. Include the date, persons involved, and activities. Keep copies of supporting
documentation such as agendas, written article, and summary of activity... a maximum of 5 points
may be earned in Other Proposed Tasks) Other proposed tasks might include: independent study,
research, conference presentations and teaching activities, development of professional products,
submission of articles to professional journals and other special projects leading to increased
professionalism. All activities to be included as an Other Proposed Task must be specific to
early intervention and children birth to three.
Do not submit this packet until you have completed the credentialing requirements. Except for a copy of your current license, proof of
insurance, and criminal history inquiry. Please do not submit supporting documentation at time of credential/re-credential. The Division
conducts random audits. If you are audited, you will receive a letter informing you of the procedures for the audit. Only submit
supporting documentation to your credential if you are audited or if otherwise requested by the division. Please keep all of your
Continuing Education records and other required documents for 5 years.
June 2008 Indiana Personnel Guide Page 20 of 29
Current Summary of Activity for Direct Service Providers
Initial Credentialing
Name: __________________________________________Credential Date: _____________to __________
Address:____________________________________________________________Rendering #: ___________________
Phone: ______________________ Fax: __________________________ NPI #: ________________________
To earn an early intervention credential, a minimum of one point must be earned in each competency area, with the
exception of the provider forum which must total .3 points for each year. The total points must equal 10 points for an
Early Intervention Associate, or15 points for an Early Intervention Specialist. *Please use a sheet for each year.
Date Activity (name of conference, course,
task or experience)
Early Intervention
Competencies Year:
______
Brief description Competency Points
(please check all that apply)
(For complete descriptions, please
refer to page)
Total Points
Foundations
Development
Assessments
Family
Partnership
Team Relations
EI Strategies
Experience
(max. 5 points)
State Training
Annual Provider Training/Meeting
Training Times
(list test dates for the year)
Training Times
(list test dates for the year)
Training Times
(list test dates for the year)
Training Times
(list test dates for the year)
In-service
(max. 5 points)
Education
(max. 5 points for
credits over 10
years)
Other
Propose
d Task
June 2008 Indiana Personnel Guide Page 21 of 29
Continual Professional Development
Direct Service Providers (Associates and Specialists)
Annual Re-Credentialing
Name: ______________________________ Date: _____________________
Address: ________________________________________________________
Phone: _________________________Fax:_____________________________
Rendering #: _______________________ NPI #: __________________________
All associate and specialist level enrolled or credentialed providers must document a minimum of three credit points
each year of portfolio activities related to professional development in the competency areas. There are no required
minimum or maximum amounts in each area. Associates and specialists providing early intervention services in Indiana
are required to obtain an Early Intervention Credential within two years of enrollment with the Central
Reimbursement Office.
Date
Early Intervention Competencies Year: ______
Activity
State required training
(AnnualTraining/Meeting
Training Times)
Foundations of early
intervention
Infant & toddler typical
and atypical
development
Infant &toddler family
assessments
Early intervention service
delivery strategies
Family Partnership
Team relationship skills
Total Points: ______
June 2008 Indiana Personnel Guide Page 22 of 29
Current Summary of Activity for Early Intervention Service Coordinators
INITIAL CREDENTIAL
A minimum of one point must be earned in each of the following competency areas with a total of 15 points to become an Early Intervention Specialist
in Service Coordination. ** Please use one sheet for each year.
Competency Areas for Service Coordination
I. Knowledge of community resources including the ability to obtain information based upon individual family needs.
II. Knowledge and understanding of the principles and practices of family centered care.
III. Ability to communicate in written and oral manner.
IV. Knowledge of early intervention assessment/evaluation instruments that are designed to assess family needs, resources, priorities and concerns.
V. Knowledge of Indiana’s due process and procedural safeguards, regulations, policies and practices regarding infants and toddlers
eligible for Early Intervention.
VI. Knowledge of Part B regulations.
VII. Knowledge of transition including but not limited to the transition from Part C to other services when eligibility for Part C
terminates.
VIII. Knowledge of financial resources available for individuals participating in the Part C program.
IX. Participation in the quality review of the cluster’s Early Intervention records in collaboration with the Quality Review-Focused
monitoring process.
X. Attendance of Annual Provider Training/Meeting and Training Times.
Date
Activity (Name of
conference, course,
task, or position)
Brief Description
Early Intervention
Competencies Year:
______
Total
I I
I
I
I
I
I
V
V V
I
V
I
I
V
I
I
I
I
X
X
Section
Total
Experience
Provider meetings/
File Review
In-services/Conferences
Academic Credit
Other
Total:
June 2008 Indiana Personnel Guide Page 23 of 29
Current Summary of Activity for Early Intervention Service Coordinators
Annual Re-Credentialing
Name: ____________________________________ Date: _________________Rendering #: ________________
Address: _____________________________________________________________________________________
Phone: ________________________________________ Fax: __________________________________________
A minimum of one point must be earned in each of the following competency areas with a total of 3 points to become an Early Intervention Specialist in
Service Coordination.
Competency Areas for Service Coordination
I. Knowledge of community resources including the ability to obtain information based upon individual family needs.
II. Knowledge and understanding of the principles and practices of family centered care.
III. Ability to communicate in written and oral manner.
IV. Knowledge of early intervention assessment/evaluation instruments that are designed to assess family needs, resources, priorities and concerns.
V. Knowledge of Indiana’s due process and procedural safeguards, regulations, policies and practices regarding infants and toddlers
eligible for Early Intervention.
VI. Knowledge of Part B regulations.
VII. Knowledge of transition including but not limited to the transition from Part C to other services when eligibility for Part C
terminates.
VIII. Knowledge of financial resources available for individuals participating in the Part C program.
IX. Participation in the quality review of the cluster’s Early Intervention records in collaboration with the Quality Review-Focused
monitoring process.
X. Attendance of Annual Provider Training/Meeting and the completion of Training Times.
Date
Activity (Name of
conference, course, task,
or position)
Brief Description
Early Intervention
Competencies Year:
______
Total Points
I I
I
I
I
I
I
V
V V
I
V
I
I
V
I
I
I
I
X
X
Section
Total
Totals:
June 2008 Indiana Personnel Guide Page 24 of 29
Attachment A
State Required Trainings
Professional Development for Associate and Specialist level for Direct Service Providers:
1. Attend an annual Provider Training/Meeting
2. Complete 4 quarterly “Training Times” through UTS (.8 points)
3. Attend other state approved trainings to complete your 10 or 15 points for initial credentialing or 3
points for re-credentialing.
June 2008 Indiana Personnel Guide Page 25 of 29
Provider with an Established First Steps Facility
Enrollment Checklist
1. Name of provider: ___________________________________________
Name of Facility: ____________________________________________
(Please be sure that all required information below is returned complete in order to
expedite your enrollment with First Steps.)
2. ( ) Completed Schedule G of the Provider Enrollment Packet
3. ( ) Rider A (All Providers must have a signed Rider A on file at CRO)
** If Associate or Specialist requiring supervision (DT will require supervision unless they
can provide a letter from a previous employer documenting 1 year DT experience with
children 0-3):
( ) Service Provider Supervisor Agreement
( ) Copy of Supervisors License/ Credential letter (DT)
4. ( ) Copy of your current Indiana State License if required or a copy of your diploma
and transcripts signifying you meet the entry level qualifications for Early
Intervention Personnel. Your diploma/transcripts must show area of degree
i.e., Elementary/Early Childhood, etc.
5. ( ) Copy of an Indiana State Police Inquiry-must be ran within the last 12
months. (County and City Police Checks are not acceptable.)
6. ( ) Proof of professional& general liability insurance policies for all disciplines
with the exception of translators and parent transportation providers
7. ( ) Copy of the Orientation to First Steps Certificate of Completion
8. ( ) E-mail address
9. ( ) Completed IHCP Provider Agreement (Medicaid/Private Insurance Providers)
Signature: ___________________________________ Date: __________________
Mail all checked items along with this coversheet to the address below. We cannot
accept photocopies of signed documents or signed documents via fax. Documents
with original signatures must be submitted. Please submit to:
CRO Provider Enrollment
C/O EDS
P. O. Box 7263
Indianapolis, IN 46207-7263
Please be aware that all enrollment packets that are received incomplete will be returned with a letter
requesting the missing required documents.
June 2008 Indiana Personnel Guide Page 26 of 29
New First Steps Facility
Enrollment Checklist
1. Name of provider: ___________________________________________
Name of Facility: ____________________________________________
(Please be sure that all required information below is returned complete in order to
expedite your enrollment with First Steps.)
2. ( ) Completed Provider Enrollment Packet
3. ( ) W-9
4. ( ) Central Reimbursement Office (CRO) Provider Agreement
5. ( ) Rider A (All providers must have a signed Rider A on file at CRO)
6. ( ) Copy of your current Indiana State License if required or a copy of your diploma
and transcripts signifying you meet the entry level qualifications for Early
Intervention Personnel. Your diploma/transcripts must show area of degree
i.e., Elementary/Early Childhood, etc.
7. ( ) Copy of an Indiana State Police Inquiry-must be ran within the last 12
months. (County and City Police Checks are not acceptable.)
8. ( ) Proof of professional& general liability insurance policies for all disciplines
with the exception of translators and parent transportation providers
9. ( ) Copy of the Orientation to First Steps Certificate of Completion
10. ( ) E-mail address
11. ( ) Completed IHCP Provider Agreement (Medicaid/Private Insurance Providers)
Signature: ___________________________________ Date: __________________
Mail all checked items along with this coversheet to the address below. We cannot
accept photocopies of signed documents or signed documents via fax. Documents
with original signatures must be submitted. Please submit to:
CRO Provider Enrollment
C/O EDS
P. O. Box 7263
Indianapolis, IN 46207-7263
Please be aware that all enrollment packets that are received incomplete will be returned with a letter
requesting the missing required documents.
June 2008 Indiana Personnel Guide Page 27 of 29
Independent Provider Enrollment Checklist
1. Name of provider:___________________________________________
(Please be sure that all required information below is returned complete in order to
expedite your enrollment with First Steps.)
2. ( ) Provider Enrollment Packet
3. ( ) W-9
4. ( ) Central Reimbursement Office (CRO) Provider Agreement
5. ( ) Rider A (All providers must have a signed Rider A on file at the CRO)
**If Associate or Specialist requiring supervision (DT will require supervision unless they
can provide a letter from a previous employer documenting 1 year DT experience with
children 0-3):
( ) Service Provider Supervisor Agreement
( ) Copy of Supervisors License/ Credential letter (DT)
6. ( ) Copy of your current Indiana State License if required or a copy of your diploma
and transcripts signifying you meet the entry level qualifications for Early
Intervention Personnel. Your diploma/transcripts must show area of degree
i.e., Elementary/Early Childhood, etc.
7. ( ) Copy of an Indiana State Police Inquiry-must be ran within the last 12
months. (County and City Police Checks are not acceptable.)
8. ( ) Proof of professional& general liability insurance policies for all disciplines
with the exception of translators and parent transportation providers
9. ( ) Copy of the Orientation to First Steps Certificate of Completion
10. ( ) E-mail address
11. ( ) Direct Deposit form and voided or cancelled check.
12. ( ) Completed IHCP Provider Agreement (Medicaid/Private Insurance Providers)
Signature: ___________________________________ Date: __________________
Mail all checked items along with this coversheet to the address below. We cannot
accept photocopies of signed documents or signed documents via fax. Documents
with original signatures must be submitted. Please submit to:
CRO Provider Enrollment
C/O EDS
P. O. Box 7263
Indianapolis, IN 46207-7263
Please be aware that all enrollment packets that are received incomplete will be returned with a letter
requesting the missing required documents.
June 2008 Indiana Personnel Guide Page 28 of 29
Annual Re-Credentialing Checklist
First Steps Direct Service and Service Coordinators
1. Name of Provider: _________________________________________________
Rendering #: _______________________ NPI #: _________________________
Please be sure all required information below is returned complete in order to expedite your annual
credent