Last Modified: 12/04/2019
State Examples
NCHAM is gathering examples of how states are facilitating the exchange of information with other EHDI stakeholders to make it easier to connect families with needed services, resulting in more comprehensive and coordinated care. Click on the topics below to see state examples to facilitate exchange of information.
NCHAM welcomes examples from your state. Email your documents to NCHAM if you’re willing to have us post your state’s examples.
Examples of the following tools are available:
Legislation
States have developed their own legislation to emphasize the importance of reporting information to EHDI as well as to other partners, such as primary care providers. Click on an individual state to learn about their legislation.
Memoranda of Agreement
The following are examples of how state EHDI stakeholders have developed policies to work together, including how they share data. These documents go by many names, including state memoranda of agreement, memoranda of understanding, and/or joint powers agreement as named by the state. Click on an individual state to learn about their policies and practices.
Coordinated Referral Forms
States have worked together to develop consent forms that reduce the amount of individual forms needed to exchange information among providers who play a role in serving families. Click on an individual state to learn about their policies and practices.
- Nebraska [PDF]
- Colorado - Release of Information Form [PDF]
- Colorado - Referral Status Update Form [PDF]
Data Sharing and Reporting
Some states have developed forms to expedite the exchange of information among providers, such as forms to fax EHDI diagnostic results. State procedures that describe rules for accessing shared data systems also are provided here. Click on an individual state to learn about their policies and practices.
- Utah 1 - Data Reporting Form [PDF]
- Utah 2 - Data Sharing Form [PDF]
- Oregon - Data Reporting Form [PDF]
- Oregon - EI Enrollment Status Form [PDF]
- Oregon - EI Reporting [PDF]
- Oklahoma - Reporting Rules [PDF]
IFSP's
An IFSP is a document developed by the state Part C Early Intervention Program that delineated the services being provided to a child and family. Some states have developed an IFSP form that allows for the parent to give permission for a copy of the IFSP to be given to other providers and/or agencies. Including EHDI as a recipient of the IFSP allows EHDI to monitor the appropriateness of hearing-related services. Click on an individual state to learn about their policies and practices.