An ICPC intake is to be entered in FACTS by the homefinder. Only the homefinder has security to enter this provider information.
Workers assigned to complete the home study as requested by the ICPC 100A form requesting the opening of an ICPC provider must supply the homefinder with the necessary information.
This guide gives the minimum amount of information required to enter an ICPC Request to Provide Intake in FACTS.
PATH: Workload - Intake - New - OK - Intake - Prov Svcs
Request to Provide Services Screen
Type of Contact: Letter
Type of Intake: Other
Reporter Information: enter First & Last name of the person from the sending state (located on the ICPC-100A, section III, signature) If you can not read the signature, check on the ICPC-WV form.
Address information: enter City and State of sending state (see ICPC-100A, section I)
County: out of state
Phone: enter sending state phone number (see ICPC-100A, section I)
Relationship of reporter to: Requestor of Services - ICPC
Client/Agency Information
First and Last Name: enter proposed placement resource (potential provider) (see ICPC-100A, section II)
Agency: if applicable ( this is the name of the agency with which the child is being placed)
Address: enter address of potential provider (see ICPC-100A, section II)
Phone: if the potential provider has a phone it is located on ICPC-100A, section II.
Other Client/Agency Information
If known, check any of the following boxes that apply: former client, previous services provided/received, currently a medley provider
Referred By: Other Specify: ICPC 100A
If known, answer how many children are in the home and if a member in the home has been convicted of a felony or misdemeanors.
Specific Child Information
Enter info in these fields based on the information on the children on the ICPC-100A, section I.
Marital Status: of potential provider - enter if known Date Married: enter if known
Add screen.
Demographics Screen
Enter the names of family members currently living at the home of the potential provider. How much you can enter on this screen depends on what information you have received from the sending state. You may only have one name entered on the ICPC-100A, section II.
Note: Do not enter the names of the children on the ICPC-100A even if they are currently living with the provider.
First name: this field will be populated with the potential provider=s name from the Request to Provide Services screen.
Last name: populated from Request to Provide Services Screen
Enter Gender,
SSN: (if available),
*Date of Birth or *Approximate age
Check the box AIn Household@.
Enter number of persons in household. If unknown, enter 1.
Race: required field - if unknown enter unknown
Address and phone numbers are populated from the first screen
Information such as an employer name, title, school name, day care name, business hours, school hours, day care hours, and approximate MGI will probably not be available at the time of intake.
Role in Intake: potential provider and Requestor of Services - ICPC (could be relative also)
Click on Change.
Clear and complete this screen for each household member in the potential provider=s family if you have the information.
Outcome Screen
Choose client from the picklist and complete a Search in FACTS. Repeat for each household member. If results are found in either FACTS or Other Systems, associate to this intake, exit the Search, and click on the Refresh button on the Outcome Screen.
Click in the radio button Accept
In the Comments box: enter ICPC-100A information.
For example: ICPC-100A from Ohio Department of Human Services requesting an adoptive home study for the following children: (give names of children). Court in Ohio is requesting a study to be completed by (enter the date).
Click on Add
Click on the Approval button - check the request to send to your supervisor.