This intake is to be entered by the supervisor of the district or region receiving the 100A from OSS. This guide gives the minimum amount of information required to enter an ICPC Request to Receive Intake in FACTS.
PATH: Workload - Intake - New - OK - Intake - Rcv Svcs
Request to Receive Services Screen
Family Name: enter last name of oldest child (child=s name is on ICPC-100A, section I)
Type of Contact: Letter
Type of Intake: ICPC
Reporter Information: enter First & Last name of the person from the sending state (located on ICPC-100A, section III, signature)
Address information: enter City and State of sending state (ICPC-100A, section I)
County: out of state
Phone: enter sending state=s phone number (ICPC-100A, section I)
Relationship of reporter to: Requestor of Services - ICPC
Add the screen.
Demographics Screen
Request Information TAB
Enter names of children needing placement. There will be an ICPC-100A for each child.
First name: if more than one child, enter name of oldest child (see ICPC-100A, section I)
Last name: of oldest child (see ICPC-100A, section I)
Gender: of oldest child (see ICPC-100A, section I)
SSN: enter if available (it may be included in some enclosed documentation)
Date of Birth: see ICPC-100A, section I
Check box - Participating as Child.
Race: ethnic group on ICPC-100A, section I
Address: If the child=s address is not available, enter the minimal information that you know. For example, enter the state that the child currently lives in, or the city and state. If the child is currently living with the potential provider in WV, enter the address of the potential provider.
County: enter out of state if the child has not been placed in WV yet.
Role in Intake: Child and Requestor of services - ICPC
Add the screen. If there are additional children, Clear and complete screen for each child.
Service Needs Screen:
Client Name: Picklist choose name of child
What is the reporter=s/client=s expectation of the agency? If it is a Home Study that is requested - enter type of study -Parent, Relative, Adoptive or Foster
Is there a time critical need? Check if appropriate
What is the nature of the critical need? This information will be on the ICPC-100 A.
For example - Is there a court ordered time frame to complete the study?
Service Request: ICPC
Homestudies (if applicable)
Add the screen.
Characteristics Screen:
This screen is not required. Document only if relevant to the home=s ability to meet the child=s needs.
ICPC Screen:
(This screen must be completed for each child on the 100A)
Highlight name of child and click on New ICPC button.
The 100A paper copy will be sent to the district supervisor or regional Homefinding supervisor.
Date: the system will populate to the current date - change this to the date on the top of the ICPC-WV received from OSS
From state: enter sending state
To State: West Virginia
Click on radio button - 100A Received
Name of Agency/Person Responsible For planning For Child
Type: Public Agency
Agency: enter name of sending state agency and the name of the child=s social worker if known.
For example - Ohio DHS - Jane Smith
Address: enter the address of the child=s social worker if in the packet - look on ICPC-100A or in the requesting letter from sending state.
County: out of state
Phone number: enter name of social worker=s office telephone number if available
Person financially responsible (this is usually the same as the person responsible for planning)
Type: court, private agency, private individual, public agency, or other
Agency: name of agency or person financially responsible
Address: address of agency or person financially responsible
County: out of state
Phone number: of agency or person financially responsible
Other: Type of care: on the ICPC-100A, section II
Legal Status: on the ICPC-100A, section II
Service Request
Initial Report: enter type of study (see ICPC-100A, section III)
Supervisory Service: see ICPC-100A, section III
(Do not choose the 4th value from the picklist because it is not a valid value for 100A=s)
Supervisory Report Frequency: should be on 100A - if not there choose quarterly.
Agency Name: if applicable (this is the name of the agency with which the child is being placed)
First and Last Name: Enter proposed placement resource (potential provider) from 100A
Address: enter address of potential provider
Phone: Home: Work: Other: enter potential provider=s numbers if available
Directions to Home/Agency: enter directions to potential provider=s home if available.
Required Enclosures and Other: Check all that apply.
Termination Reason: Do not complete this section for 100A=s - this only applies to 100B=s.
Add the screen.
Outcome Screen
Check Results TAB
Choose client from the client picklist and complete a Search in FACTS.
Supervisory Approval TAB
Click in check box - Accept
Enter any comments in the Supervisor=s Comments box.
Click on Add
Click on the Approval button - check the request and approve box.
Please note: You can not screen out an ICPC intake, all ICPC intakes must be accepted..
Assign/Transfer box: Click on New and on the radio button Assign to Worker.
Enter the name of supervisor in the unit and the name of the social worker. Enter a summary. Click on OK. Answer yes to the question - Are you sure you want to change the primary assignment?
The intake will now be Read Only. Cancel the screen.
Supervisor will then do the case connect.
After canceling the Outcome screen, click back on Workload.
PATH: Workload - Other - Case Connect
Case Connection Screen
Choose Open a New Case and enter comments if appropriate.
Click on ADD - answer Yes.
Click on the Approval button - check the request and approve box.
Assign/Transfer box: Click on New and on the radio button Assign to Unit and enter the name of supervisor who will be supervising the case. Enter a summary. Click on OK. Answer yes to the question - Are you Sure You Want to Change the primary assignment?
Note: if you know the unit and worker=s name at this time, you may make the assignment to the worker.
Note: In ICPC supervision, state wards who are siblings do not have to have separate cases - they can all be put in one case.