Effective Date
Instructions
Effective Date: 10/2025
Purpose
- To serve as a letter documenting the details of an IDT meeting.
- To notify the person of the actions needed to continue services.
Procedure
When to Prepare
Send Form 2066-IDT within five business days of the IDT meeting date.
Number of Copies
Complete an original and two copies.
Transmittal
Send the original to the person, a copy to the provider agency and retain a copy in the case record.
Form Retention
Retain the case record copy for three years.
Detailed Instructions
Date – Enter the date the form is completed and mailed to the person.
CCSE Caseworker – Enter the caseworker’s name.
Office Address – Enter the caseworker’s office address.
Area Code and Phone No. – Enter area code and phone number.
Person’s Name and Address – Enter the person’s name and mailing address.
Notice of IDT Meeting – Mark if this was the first, second or third IDT meeting.
Type of Meeting – Check the appropriate box to indicate the meeting location. If Other was selected, note the location in the Other field.
Select the meeting date using the drop-down calendar, then choose the type of service discussed from the drop-down menu.
This letter is about our Interdisciplinary Disciplinary Team (IDT) meeting on _____________, where we discussed your __________________________.
Meeting Attendees – Enter names of the meeting attendees in the designated boxes.
The following concerns were discussed – Provide a detailed account of the situation that required the IDT meeting. Include factual statements about ongoing noncompliance with service delivery provisions. Do not include personal opinions or evaluated conclusions in the document.
It was agreed that – Clearly state what the person agreed to and what actions they must take to continue receiving services.
CCSE Caseworker signs and dates the form on the same date it was prepared and mailed.
Enter the contact information for the CCSE Caseworker, CCSE Supervisor and CCSE Program Manager.