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Early Intervention Services in Natural Environments Indicators C-1, C-2 and C-7 Analysis and Summary Report of All States

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Title: Early Intervention Services in Natural Environments Indicators C-1, C-2 and C-7 Analysis and Summary Report of All States


1
Early Intervention Services in Natural
EnvironmentsIndicators C-1, C-2 and
C-7Analysis and Summary Report of All States
2008-2009Annual Performance ReportsJoicey
HurthLynda Pletcher and Betsy Ayankoya,
(NECTAC)
November 10, 2010, 400 PM EST
2
Webinar Focus
  • National Trend Data for C-1, C-2 and C-7
  • Continuing Challenges
  • Improvement activities that are contributing to
    improved performance
  • Implications for
  • State administrators
  • Personnel Preparation
  • Local administrators and providers

3
  • The analysis of data across Indicators C-1, C-2,
    and C-7 provides a national perspective on the
    extent to which early intervention services are
  • provided within timelines
  • in natural environments.

4
  • Performance does not provide measures of the
    quality of services, but the extent to which
    these requirements of IDEA are being met.
  • These analyses yield data on performance that is
    necessary but not sufficient to ensure quality

5
NationalTrendData
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14
Challenges to Meeting Timelines and Providing
Servicesin Natural Environments
15
Personnel Shortages
  • Shortages of therapists
  • Difficulties in recruitment due to a discrepancy
    in pay
  • Many specialists do not have a pediatric
    background and are unfamiliar with the evidence
    base in early intervention.
  • Shortages in developmental specialists
  • Other personnel issues include too few
    evaluators, finding interpreters, losing private
    providers due to decreased rates or slowdowns in
    billing and reimbursement, and staff turnover.

16
Fiscal Barriers
  • Severe fiscal crisis impacting the States
    mandatory budget cuts, state hiring freezes,
    furloughs or reduced hours
  • Costs related to travel time and expense were
    barriers to providing services in natural
    environments.
  • Inability to negotiate Medicaid reimbursements
    for children served outside of medical settings.

17
Challenges in the IFSP Process
  • Scheduling delays
  • Communication challenges
  • Coordination with other agencies
  • Requirements for prior authorizations for services

18
Challenges in Service Delivery
  • Multiple providers acting separately
  • Inadequate or no funding for team-time, the
    IFSP Meeting and training (especially private
    providers)

19
Comprehensive and Targeted Improvement
Activities
20
Continuous Monitoring and Review of Data
  • Continuous focus on local performance on the
    timeline indicators (C-1 and C-7)
  • Regular performance reports (quarterly, monthly
    or even weekly)
  • Develop capacity at the regional or local level
    to regularly monitor their own performance
  • Ongoing public reports
  • Tied fiscal rewards and sanctions to timelines.
  • Used monitoring information to target TTA to
    specific programs and root causes

21
Increase Personnel Capacity
  • Comprehensive multifaceted activities
  • Secured additional funding and used ARRA funds
    for personnel
  • Hire state staff cover areas with chronic
    shortages
  • Use retired personnel or school or clinic-based
    personnel on off hours
  • Special rates for therapist
  • Increase travel allowances

22
Redesigning Models of Service Deliveryto Improve
Effectiveness and Efficiency
  • 14 states reported working on changes to service
    delivery system
  • Shift away discipline- specific multidisciplinary
    approaches to a more integrated approach
  • Primary provider approach to extend the reach of
    scarce personnel
  • Pilots, TTA and a focus on evidence-based
    practice

23
Redesigning Models of Service Deliveryto Improve
Effectiveness and Efficiency
  • Distance service delivery
  • Improve efficiencies screening, streamlining
    evaluation /assessment, revising IFSP forms and
    guidance
  • Streamlining prior authorization and provider
    enrollment

24
Implications for Policy Makers
  • Build capacity for continuous monitoring and
    reporting to assure that causes of delays are
    identified and corrected quickly
  • Improvement activities -data-based,
    comprehensive and long term to address the
    personnel shortages
  • Monitor on quality measures as well as compliance
    and performance
  • Investment in quality practice

25
Implications for Personnel Preparation
  • Lack of knowledge and experience with Infants and
    Toddlers
  • Some states require inservice orientation
    training to become a qualified provider
  • Preservice programs need to include competencies
    for infant and toddler services and share the
    professional associations position statements on
    natural environments and inclusive settings
  • http//www.nectac.org/topics/natenv/natenv_positio
    n.asp
  • (link available on webinar series page)

26
Implications for Administrators and Providers
  • Embrace the mission Promote young childrens
    successful participation in family and community
    activities through supporting families and
    caregivers capacity to promote their childrens
    learning and development
  • Include quality measures about effectiveness of
    services the quality of IFSPs in on-going
    monitoring activities
  • Use data for program improvement

27
Full Reports Available On-line
  • Part C
  • State Performance Plan
  • Annual Performance Report
  • 2009 Indicator Analysis
  • FFY 2008-2009
  • http//leadershipmega-conf-reg.tadnet.org/
    uploads/file_assets/attachments/460/
  • original_Analysis_of_Part_C_Indicators_
    FINAL080910.pdf?1283446411
  • (link available on webinar series page)

28
Early Intervention Services in Natural
EnvironmentsIndicators C-1, C-2 and C-7
Thank you for participating. Presentations from
this series and their related resources are made
available on the NECTAC website
at http//www.nectac.org/calls/2010/partcapr/pa
rtcapr.asp
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