Early ACCESS: Supporting Infants and Toddlers in Iowa

2. Today’s Purpose • Familiarize participants with Early ACCESS. • Familiarize participants with Early ACCESS process. • Familiarize participants with Early ACCESS documentation requirements.

3. Purpose of Early ACCESS • The purpose of this system is to identify, coordinate and provide needed services and resources that will help the family assist their infant or toddler (0 to 3 years of age) to grow and develop.

4. Early ACCESS

5. What is Early ACCESS? • Early ACCESS (EA) is Iowa’s federal program under The Individuals with Disabilities Education Act (IDEA), Part C. • Part C revolves around the family’s needs

6. State Requirements for EA • Determine the Lead Agency • State Interagency Coordinating Council • Develop a Central Directory • Public awareness program • Comprehensive child find system • Comprehensive system of personnel development • Develop eligibility criteria • Funding • Early Intervention Services

7. Required Interagency System Collaboration between the Departments of: • Education, • Public Health, • Human Services and • Child Health Specialty Clinics. • The Department of Education is Iowa’s lead agency

8. Service Delivery • Primary Provider of Services: AEAs • 9 Regions in the state. • Each AEA has an Early ACCESS Regional Liaison • Interagency Partners • CHSC • Public Health • DHS

9. Early ACCESS Regions

10. Title V- Public Health

11. Child Health Specialty Clinics

12. Iowa’s Eligibility Definition: Children 0 to 3 years of age • Known conditions • 25% or more delay • Informed Clinical Opinion

13. Early Intervention should be: • Community based • Coordinated • Family Centered • Interagency • Flexible • Available year around

14. Service Coordination • An Early ACCESS Service Coordinator is assigned to help families obtain the services and resources they want for their child. • Coordinate the evaluation, determination of eligibility, development of Individual Family Service Plan (IFSP), and linking families with services • Advocate for the family and teach the family how to advocate for their child

15. Interagency Partners providing Service Coordination • AEA • Some community partners: • Example: Early Head Start • Other Contracted Private Providers • Example: Bright Horizons • Maternal Child Health (Title V agencies) • Child Health Specialty Clinics (CHSC) • Dept. of Human Service (CAPTA, Foster Care)

16. Individualized Family Service Plan (IFSP) • Should reflect the family’s wishes, hopes and dreams • Family is actively engaged in the planning, implementation and review of services • The IFSP is flexible and changes as the family’s needs change • Must be written within 45 days of referral • Reviewed and/or revised at least every 6 mo • Reassessed annually

17. Families receive at no cost: • Comprehensive multidisciplinary evaluation • Individual Family Service Plan • On-going service coordination • Early Intervention services • Medicaid is billed in Iowa---marginal • Private insurance is not billed in Iowa but is in other states

18. Assistive Technology Audiology Family Training/ Counseling Health Services Medical Evaluation Nursing Nutrition Occupational Therapy Physical Therapy Psychological Service Coordination Social Work Special Instruction Speech and Language Pathology Transportation Vision Early Intervention Services

19. Natural Environments • Places where typically developing children would participate in activities

20. Transition • Begins at least 90 days prior to the child’s and up to 9 months prior to the child’s 3rd birthday • Child may be transitioned to other community based services • Child may be transitioned to Part B Services, Early Childhood Special services • Child is not automatically eligible for Part B.

21. One Day Count • Child Count • Birth to Three: 3185 children 2.7% of 0-3 population • Birth to One: 612 children and 1.54%% of 0-1 population

22. Federal Reporting • Indicator 1: Timely Services • Indicator 2: Natural Environment • Indicator 3: Early Childhood Outcome • Indicator 4: Family Centered Services • Indicator 5: Child Find B-1 • Indicator 6: Child Find B-3 • Indicator 7: Timely Evaluation and Assessment • Indicator 8: Transition C to B • Indicator 9: Monitoring • Indicator 10: Complaints • Indicator 11: Hearings • Indicator 12: Resolution Sessions • Indicator 13: Mediations • Indicator 14: Timely and Accurate Data

23. Questions?

24. Early ACCESS Process

25. Initial Referral • Referrals come from anyone including: parents, physicians, child care providers, WIC, foster care • Anyone can make a referral

26. Initial Service Coordination Activities • Gather information about child and family • Concerns and resources • Screening info • Diagnosis info • Coordinate multidisciplinary evaluation • Inform family of rights, procedural safeguards and services

27. Eligibility Determination • Has a condition or disability that is known to have a high probability of later delays if early intervention services were not provided • Examples: down syndrome, prematurity, lead poisoned, in foster care, drug exposed, cerebral palsy, etc. OR • Is already experiencing a 25% delay in one or more areas of development as determined by multidisciplinary evaluation. OR • As determined by Informed Clinical Opinion

28. Write the PLAN: IFSP • Must be done within 45 days of referral • All have • Service Coordination • Services may include: • EA services • Non-EA services related to outcomes

29. Interim IFSP • Used when Early ACCESS services need to be provided to the child and family before the comprehensive multidisciplinary evaluation is completed. • The 45-day timeline must be followed and appropriate documentation completed.

30. Review the Plan • Periodic Review: At least every 6 months the IFSP plan will be reviewed. • Annual Review: At least once every 12 months from the date of the initial IFSP, the child will be reassessed and the plan updated • Transition Planning would occur as part of the above meetings

31. Exiting IFSP • Children with known conditions are eligible for Early ACCESS until their 3rd birthday. • Children who continue to meet state eligibility requirements may continue to receive Early ACCESS until 3rd birthday. • Parents may withdraw their children from the Early ACCESS.

32. Questions?

33. Early ACCESS Documentation Requirements aka “paperwork”

34. IFSP-Legal Document • An IFSP is not an IEP for little kids • IEP’s contain information about what teacher needs to do or the support the child will have while in the school building or accessing the school building. • The IFSP is Family Centered and looks at the entire child, and their family.

35. Intake/ Referral Form • Referrals come from many sources • Should have discussed referral with the parent prior to Early ACCESS receiving referral.

36. Family Information Page • Contains demographic information • Help to know who family is already involved with---who might need an exchange of information

37. Family Statements • Family statement must be completed; however the family may decline the family-directed assessment. • Important that parent’s perspective is a part of the over-all development of the IFSP process • Helps give service providers insight into the family and their needs.

38. IFSP Evaluations and Assessments • Results of the evaluation are entered based on the domain • RIOT: • record review • interview • observation • test

39. IFSP Outcomes • These are the “goals” • What are we going to be working on? • What will it look like? • How will we know when we get there? • How are we doing?

40. IFSP Early Intervention Services • Services that Early ACCESS is RESPONSIBLE for providing • What parents can expect to receive • Entry of this information may be essential for Medicaid

41. IFSP Other Services • Services that the child receives that are NOT the responsibility of Early ACCESS to provide. • Services must be related to an outcome.

42. Transition Plan • Documents the plan for the child’s transition/exit at age 3.

43. Early Childhood Outcomes (ECO) • Compares children to their peer group • ECO form is completed for initial and annual IFSP and exit from Early ACCESS.

44. Service Coordinator Log/ Service notes • This form is used by service coordinators to document contacts or attempts to contact family

45. IFSP Meeting Details • Documents meeting type, who is at the meeting, eligibility, and primary setting code.

46. Consents • Early ACCESS Evaluation with Prior Written Notice form • Consent for Early ACCESS Services form • Parent/Guardian Authorization form for Medicaid Reimbursement for IFSP Services

47. Authorization for Exchange of Information • Makes sure that everyone can contribute to the child’s plan • Allows communication between service providers on the IFSP team from multiple agencies

48. Authorization to Release of Health Information • Allows communication and sharing of written health records between IFSP team members

49. Meeting Notice • Notifies team about the purpose, location, invited paricipants and date of meeting.

50. Prior Written Notice • Written record of decisions. • Required anytime a service is changed, added, or deleted