Focused Monitoring Stakeholders

1. Focused Monitoring Stakeholders May 2010

2. Purpose: Massachusetts Monitoring System • Monitor and evaluate program compliance with federal Part C IDEA and Massachusetts DPH EIOS • Monitor and evaluate vendor and program contract activities • Contribute to ongoing quality improvement of programs and vendors to assure a baseline of quality services for all families participating in Massachusetts EI System

3. General Supervision Vision Statement Revised 6/30/04, MA Stakeholders Group • General Supervision of Early Intervention in the Massachusetts system is designed to promote core values and to ensure compliance with federal and state requirements through training, technical assistance, and monitoring. • General Supervision focuses on identifying commendable practices, suggesting improvements to enhance quality of services and specifying and enforcing corrective actions in areas of non-compliance.

4. Process: Collecting/Verifying Data • Five Components of the Massachusetts Monitoring System • Annual Report/Self Assessment • Focused Monitoring Site Visit • Data Verification Process • Dispute Resolution System • Local Program Determinations

5. Massachusetts Focused Monitoring • Components of the Massachusetts Focused Monitoring Process • Analyze data –select programs • Scheduling/Annual Calendar • Desk Audit/ Hypothesis Setting • Onsite Activities/ Exit Interview • Focused Monitoring Summary Report

6. Analyze data:Selecting programs • Complete selection of all EI programs in priority areas • Priority areas may change based on current issues and concerns in the EI system • Used most current data • First six months of FY ‘10

7. Priority Areas/Data Sources • Data/ EIIS Issues • EIIS report on enrolled IFSP children whose eligibility was ineligible, missing or undetermined • Program with the highest percentage of ineligible, missing or undetermined

8. Priority Areas/Data Sources • Clinical Judgment • EIIS report on enrolled IFSP children whose eligibility is clinical judgment • Program with the highest number of children enrolled based on clinical judgment • Information gathered in this priority area will be used to inform practice on the use of clinical judgment throughout the EI system

9. Priority Areas/Data Sources • Transition Practices • EIIS report on children receiving services after 21 days from ineligibility determination • Program with highest number of children receiving services after 21 from ineligibility determination • Program with the highest number of children receiving services over 45 days from ineligibility determination

10. Priority Areas/Data Sources • Comparison of units of service/ Number of Clients • DPH generated report through service delivery data • FY’ 09 & FY’ 10 comparison of number of clients served, number of hours of service and percent of change

11. Components of Focused Monitoring • Scheduling Cycle • March of every year the DPH will analyze data and select programs based on indicators/data sources collected from the previous year • Programs selected for each priority area to receive an onsite visit for a total of 10 visits per fiscal year • EIPs will be notified in May/June • Onsite visits will begin in July/ August

12. Selection of a program for an onsite visit does not directly relate to compliance.

13. Team Composition • DPH Regional Specialists • Focused Monitoring Parent Coordinator • Parent Team Member

14. Components of Focused Monitoring • Pre-Audit Interview/ Conference Call • Meeting with the program director of selected program and focused monitoring team • Discuss reason for selection • Gather information from program director • Identify other data sources to be reviewed at desk audit

15. Components of Focused Monitoring • Desk Audit • Prior to the onsite visit • Pre-Onsite data collected reviewed by monitoring team • Focus on the priority area for which the program was selected • What do we know now? • What do we want to look at before the onsite? • What do we want to learn onsite and how do we get it? • Plan for onsite visit

16. Hypothesis forming Infrastructure Policies and Procedures Professional development and training Practices Data Supervision Components of Focused Monitoring • Form hypothesis based on data submitted • Share the hypothesis with program director • Give program director opportunity to provide feedback on the hypothesis and share program thoughts about data

17. Components of Focused Monitoring • Onsite Protocols • Interviews • Families • Staff • Administration • Meet with program director to review onsite visit schedule • Review both team and program hypothesis • Record review • Tailored to address specific priority area

18. Components of Focused Monitoring • Onsite Protocols • Exit Interview • Monitoring Team will meet with the Program Director and other interested administrative staff at end of the onsite visit to summarize the results of the visit • Focused Monitoring Summary Report • Within one month of onsite visit monitoring team will send report summarizing the results and findings

19. Remember: The goal of focused monitoring is to develop a hypothesis, drill down by examining information in order to best provide support and technical assistance to a program and inform policy decisions

20. Components of Focused Monitoring • Follow Up Visits • As needed, members of the team will be available to the program for Technical assistance and support as identified in the summary report