EarlySteps and the SICC: An Overview of Louisiana’s Early Intervention System and its Advisory Council

What is EarlySteps? EarlySteps, Louisiana’s Early Intervention System, is the Part C program of the Individuals with Disabilities Education Improvement Act (IDEA), which is federal legislation that was reauthorized by US Congress in November 2004

EarlySteps History and Legislation Early intervention is a series of supports provided by authority of this federal law originally passed by Congress 20 years ago. Louisiana has always participated in Early Intervention since the legislation began and was originally called ChildNet with the Department of Education. In July 2003, DHH became the Lead Agency, and the system name was changed to EarlySteps. OCDD administers the program in DHH. Currently, every state participates in the Part C program (Ex. Georgia’s early intervention is called “Babies Can’t Wait.” Mississippi’s is “First Steps.” )

EarlySteps: Progression in Legislation Individuals With Disabilities Education Act Known as Part C; reauthorized in 2004 ChildNet Department of Education is Lead Agency EarlySteps 2003 DHH becomes Lead Agency; 2007 OCDD oversees

What does EarlySteps provide? Children and families enrolled in EarlySteps receive supports and services which enable them to help their child progress developmentally and to improve their child’s functioning as a family member within the daily routines of the family. EarlySteps is a family education and training program. You’ll see how services are established and that our activities reported are focused on supporting families We have a quality process that uses family feedback to determine if our service system has accomplished this

Mission and Philosophy To provide a family-centered, community based, interagency service system for infants and toddlers with disabilities and their families, where families are supported and the potential of each child is maximized. All eligible children and families have a right to comprehensive early intervention services, therefore they will be provided regardless of sex, race, color, creed, place of residence, culture, language or the family’s ability to pay. The family is the constant in the child’s life, while the service systems and the personnel in those systems fluctuate, therefore the system will be family-centered and designed to meet the needs of the family rather than meeting system needs

Mission and Philosophy The structure and definition of families vary widely, as do the existing natural support systems of individual families. Therefore, the system will define “family” in a broad manner to include individuals considered as family and their supports Children and families vary according to specific strengths and needs. Therefore, the service system will be comprehensive and flexible to meet varying strengths and needs of children and families. It will strive to assist families in other areas such as respite and child care. Families and children will have access to coordinated resources. Therefore, The system will coordinate services across all agencies , provide families with clearly defined points of entry and support the family through effective service coordination.

A Family-Centered Support Model All children have a right to be part of a family, and families have the right to remain intact. Therefore, the service system will be committed to supporting families in their efforts to maintain children with special needs in the home. The service system will service children in the context of the family, and efforts will be directed toward maintaining family unity. Children and families have the right to develop their potential within natural settings. Therefore, the system will provide early intervention services in natural environments, and encourage maximum participation and integration in community life. The needs of children and families are dynamic. Therefore, the system will allow for ease of entry, and ease of exit when services are no longer necessary. Additionally, the system will provide a mechanism for re-entry should services once again become needed.

A Family-Centered Support Model Children and families have a right to quality programs. Therefore, the system will ensure that services are provided by appropriately trained and qualified personnel. Families have a right to privacy and other procedural safeguards. Therefore, the system will be designed in such a manner as to protect these rights. Families have a right to determine what is best for their individual situation and to fully and equally participate in the planning and implementation of intervention. Therefore, the system will provide necessary resources to the family to enable the family to become, or continue to be, the primary advocate and planner for the child. However, these roles will not be thrust upon families who are unable or unwilling to assume them. In all cases, the family will play an integral part in the assessment and the development of the individual family services plan.

Who is Eligible? The child must be age birth to 3 years, but not passed their 3rd birthday. The child must live in Louisiana. The child must have a diagnosed medical condition that has a high probability of resulting in a developmental delay. OR The child is experiencing developmental delays in two areas as measured by a developmental assessment [Battelle Developmental Inventory—(BDI-2)]in the following areas: Medical condition: List of medical conditions that we recognize—in practice manual Developmental Delay: see next slide

Who Is Eligible Continued? Physical Development (crawling, walking, seeing, hearing)-fine and gross motor. Cognitive Development (learning skills or problem solving) Social and Emotional Development (playing with others, showing feelings) Adaptive Development (feeding, getting dressed) Communication (listening, talking, expressing self)-receptive and expressive language

Autism Screenings Offered at the initial evaluation to newly referred children age 18 months and older At every six month review and annual review for children age 18 months and older who are already receiving services At the request of families

What supports and services are offered? There are 17 early intervention family support services that may be accessed through EarlySteps: Assistive technology devices and services Audiology Services Family Training, counseling and home visits Health Services (family education and to assist with other EarlySteps services only) Medical Services (for diagnostic & evaluation purposes only) Nursing Services(family education and to assist with other EarlySteps services only) Nutrition Services

What supports are offered? Special Instruction Speech Language Pathology Transportation (to and from EarlySteps services only) Translation/Interpreter Services (Foreign Language and Sign Language) Vision Services Occupational Therapy Physical Therapy Psychological Services Service Coordination Social Work Services

Where are supports provided? EarlySteps supports are provided in the home or any other community setting where children live and play. This is often referred to as the natural environment of the child, a setting which would be typical for a child between the age of birth and three years. Some examples would be the home, childcare center, park and grandmother’s house. Provided in NE or why not Settings that are natural or normal for the child’s age peers who have not disabilities Includes home, child care centers, or other community settings to meet child’s needs.

Natural Environment - Home

Why provide supports here? Providing supports and services in the natural environment reinforces the acquisition of developmental skills that can be practiced throughout the day during the typical routines of the child and family. Remember earlier slide: focus on support families

Child Find Component Federal law (IDEA) requires that Louisiana identify, locate and evaluate all infants and toddlers who are eligible for Part C (EarlySteps) supports and services.

Referral Process Physicians, hospitals, public health facilities and other health care providers are required to refer any child they suspect may have a developmental delay or a medical condition with a high risk of resulting in a developmental delay to EarlySteps no more than 7 days of seeing the child. To make sure we identify all children needing Early Intervention services, parents may refer their own child. Anyone can refer a child to EarlySteps.

How are referrals made? Referring a child is a simple process. EarlySteps has 10 System Points of Entry (SPOEs) set up across the state to perform intake and eligibility activities for children referred to EarlySteps. The person making the referral should determine which parish the child lives in and contact the SPOE for that parish by phone, fax, mail, or email. A list of SPOEs is on the SICC website and on the EarlySteps website A parent can call the SPOE and make a referral by phone. Remember, anyone can make a referral to EarlySteps. Referral number: 1-866-EarlySteps or 1-866-327-5978

After the referral: After the SPOE receives the referral, the SPOE Intake Coordinator contacts the family of the child being referred within three working days. If the family is interested in receiving supports, arrangements are made to make a visit within 10 working days from the date the referral was received, to complete the intake activities. Service coordination during intake process

Determination of Eligibility The next step is determination of eligibility, which will involve a Comprehensive Developmental Assessment of the child by professionals enrolled as EarlySteps providers. For those children who have a medical condition, their medical diagnosis must be documented by the appropriate professional qualified to make the diagnosis, such as their pediatrician.

If child is eligible … If the child is found eligible to receive EarlySteps services, a team, which includes the parents, is chosen to complete an Individual Family Service Plan (IFSP) for the child. During this meeting, the outcomes the family wants to achieve are identified from the family-directed assessment. The teams decides what supports are needed to assist the child and family to achieve these outcomes. The family also chooses service providers who are enrolled with EarlySteps to provide these supports. Timely Services Child and Family Outcomes Based on team decision-making

Timelines The entire process we just described should not exceed 45 calendar days and services are available at no cost to families.

Indicators of Success How do we measure EarlySteps’ success? How do we know we are meeting our 17 requirements? General Supervision System or Quality Enhancement Process

Quality Enhancement Monitoring Activities: cyclical and focused Policies and Procedures Professional Development and Targeted Technical Assistance Fiscal Management Data Processes: EIDS and Complaint System Dispute Resolution Improvement, Correction, Incentives, Sanctions

Quality Enhancement State Performance Plan Annual Performance Report – Due February 1 Annually --Performance Indicators Services provided within 30 days of IFSP Infants and Toddlers receive services in Natural Environments From entry to exit children improve in social emotional, knowledge, and behavior Indicator 1 Indicator 2 Indicator 3

Quality Enhancement Families know their rights, communicate child needs, help children develop and learn 1.5% of 0-1 year olds in LA are identified (1.64%) 2.65% of 0-3 year olds are identified (2.50%) IFSPs developed within 45 days of referral Procedural safeguards Child Find/Public Awareness Timely Service Deliver

Quality Enhancement Children transition at age 3 System identifies and corrects noncompliance within 1 year Complaints are resolved in 60 days Due process hearings adjudicated within timelines Mediations result in agreements Data is timely and accurate Monitoring Dispute Resolution EIDS

Keeping up with the latest … Updates for EarlySteps including the State Performance Plan (SPP) and the Annual Performance Report (APR) are reviewed at quarterly State Interagency Coordinating Council (SICC) meetings and are posted on the EarlySteps website. EarlySteps child count and Status of the Region reports are discussed at SICC quarterly meetings Public comment and questions are encouraged at SICC quarterly meetings

What is the SICC? The SICC is an independent board that advises EarlySteps. When a State participates in the early intervention program, the SICC is a required component. The ICC functions under the Governor’s Office of Community Programs.

Organizational Structure: SICC and EarlySteps Governor’s Office of Community Programs Governor’s Office Department of Health and Hospitals (DHH) Office for Citizens with Developmental Disabilities (OCDD) State Interagency Coordinating Council for EarlySteps (SICC) Executive Director EarlySteps: Louisiana’s Early Intervention System MOU

Council Membership All council members are appointed by the governor and represent the population of Louisiana. The SICC membership is composed of: (1) at least 20% parents of children with disabilities; (2) at least 20% public or private providers of early intervention services; (3) at least one member from the state legislature; (4) at least one member representing personnel preparation; (5) at least one representative from each of the state agencies involved in the provision of, or payment for, early intervention services; (6) at least one member from the state education agency responsible for preschool services; (7) at least one member from the agency responsible for the state governance of health insurance; (8) at least one member representing a Head Start agency or program in the state; (9) at least one member representing the agency responsible for child care; (10) other members selected by the Governor. 

Committee Information What are standing committees? What are ad-hoc committees?   Our standing committees include the Executive Committee, the Program Components Committee, the Comprehensive System of Personnel Development (CSPD), and the Public Relations Committee. The Executive Committee is made up of the ICC council officers and chairpersons from each committee, including ad-hoc committees, and each committee receives one vote on the SICC Executive Committee. The vice-chair of each standing committee may attend and vote in the absence of the chair. A Lead Agency Representative shall be present at the Executive Committee meetings.   Ad-Hoc committees are formed to complete a specific goal/purpose and dissolve after the task is completed. The SICC Chair determines the need for an ad-hoc committee and appoints the chair of the Committee

How do I join a committee? You may request an application from Christie Smith @ Christie.Smith@la.gov or you may visit the SICC website @ http://gov.state.la.gov/SICC to fill out an online application.   Your application will be reviewed at the next Executive Committee meeting for approval and you will be notified of your acceptance. If you have questions about which committee you may be the best fit for, reach out to Christie Smith @ Christie.Smith@la.gov or 225-219-7560.

Your role as a member: Advising Effectively Attend Regional Interagency Coordinating Council (RICC meetings) in your area. Attend quarterly SICC meetings (January, April, July, October) Email Christie Smith @ Christie.Smith@la.gov to be added to the email distribution list to receive all statewide updates and ICC meeting notices. Visit the SICC website—it is updated regularly @ http://gov.state.la.us/SICC. Review the Strategic Plan online to take a comprehensive look at pending work of the ICC and completed activities. Join a committee. Schedule meeting or call at your convenience with Executive Director.

RICC meetings Each Region within the state has an Interagency Coordinating Council (RICC). Parents, guardians, caregivers, providers, stakeholders, and all interested parties are encouraged to attend RICC meetings to stay current with the latest information and provide valuable feedback. Regional Coordinators are listed on the SICC Website and the EarlySteps Website

Quick Facts: Recap EarlySteps is Louisiana’s Early Intervention system The SICC, a required component, is the advisory council The council is governor appointed EarlySteps is an interagency delivery system based upon a family support model Supports are delivered in the child’s natural environment Referrals to EarlySteps are processed by the SPOE in each region (Single Point of Entry) Each region of the state has a RICC that discusses regional developments and concerns. Each region has a regional coordinator (list on SICC website and EarlySteps website) EarlySteps has a quality assurance plan—all documents and updates are discussed at quarterly SICC meetings (Jan. April, July, and Oct.)

Websites http://gov.state.la.us/SICC www.earlysteps.dhh.louisiana.gov/ EarlySteps Program Manager, Brenda Sharp Brenda.Sharp@la.gov SICC Executive Director, Christie Smith Christie.Smith@la.gov