1. Sunny Days Orientation

2. A little history about Sunny Days
Established in 1994 by Joyce Salzberg MSW and Donna Maher RN, two women who have become recognized leaders and innovators in the field of Early Intervention
Largest provider of EI Services in New Jersey
Provides services nationally, in New York, Pennsylvania, Delaware, New Jersey and California

3. Sunny Days CEO’s
Joyce Salzberg, holds a BA and MSW from Temple University. She has over 40 years of experience in the field of healthcare and developmental disabilities. She was the past Associate Executive Director of United Cerebral Palsy of NJ. She has been a member of the SICC since 1998, where she chaired several sub-committees. She has also served on numerous charitable boards, oversight committees and industry advocacy groups

4. Sunny Days CEO’s
Donna Maher, RN is a graduate of Misericordia Nursing School. Prior to establishing Sunny Days, Donna was a Labor and Delivery Nurse at Albert Einstein Hospital. She has also worked as a school nurse with children with disabilities as well as a nurse and Director of Development in an Early Intervention program . She served on the NJ State Quality Assurance Task Force and Board of Directors at a state REIC

5. Our Mission
To provide quality Evaluative and Therapeutic Early Intervention Services. Our family-centered philosophy supports the family as well as the most significant component to the child’s progress.
To foster the family’s ability to promote their child’s development to their fullest potential.
To empower family to incorporate support strategies into their daily routines which will maximize the child’s ability to participate in their environment.

6. Who’s Who at Sunny Days? Program Director - NJ
Karen Olanrewaju BSN, RN

7. Who’s Who at Sunny Days? Clinical Educators
Kathleen V. Flatley, MS, OTR
Jacqueline Jupin-Manzi RNC-NIC, MHA
Carola d’Emery, PhD, PT
Scott Rieger, MA, NCC, BCBA

8. Role of Clinical Educators (CE’s)
Provide practitioner orientation and trainings
Conduct routine and/or targeted observations of practitioner sessions in person or via facetime
Function in supervisory/mentoring capacity
Offer suggestions and help practitioners problem solve cases, however IFSP team has final say on all IFSP decisions!
Parents can decline to have a CE observe a session and should know CE’s are there to observe practitioner. If parent requests feedback on child, CE’s may provide their impressions

9. Who’s Who at Sunny Days? Regional Administrators
Marisa LaMonte Paulsen
Debbie Zielinski
Essex
Union
Autism Services
(Central and
Northern NJ)
Atlantic/Burlington
Camden/Cape May
Glouster/Hunterdon
Monmouth
Autism Services
(Southern Region)
Sheryl Newman
Sarah Martin
Bergen
Hudson
Morris
Passaic
Sussex
Mercer
Middlesex
Ocean
Somerset

10. Who’s Who at Sunny Days? Regional Administrators
Targeted Evaluation
Teams
Hunterdon/ Ocean, Atlantic and Cape May and Exit Evals in Union and Passaic
Audrey Searles
Helen Godfrey
Hudson, Morris, Sussex, Bergen-Back up and Exit Evals in Bergen

11. Regional Administrators
Assign and manage referrals/cases
Primary contact people once you begin providing services.
Please note contact info which can also be found on our website and will be sent to you with your contract as well
Check to see if is from Sunny Days ; consider a separate address…we have a big staff

12. Other Staff
You may receive s/calls from HR, Billing or Program Departments
All Regional Administrators (RA’s) have assistants who you may deal with as well
Service coordinators are not SD personnel. Check with your RA if you have any concerns about service coordinator or family requests
Check to see if is from Sunny Days ; consider a separate address…we have a big staff

13. Sunny Days
Sunny Days NJ serves children from birth to 3 through the Early Intervention System
Our sister company, the Sunshine Center, provides services to children privately - both home and center based

14. NJ Early Intervention (EI) System
NJEIS receives funding from the federal government and must comply with Part C of the Individuals with Disabilities Education Act (IDEA)
NJ Dept. of Health (DOH) is the lead agency that administers the program
Most directives we provide are based on need to comply with IDEA or NJEIS policies

15. NJEIS
Four grant funded organizations called Regional Early Intervention Collaboratives (Southern, Mid-Jersey Cares, Family Link, Helpful Hands)
REIC’s plan and coordinate NJ’s EI system at the regional/community level
Provider agencies and service coordination units

16. EI Services at Public Expense
Child Find
Procedural Safeguards
Service Coordination
Evaluation and Assessment
Individual Family Service Plan Development (IFSP)
Review and Transition Planning

17. EI Services not at Public Expense
All other direct service is subject to a family cost share
Cost share is based on income and family size
Suspensions may occur for non-payment. You will be notified if services must stop and when they can be resumed.

18. Early Intervention Process
Referral –NJEIS-06
Intake
Eligibility Evaluation NJEIS-02 and NJEIS-07
Family Information Gathering
IFSP Development
Assignment of EI Agency NJEIS-09
Service Provision NJEIS-16
Direct Service
IFSP Reviews (including an annual BDI-2) NJEIS-11 , NJEIS-13
Transition out of EI Policy NJEIS-20
Relevant state policies in red

19. Identification and Referral
Referral is made to SCHS when there is a concern. NJEIS or njeiinfo
Family consent is required prior to the referral
Family consent is not needed prior to referral in:
Substantiated cases of abuse
Cases where an infant has been exposed to drugs prenatally NJEIS-01

20. Evaluation for Eligibility NJEIS-07
Family provides consent
Service Coordinator coordinates evaluation
Evaluation team is multidisciplinary
Must be completed within 45 days of referral
State using Battelle Developmental Inventory (BDI-2) for initial evaluations

21. Eligibility Criteria NJEIS-02
Two categories of eligibility
Developmental Delay
Conditions with High Probability of Delay

22. Eligibility NJEIS-07
Developmental Delay is measured as 2.0 standard deviations below the mean in one developmental area or 1.5 standard deviations below the mean in two or more developmental areas. (Can also be documented with Informed Clinical Opinion)
Conditions with High Probability of Resulting in Delay – must be confirmed in report from physician, advanced practice nurse or psychologist (includes 10 presumptive diagnoses which don’t require the signed statement or report)

23. 10 Presumptive Diagnoses
Down Syndrome
Fetal Alcohol Syndrome
Hearing Impairment
Vision
Autism
Spina Bifida
Cerebral Palsy
Trisomy 13,18, etc
Fragile X
Hydrocephalous

24. Initial IFSP Meeting and Development NJEIS-07
Done within 45 days of referral
Conducted at a place convenient for the family
Conducted in native language of the family.
During this meeting the team develops child and family outcomes and decides upon strategies and services necessary to meet those outcomes

25. IFSP Participants Family Service Coordinator Evaluation Team Members
Family can also choose to include other relatives, daycare staff or advocate, etc. if they choose
Family can also invite an advocate, supporter or other family members to participate

26. Provision of Services
Family provides written consent for services NJEIS-16
Family provided with agreed upon services
Services provided in Natural Environments and are consistent with the outcomes (goals)/strategies of the IFSP
Services are reviewed periodically and eligibility is re-determined annually NJEIS- 13,11,19

27. Practitioner Responsibilities for Service Provision
Respond to the RA as soon as possible indicating your availability to fill the service
Cases will appear under “My Caseload” field on the EIMS (when fully implemented) Family contact information is listed under demographics.
If accepting case, contact family to schedule and immediately notify your RA of scheduled start date. We have 12 calendar days from agency assignment to complete first session per NJEIS-16
If any time has passed since RA was assigned case you may need to start sooner to meet EI timelines. Best to schedule ASAP

28. Provision of Services NJEIS-16
Support all outcomes to the maximum extent possible when appropriate and safe. All practitioners must be aware of all outcomes
Communication between multiple practitioners is encouraged

29. NJ EIMS
NJ is using the Early Intervention Management System (EIMS) database for case management since 12/1/17 – system still in transition – some things are still being done on paper until EIMS fully implemented
Run by Public Consulting Group (PCG)

30. NJ EIMS
Practitioners will receive an with a password to access the site
Password needs to be changed every 90 days
PCG Call Center
Can contact them for help with logging issues M-F 8 am to 5 pm

31. NJ EIMS
On demand training webinars can be found after logging into EIMS.
After signing in to the site, click training link under announcements.

32. NJ EIMS
You can also access the training modules through the billing portal
Go to EI Billing Portal tab (on green menu bar) that takes you to NJEIS Fiscal Portal where you click on “Help” and from drop down menu choose “Training” to access Webinars

33. NJ EIMS
Please view “Intro to EI Management System” webinar and “Practitioner Training” webinar
TET members also view “Evaluation Training” webinar
No documentation of attendance or certificate is required

34. NJ EIMS
Every session you complete must be logged in the EIMS or the agency will not be paid. This includes IFSP meetings TPC’s and all TET services
During transition anything done on paper will need to be logged in EIMS eventually!

35. Contact Log Entries
Document initial contact with families on the parent contact log feature of the EIMS database when scheduling a new service
If unable to log in EIMS, document on a paper communication note
Review Policy/Procedure on Communication Note Completion
Please let RA know when your 1st session is scheduled or if you have had difficulty scheduling
Should all be attending full day state training on IFSP document. For

36. Contact Log Entries
Every time a contact is made with family a new entry to log must be completed. For example first session rescheduled from 1/16/18 at 11:00 am to 1/16/18 at 4:00 pm due to family conflict. Discussed that ongoing sessions will stay at 11:00 am
Should all be attending full day state training on IFSP document. For

37. Contact Log Entries
Follow prompts on EIMS and include description of outcome of contact (Left voice mail on mother’s cell attempting to schedule first visit for Tuesday 1/9/18 at 11:00 am) or (Spoke to mother and offered Tuesday 1/9/18 at 11:00 am. Parent stated that she has a doctor’s appointment but could start the following Tuesday 1/16/18. Scheduled first visit for 1/16/18 at 11:00 am)
Must provide details of conversation in the notes field of contact log
Should all be attending full day state training on IFSP document. For

38. Contact Log Entries
The EIMS also has a contact log for documenting non-family contact
Can use for SC contacts, RA, interpreter, other practitioners, providers outside of the system (with proper consent), etc.
Should all be attending full day state training on IFSP document. For

39. Non Parent contact Note from NJ EIMS

41. Schedule Please set up a consistent schedule with the family
Document on the EIMS if there will be any changes to your schedule with the family

42. IFSP Document Review IFSP before starting services
Must understand outcomes to be addressed
New IFSP’s will be in EIMS
Read service pages to see what services child is receiving (legal document between families and NJEIS)
Should all be attending full day state training on IFSP document. For

43. Frequency and Length
Must provide services at agreed upon frequency and length
Example – If IFSP says 3 x 60 minutes can’t do 2 x 90 minute sessions
If there is to be an ongoing change a meeting and IFSP re-write must occur
The EIMS system will not allow you to log in sessions outside of the assigned frequency and length

44. Natural Environments Means more than simply home based services!
Natural Environments are the philosophy of the NJEIS and IDEA
Caregivers must always be present during a session. Caregivers should be actively participating and engaged with their child throughout the entire session
Eliminate or minimize bringing in toys or other items that limit parental carry over

45. Natural Environments
Children receiving Early Intervention services in a daycare setting should not be removed from the classroom
Practitioners should work within the routines of the center, and facilitate the child to participate in the activities

46. Natural Environments
Settings that are natural or typical for the child’s age peers who have no disabilities
Outcomes are contextualized around daily routines or times of day

47. Location of Services
When going out into the community never drive with or take the family
Ongoing location change will be reflected on IFSP – daycare vs. home
If daycare is closed or family schedule changes can do a session at home instead at family request

48. Documentation All documentation not done through EIMS must be in ink
If a mistake is made, cross out with one line with your initials next to it. You may not use white out!!
All forms should have dates, month/date/year, and a.m. or p.m. must be indicated. Please list exact times in and out
Signatures are required on all consents or log verifications. Initials are not acceptable

49. Session Notes Will be completed through the EIMS
Must complete three fields; 1. Who was present?; 2. Successes and concerns since last visit; 3. Intervention Techniques (Routines and Strategies).
Also log missed sessions on EIMS – follow prompts to indicate why session was missed - and enter narrative explanation
Contacts with other practitioners and the Service Coordinator can go on a communication log.

50. Session Notes
There is also a section at the bottom for additional comments “Today’s Progress/Highlights/Overall Comments” – use this section to add additional information not captured in other 3 fields. Any discussions that occur during session about switched days, etc. can go here.
*for cases not yet in EIMS complete paper notes
Contacts with other practitioners and the Service Coordinator can go on a communication log.

52. Missed Services NJEIS-14 addresses missed services
If a family cancels their session we can not offer a make-up service
Practitioner is free to accommodate family with a rescheduled visit during the same week (month if monthly service) if possible

53. Make Up Sessions (NJEIS -14)
If a service is missed due to a holiday that Sunny Days observes, make-ups are not permitted – only reschedules during same week (for weekly service) are allowed
If a service is missed due to extreme weather or a natural disaster, make-up services are not permitted – only reschedules during same week
When a practitioner cancels for other reasons, the provider agency must offer the family the opportunity to receive makeup services
Make ups can be done any time during IFSP period

54. Make Up Services Continued
Any offers for make ups must be documented so even if family does not accept the offer to do make ups we have it documented that we made the offer. Include dates and times offered in your documentation
Let your RA know about any anticipated or actual disruption in services

55. Make Up Sessions Continued
Additional time of 15, 30 and 45 minutes can not be added onto a session for the purposes of make-ups
The duration of all make up services must occur as written on the IFSP
Please document all cancellations and discussion with parents about make ups in the EIMS and actually log in the missed sessions with the logging wizard indicating reason session was missed
Keep good notes. SC or RA may need to review contact log information so be clear

56. Make up Sessions
Please remind parents when they cancel that they are not entitled to a make up session. We can always reschedule during the same week in the event of a parent or practitioner cancellation
Week is from Sunday through Saturday. This means if a parent cancels a Saturday session you can not reschedule for Sunday. If you know ahead of time you can reschedule for earlier in the week

57. IFSP Review Process
Form 25 Practitioner IFSP Review Summary is available on the SD website NJEIS-13,19
Form must be completed before 6 month and annual reviews at minimum
Progress should be tracked continually as periodically IFSP meetings can happen more frequently than the 6 month and annual

58. IFSP Review Process Practitioners must report on all outcomes
Guidelines for completion of this form can be found on our website
Form completed and returned to the Manalapan office – can be ed to RA – may be able to do on EIMS at some point
Discuss completed form with parent

59. IFSP Review – Form 25 NJEIS-13,19
Must reflect on how you help family know their rights, effectively communicate their child’s needs, help their child develop and learn
Must also describe how you helped child develop positive social emotional skills, acquire and use knowledge and skills and use appropriate behaviors to meet their needs

60. Practitioner IFSP Review Summary Form 25 NJEIS-13,19
Utilizing ongoing assessment – must track child’s progress. Multiple methods to do this include use of a tool such as ELAP, HELP, DAYC in conjunction with Birth to Three Early Learning Standards, parent report, observations, data collection
Focus is on progress towards outcomes but we always look at overall development and report ongoing challenges

61. IFSP Review
Sunny Days will send completed form(s) to the Service Coordinator prior to the end of the current IFSP period
SC will schedule the meeting
There may be circumstances in which a meeting may not take place face to face. (please see NJEIS-19 Annual IFSP Reviews and NJEIS-13 Scheduling of Required Periodic Reviews)

63. Periodic BDI-2 NJEIS-11
For children who were initially determined eligible by informed clinical opinion (ICO), a periodic BDI-2 will be conducted to determine continued eligibility
At the 6 month review these children must be eligible by the BDI-2 scores or a high probability diagnosis to continue. ICO can not be used again to keep them eligible

64. Role at IFSP Meeting Discuss Child’s Progress
Review Annual and Periodic Review Notes at the meeting with the rest of the team
Discuss current strategies and outcomes and help to facilitate new outcomes with the family
Service Coordinator is responsible to bring form 13 to IFSP meetings.

65. Annual IFSP
TET re-administers BDI-2 annually and results are used in conjunction with information from the team in the home for eligibility redetermination
NJEIS Form 14 – Documentation of Continued Eligibility Discussion and Decision is completed with the team at annual meetings
In some cases, Informed Clinical Opinion can be used to establish eligibility when BDI-2 does not
Service Coordinator will bring form NJEIS 14 to the meeting

66. Developing an Outcome Statement
Behavior-desired of the child/family.
Specific details that describe what the behavior should look like
Routine or activity in which the child/family will use the behavior
Conditions associated with the behavior

67. Outcome example: Child Outcome Statement:
Jacquie will use words during mealtime to request or reject more food
What is happening now?
She whines when she wants more food and throws her dish when finished

68. Outcomes
Strategies - very important part of outcome and can not be a restatement of the outcome
Must be specific enough so families know how to implement strategies
Also a good starting place when you receive a new case

69. What to bring to the IFSP Meeting
Copy of your IFSP Practitioner Review Summary Form 25
Tool used for ongoing assessment (for discussion)
Service Encounter Verification Log

70. Transition Planning Conference (TPC) NJEIS-20
With approval of the parent, a TPC must be convened not fewer than 90 calendar days and no sooner than 9 months before the child’s third birthday
If the parent declines to have a TPC the transition plan is developed at an IFSP meeting
Participants-Family, Service Coordinator, EI Practitioner, Child Study Team Member

71. Transition Plan Must Include:
Review of the program options for the toddler from their third birthday through the remainder of the school year
Steps for the toddler and their family to exit from the Part C program
Any transition services that the IFSP Team identifies as needed by the toddler and/or their family

72. Transition Planning Conference NJEIS-20
Your primary role at a TPC is to share child’s progress in EI not to make recommendations about placement after child turns 3
Team members can offer strategies to support transition
Practitioners should not attend the eligibility evaluation or IEP meeting that takes place at the school. They are not EI meetings
See Policy NJEIS-20 Transition Planning and Opt-Out for further information on Transition Process

73. Note for Practitioners providing Applied Behavior Analysis Services
ABA is a structured systematic approach to teaching, rooted in the principles of reinforcement that is most commonly associated with teaching individuals with autism
Sunny Days uses A Step by Step Curriculum for Early Learners with Autism Spectrum Disorders’ by Dr. Lindsay Hilsen, BCBA-D
NJEIS does not recognize ABA as its own specific discipline or service

74. ABA
ABA services are considered to be DI (Developmental Intervention) within NJEIS, and can be considered an ABA approach to DI
Targeted skills acquisition programs from the curriculum and teaching data should be included in an ABA binder that is kept in the families home

75. Working with Interpreters
If you are working with an interpreter they will need to make the initial call to the family to schedule your first session and they should make an entry into the family contact log in the EIMS
You should make an entry into the non-family contact log documenting your conversation with the interpreter

76. Interpreter Tips
Interpreters should repeat what everyone is saying and not make judgments about what to interpret and what not to
Interpreters should not put their hands on a child or have side conversations with the family that don’t include the practitioner
If there are any concerns we need to know.
If the family has multiple services through the same interpreter don’t ask the interpreter about how the other sessions are going…reach out to the other practitioner directly

77. Interpreters
If an interpreter is unable to make a session, you may use the language line. Please contact your RA for the instructions on how to utilize this service

78. Practitioner Responsibilities
Please make sure HR receives all required paper work and updates such as address, or legal name change, licenses, liability insurance, and certificates of attendance for NJEIS trainings
Please keep current on any changes in the EI system. You will receive some information from Sunny Days and can also check periodically

79. Practitioner Responsibilities Confidentiality Code of Conduct
Documentation with any identifying information should be kept in a secure location. Please see Child Record Maintenance Policy
Information concerning clients and their families may only be shared with outside agencies after written permission is received from the parent and/or legal guardian NJEIS-17
You can find a consent to share information form on our website.

80. Practitioner Responsibilities Confidentiality Code of Conduct
Information about children and their families should not be discussed in public places, other families’ homes or with family members or friends
Do not discuss information when gathered at meetings with other practitioners or with other parents

81. Practitioner Responsibilities
Under no circumstances are practitioners permitted to bring other people into a family’s home during or after sessions
This includes children parent(s) spouses or pets

82. Practitioner Responsibilities
Please be mindful of the fact that families may have security cameras installed in and around their homes
Cameras may record audio as well as video so it is possible you may be recorded in yard, driveway, front porch as well as inside house

83. Consents
If you are seeing a child with anyone other then the parent or guardian you must have consent to talk to them or provide any written documentation
For a child who receives services in the daycare Sunny Days will send the consent to the family and the family will return it indicating who you can speak with. You should receive a copy. (NJEIS Consent to Release/Obtain information) displayed on website

84. Guidelines for Illness
Refer to information on website regarding child and family illness as well as toy washing policy
Make sure you do not go into families’ homes when you are ill
Check with your physician to make sure you are up to date on your immunizations

85. Practitioner Responsibilities: Safety
Personal Safety
seat belts
let someone know how to contact you
Child Safety
You should not be alone with the child
Be mindful of choking hazards, etc.

86. You must report Child Abuse and Neglect
Anyone who has reasonable cause to believe that a child has been or is being subjected to any form of hitting, corporal punishment, abusive language, ridicule, harsh, humiliating or frightening treatment or any other kind of abuse neglect or exploitation. We are all Mandatory Reporters!

87. Division of Child Protection and Permanency
Must report concerns immediately to CP&P NJAbuse
In addition please notify your RA and complete incident report

88. CP&P
If a request is made from CP&P for an update on a child’s developmental status, please inform your RA immediately so that we can ensure that the proper consents are signed prior to disseminating any information

89. Practitioner Responsibilities: Incident Reports
Should be filled out if incident occurs involving the practitioner, child or other individual (ie. falls, biting, etc.)
Please notify your RA if an incident report has been completed

90. Billing Procedure Bi-monthly billing schedule is as follows:
For services provided between the 1st and the 15th of the month, billing must be received to the corporate office no later than the 20th of the month
For services provided between the 16th and the end of the month, must be received no later than the 5th of the following month

91. Billing
Please note that billable hours are for face to face interaction with the child and family. This includes logging sessions into the EIMS
Practitioners may not leave a session early to log their sessions at home and then bill for that time
NJEIS-15- Policy on FRAUD, WASTE and ABUSE

92. Billing Procedure
Submit a billing invoice as a cover sheet for each billing cycle (this is the only document that can have more than one child’s name on it)
List all services by child for that 2 week billing cycle on the billing invoice
Include signed service encounter verification log listing each session you did

93. Billing Procedure
Billing invoice was recently updated to add a column where you can indicate whether or not a session was successfully logged into the EIMS

97. Billing
Mail completed billing to corporate office – (can not be faxed or ed)
Sunny Days Inc.
300 Corporate Center Drive, Manalapan, NJ 07726

98. Billing Checks are mailed out the third week of the following month
For example, you receive May’s billing the third week in June.
Check schedule with dates checks are mailed is on our website

99. Questions ?
Please feel free to contact us with questions as you begin to take cases
If you have any questions about the enrollment process (up through signing your contract) contact HR
RA’s will receive a copy of your resume and profile when you become active

100. Reminder………
For those of you who are not hired as employees, you are an independent contractor and are self-employed and will receive a 1099 at the end of the year
We cannot be listed as an employer for disability or unemployment. If applying for a mortgage we cannot provide any information

101. Thank You! Kathleen V. Flatley, MS, OTR kflatley@sunnydays.com
Jacqueline Jupin-Manzi RNC-NIC, MHA