1. University of Hawai`i HAWAI`I 3-5 TRANSITION TASK FORCE Jean Johnson, DrPH August 23, 2007

2. University of Hawai`i  Review purpose of Task Force  Provide background information  Put everyone on the same page  Identify the Committee  Task the Committee to develop the survey Purpose of Meeting Today

3. University of Hawai`i Purpose of ACT 289 To study the feasibility of expanding eligibility, pursuant to Part C of the Individuals with Disabilities Education Act, for services from the Department of Health’s Early Intervention Section to children between 3 and 5 years old who have developmental disabilities.

4. University of Hawai`i Tasks  Identify the potential number of children annually who may benefit from a longer transition period  Identify the number who were served by Part C, but not eligible to be served under Part B  Identify the number with delays, ages 3-5, who were not served by Part C

5. University of Hawai`i Tasks (continued)  Research evidence-based practices for service models  Define the array of services required  Based on projected numbers, derive resources and cost projections  Conduct a needs assessment of families, focusing on their transition experiences

6. University of Hawai`i The Task Force Shall Also:  Project the timeline to develop resources  Develop indicators for evaluation to assess outcomes  Submit a report to the Legislature 20 days prior to the convening of the 2008 Session (report due December 27, 2007)

7. University of Hawai`i Funding  Appropriation of $120,000  Governor allowed House Bill No. 531 to become law as Act 289 without her signature  DOH initial funding $15,000 to begin

8. University of Hawai`i To Begin The Department of Health to enter into a Memorandum of Agreement with the Center on Disability Studies for $15,000 to do the following:  Facilitate two meetings of the Task Force  Complete the needs assessment of families. focusing on their transition experiences from Part C. [(7) in Act 289]

9. University of Hawai`i Background (National) Prior to 1975 – Parental Lawsuits 1975 – Education of All Handicapped Children’s Act 1986 – PL 99-457 2004 – IDEA Reauthorization

10. University of Hawai`i Background (Hawai`i) 1949 - Exceptional Children’s Law 1972 - Early Intervention Began 1974 - Silva Consent Decree 1975 - Federal Legislation 1980 - Preschool Special Education Began 1987 - Part H 1990 - Preschool Task Force 1997 - STEPS Project 2000 - Preschool Study under Felix

11. University of Hawai`i Children Served under Part C in Hawai`i, 2005 Ages Developmental Delay/ Biological Risk Environmental Risk 0-1 years Total Number431582 Percentage18.6%44.0% 1-2 years Total Number773462 Percentage33.3%34.9% 2-3 years Total Number1,162278 Percentage50.1%21.0% Total Total Number2,3201,322 Percentage100%

12. University of Hawai`i CategoryNumberPercentage Exited prior to age 3; developmentally age appropriate 51933% Part B eligible (unknown how many enrolled) 50132% Not Part B eligible27418% Part B eligibility not determined26417% Total 1,558100% Hawai`i Part C Exit Data, 2005

13. University of Hawai`i Hawai`i Part B Indicators, 2005 Child Status Following Referral/Evaluation Part C Children Referred Indicator Measure- ment Completed PRIOR to 3 rd Birthday Completed AFTER 3 rd Birthday IDEA Ineligible8614.80%B4451.2%4248.8% IDEA Eligible47982.44%C31766.2%16233.8% No Evaluation Conducted 162.76%1593.8%

14. University of Hawai`i Timelines for Evaluation, 2005 565 Evaluations were conducted for children who were served by Part C. In 303 cases, consent for evaluation was received > 60 days prior to the 3rd birthday. In 262 cases, consent for evaluation was received < 60 days prior to the 3rd birthday. 293 children (97%) had services in place or eligibility determined by the 3 rd birthday. 10 children (3%) did NOT have services in place or eligibility determined by the 3 rd birthday. 194 children (74%) did NOT have services in place or eligibility determined by the 3rd birthday. 68 children (26%) had services in place or eligibility determined by the 3rd birthday.

15. University of Hawai`i Comparison Data On Hawai`i and Massachusetts, 2005 Hawai`iMassachusetts National Average Part C6.71%5.90%2.40% Part B4.75%6.46%5.84%

16. University of Hawai`i Question Given the apparent similarities in policies and system implementation in the two states, the question arises why the State of Hawai`i experiences a decrease in the percentage of children served in preschool special education (Part B), while Massachusetts maintains a percentage that is above the national average.

17. University of Hawai`i Hawai ` i “Developmental Delay” 1.5 SD in one area, except if the area is cognitive, then adaptive environment must also be 1.5 SD below the mean. OR Team, including parent, determines that patterns of learning deviate from age expectations across settings and provides the basis and method used in deter- mining eligibility. Massachusetts“Developmental Delay” Learning capacity significantly limited, impaired, or delayed and is exhibited by difficulties in one or more areas. Eligibility Criteria for Part B Section 619

18. University of Hawai`i Thesis Questions 1. How differently does the State of Hawai`i and the State of Massachusetts implement IDEA Part C? 2. How differently does the State of Hawai`i and the State of Massachusetts implement IDEA Part B? 3. How differently does the State of Hawai`i and the State of Massachusetts implement the transition process from Part C to Part B? 4. What are the factors that influence families’ decisions in each state to discontinue services from Part C to Part B?

19. University of Hawai`i Hawai`i Part C Service Settings, 2005 Early Intervention Section 2005 1,426 % Program for Develop. Delay 161 11.3% Program for Typical 108 7.6% Home 1,048 73.5% Total-Natural Environments 1,156 81.1% Served in Provider Location 102 7.2% Hospital/Residential 7 0.5% Other 0 0.0%

20. University of Hawai`i Massachusetts Part C Service Settings, 2005 Early Intervention Section 2005 14,023 % Segregated Setting 164 1.2% Program for Typical 1,628 11.6 Home 12,228 87.2% Total-Natural Environment13,85698.9% Served in Provider Location 0 0% Hospital/Residential 2 0% Other 1 0%

21. University of Hawai`i Hawai`i Preschool Settings, 2005 Service SettingsHawai`i State Total National Average Difference Number%% Early Childhood Setting2299.8533.93-24.08 Special Education Setting147463.432.431.0 Home110.472.93-2.46 Split Setting60025.8116.379.44 Residential facility20.09 0.0 Separate school90.392.74-2.35 Itinerant Service0010.40-10.40 Reverse mainstream setting001.14-1.14 Hawaii Department of Education, Special Education Services Branch, Part B Six-Year State Performance Plan (2005-2010).

22. University of Hawai`i Total number of preschool children with IEPs13,384 Total number of preschool children with IEPs in inclusive settings 10,498 Percent of preschool children with IEPs in inclusive settings 78.4 % Massachusetts Preschool Settings, 2005

23. University of Hawai`i Comparison by Least Restrictive Setting, 2005 Program and SettingState Part CHawai`iMassachusetts Natural Environment81.1%98.9% Segregated Setting11.3%1.2% Part BHawai`iMassachusetts Early Childhood (LRE)9.85%78.4 Split25.81%? Special Education63.4%?

24. University of Hawai`i Background on Funding  Concept of “unfunded mandate”  Part C based on state poverty formula  Hawai`i is a minimum allocation state  Part B is based on a child count formula

25. University of Hawai`i Funding Comparisons, 2005 State and Program Federal Funds Children Served $ Per Child Massachusetts Part B$9,978,73713,384$746 Part C$8,350,11414,023$595 Hawai`i Part B$1,016,6812,235$437 Part C$2,160,3173,642$593

26. University of Hawai`i Unfunded Mandate The federal dollars for educating preschool children with disabilities in Hawai`i ($437 per child in 2005) cover only about 2% of the approximately $21,000 in annual costs of educating a preschool child with disabilities.

27. University of Hawai`i Part C Funding Issues  Approximately 90% of the funding comes from State funds  Part C has been chronically under-funded  Emergency appropriations have been required for many years  For the current year, funding is inadequate to serve the number of children referred for services

28. University of Hawai`i Part C Policy Issues  Part C has been described as a “flawed national policy”  No research exists to show that early intervention should end at age three, regardless of the needs of the child and family  Decisions were driven by the compromises to get the legislation enacted rather than best practices

29. University of Hawai`i “For many families, transition means the unwilling severing of a therapeutic relationship with their service providers.” “No wonder many families endure a sharp sense of loss in spite of everyone’s best efforts to make the transition smooth.” -- Talbot Black, 2000

30. University of Hawai`i “I am suggesting that the national policy that emerged from that compromise needs to be examined, even though it has been in effect all these years. And, if the policy does not prove itself to be in the best interests of children and families, then it’s time to think about what needs to be changed.” -- Talbot Black, 2000

31. University of Hawai`i “Thinking about what needs to be changed” succinctly sum- marizes the charge to this Task Force.

32. University of Hawai`i Caveats  First, do no harm!  Design a system responsive to needs, not to birthdays  Do not design another UNDERFUNDED system  Work within other initiatives (Act 259)  Include children with 504 eligibility

33. University of Hawai`i Remember Parents have always been the guiding force in policy, whether in the lawsuits that preceded the initiation of the Education of All Handicapped Children’s Act, the Silva Consent Decree, the Infant and Toddler Program, and this Task Force.

34. University of Hawai`i Family Survey What do we need families to tell us that will help the Task Force decide on policy recommendations to the 2008 State Legislature?

35. University of Hawai`i References Black, Talbot (2000). What is early intervention anyway? Keynote Speech, First AAHBEI International Convention, Chicago, Ill. Black, Talbot (2000). A Flawed National Policy Concerning Early Intervention? Keynote Address, First AAHBEI International Conference, Chicago, Ill. Groves, Ivor (2000). Preschool Study. Honolulu, HI: Center on Disability Studies. Hawaii Department of Education, Special Education Services Branch, Part B Six-Year State performance Plan (2005-2010). Massachusetts Department of Education, Part B Six-Year State Performance Plan (2005-2010). Johnson, Jean L. (1992). A Policy Analysis of the First Component Required by P.L. 99-457: Who will be served? Doctoral Dissertation, University of Hawai`i.

36. University of Hawai`i References (continued) www.ed.gov/about/overview/budget/statetables/index.html www.ideadata.org