1. 1 Infant & Toddler Connection of Virginia Early Intervention System Presentation for Financing Systems Workshop OSEP National Early Childhood Conference Washington D.C. November 1, 2003

2. Infant & Toddler Connection of Virginia 2 Virginia’s Early Intervention System Number of children served4,743 % Children Medicaid eligible40% Eligibility definition broad (25% delay in one or more developmental areas) Local autonomy

3. Infant & Toddler Connection of Virginia 3 Virginia’s Challenges Inconsistent knowledge and use of available interagency resources, private & public funding Continued barriers to accessing public funding sources and EI private insurance benefits

4. Infant & Toddler Connection of Virginia 4 Virginia’ Priorities To maximize the use of available funding, such that all eligible children & families will receive the early intervention services to which they are entitled under Part C of IDEA

5. Infant & Toddler Connection of Virginia 5 How Will We Know It When We See It? All eligible children & families have reduced financial barriers to accessing necessary EI services.

6. Infant & Toddler Connection of Virginia 6 What’s It Going to Take? Sound strategies and reduced barriers for consistent and efficient use of available public & private resources. Increased capacity of Part C staff to support implementation of funding strategies.

7. Infant & Toddler Connection of Virginia 7 What’s It Going to Take? (cont.) Increased capacity of localities to access available funds for service provision. Increased capacity of service providers to access available funds for service provision.

8. Infant & Toddler Connection of Virginia 8 Virginia’s Plan Re-design the finance system to reflect the demographic, political and economic context of the state Renew state interagency agreements and service contracts to clearly establish the parameters of the service delivery approach

9. Infant & Toddler Connection of Virginia 9 Virginia’s Plan (cont.) Implement an integrated data system to assist the local EI system in decision- making and management Increase knowledge of and access to: Potential formal funding at the state, local, and community level Informal community resources and supports

10. Infant & Toddler Connection of Virginia 10 How Far Have We Gotten… Commitment from the interagency management team Priority for the staff and the state interagency council Data collection/management capacity Cost study Prevalence data

11. Infant & Toddler Connection of Virginia 11 What Will the Cost Study Get Us??? Cost study: Statewide total cost of early intervention in Virginia Average hourly cost per direct service person Ratio of direct services to admin & support costs Cost differences relating to different personnel types/ disciplines. Number of children we should be serving The cost for serving all potentially eligible children

12. Infant & Toddler Connection of Virginia 12 What Will the Prevalence Data Get Us??? Variables: General demographics Race/ethnicity information Populations of special consideration Pregnancy and birth information Health challenges and child welfare issues Family households Census data plus information traditionally collected by the State agency responsible for the Maternal Child Health Grant may be used in this study.

13. Infant & Toddler Connection of Virginia 13 What Will the Prevalence Data Get Us??? (cont.) Child Count Data Part B/3-5 Preschool Eligibility Medicaid/SCHIP Eligible And/or Enrolled Income Information Eligibility Information Local Economic Resources

14. Infant & Toddler Connection of Virginia 14 What This Strategic Planning Will Get Us… Determine: If in fact the Part C system is under funded What local autonomy with minimum state involvement should be How to best finance EI services in natural environments State & local funds allocated to EI

15. Infant & Toddler Connection of Virginia 15 What This Strategic Planning Will Get Us… (cont.) Establish: An equitable reimbursement rate for Medicaid If and where personnel shortages exist

16. Infant & Toddler Connection of Virginia 16 Necessary Ingredients for Success Measuring it against “Is it in the best interest of children and families?”… Commitment at the Top (Leadership) Champions and Opinion Leaders Education and skill building Supportive administrative rules Incentives and rewards Feedback mechanisms Long term financing of EI Data Collection/ Management Capacity for decision making and managing the local EI system

17. Infant & Toddler Connection of Virginia 17 Possible Strategies for Fine- tuning the Finance System Determine impact of ability to pay policies & procedures on local & state early intervention system Request additional state dollars

18. Infant & Toddler Connection of Virginia 18 Possible Strategies for Fine- tuning the Finance System (cont.) Improve guidance and Technical Assistance related to use of funds Determine if the definition of eligibility needs to be revised

19. Infant & Toddler Connection of Virginia 19 Ongoing Monitoring Periodic updating of data from original studies Pursue new funding sources as opportunities present themselves and/or as needs change Include items in parent satisfaction survey to determine whether barriers continue to exist and where.

20. Infant & Toddler Connection of Virginia 20 For Further Information Contact: Mary Ann Discenza Part C Coordinator Infant & Toddler Connection of Virginia (804) 371-6592 mdiscenza@dmhmrsas.state.va.us