1. North Carolina Infant Toddler Program 0 Strategies Statewide State Legislative request for funding (for some areas of State) Revised IFSP Intensive Statewide Technical Assistance Development of Local Improvement Strategies (See handout) Development of Local QA Process QA Coordinator quarterly meetings

2. North Carolina Infant Toddler Program 1 TABs

3. North Carolina Infant Toddler Program 2 CHILD OUTCOMES

4. % Positive Social-Emotional Skills Data FY 2009 CDSAabcdeTotal “A”2%23%15%28%33%100% “B”2%15% 21%47%100% “C”0%14%18%35%33%100% “D”1%8%14%38%39%100% “E”1%14%30%40%15%100% “F”1%45%11%15%28%100% “G”1%28%55%15%0%100% “H”0%30%11%31%28%100% “I”2%10%25%38%26%100% “J”1%13%16%27%43%100% “K”1%26%18%31%25%100% “L”1%9%36%47%8%100% “M”0%18%26%32%24%100% “N”1%27%15%33%23%100% “O”1%12%10%27%50%100% “P”3%21%30%31%16%100% “Q”0%28%31%15%26%100% “R”2%24%19%31%24%100% NC Totals1%19%21%31%28%100% NC Statewide Data: Review for Outliers *Upon review of all outliers in each outcome area it was noticed that both CDSA “F” and CDSA “G” had consistent outliers in ALL three outcome areas.

5. North Carolina Infant Toddler Program 4 CDSA “F”

6. North Carolina Infant Toddler Program 5 CDSA “F” Comparison to State Development Areaabcde Positive CDSA “F”1%45%11%15%28% NC1%19%21%31%28% Acquiring CDSA “F”0%42%23%30%4% NC1%18%31%41%10% Taking CDSA “F”1%42%11%38%8% NC1%19%23%44%14%

7. North Carolina Infant Toddler Program 6 CDSA “F” comparison to State

8. North Carolina Infant Toddler Program 7 CDSA “F” Drill Down Looked at CDSA “F” county by county Eligibility Categories a-e categories by outcome area Actual entry and exit ratings for children

9. North Carolina Infant Toddler Program 8 CDSA “F” Data Themes Eligibility Category Reviewed children by eligibility category Found low number for established conditions Unable to conclude that high “b” percentages are in fact due to the type of children served

10. North Carolina Infant Toddler Program 9 CDSA “F” Data Themes a-e categories by outcome area Reviewed the 8 counties in this catchment area Found one county that was significantly higher than the catchment area’s average in all three outcome areas. Exclusion of this county from the CDSA’s totals increase both SSI and SSII by 4-5%

11. North Carolina Infant Toddler Program 10 CDSA “F” Data Themes Actual entry and exit ratings At entry more children received ratings of 4 and 5 than all other ratings combined. At exit, although making progress these children received a rating at or below the number received at entry.

12. North Carolina Infant Toddler Program 11 CDSA “F” Next Steps Discussions with management team Look at how CDSA is coding Developmental Delay vs. Established Condition Take a look at actual completed COSFs Drill down further at the county level

13. North Carolina Infant Toddler Program 12 CDSA “G”

14. North Carolina Infant Toddler Program 13 CDSA “G” comparison to State Development Areaabcde Positive CDSA “G”1%28%55%15%0% NC1%19%21%31%28% Acquiring CDSA “G”1%33%62%4%0% NC1%18%31%41%10% Taking CDSA “G”1%29%57%13%0% NC1%19%23%44%14%

15. North Carolina Infant Toddler Program 14 CDSA “G” comparison to State

16. North Carolina Infant Toddler Program 15 CDSA “G” Drill Down Looked at CDSA “G” county by county Eligibility Categories a-e categories by outcome area Actual ratings for children at entry

17. North Carolina Infant Toddler Program 16 CDSA “G” Data Themes Eligibility category Reviewed children by eligibility category and concluded 80.14% of children are served under the DD category and 19.86% served under EC Therefore, one would not expect all children to have a delay in ALL three outcome areas

18. North Carolina Infant Toddler Program 17 CDSA “G” Data Themes a-e categories by outcome areas Ratings and outcome areas looked consistent across the 10 counties.

19. North Carolina Infant Toddler Program 18 CDSA “G” Data Themes Actual ratings at entry At time of entry NO child received a rating of 6 or 7 in ANY of the outcome areas.

20. North Carolina Infant Toddler Program 19 CDSA “G” Next Steps Discussion with management team about usage of COSF Look at some actual completed ratings Analyze further the types of children served and begin to ask more questions such as Higher % of children eligible for Part B when compared to the state? Children made eligible by speech only? Clinical opinion?

21. North Carolina Infant Toddler Program 20 North Carolina

22. North Carolina Infant Toddler Program 21 NC next steps Complete this type of quality check for each of the 18 CDSAs Looking for both high and low outliers Provide TA tailored to identified themes. CDSA specific Regional Statewide

23. North Carolina Infant Toddler Program 22 Questions??? For additional information, refer to our website www.ncei.org