WELCOME TO FIT FOCUS

Presentation on FIT FOCUS to Cohort III Pilot Sites March 28, 2017 Race to the Top and FOCUS on Young Children’s Learning What is FIT FOCUS? Orientation to FIT FOCUS Pilot and the FIT FOCUS Document IFSP Pilot Activities Building Practitioner Capacity using a Strengths Based Coaching Approach Andy slides 1-2 (Introduction, objectives of presentation and video)

Race to the Top and FOCUS on Young Children’s Learning Our History, Evolution and State Wide Partners

Tiered Quality Rating Improvement System What is FIT FOCUS? FIT FOCUS Tiered Quality Rating Improvement System Andy does 5-8 ( a do-able Cohort Process with support)

FIT FOCUS Goal: To Increase the capacity of Early Intervention Programs to develop and maintain organizational systems that support Early Intervention Practitioners to use family centered and evidence based quality practices.

Guiding Principles for FIT FOCUS Build from within (individuals and program perspective) Build from strengths Work links across the FIT system, Intake to Transition Embedded skill building i.e. coaching, video Embedding Continuous Quality Improvement Performance based system

FIT FOCUS Steering Committee NM Key Principles NM Cross-Sector Group FIT FOCUS Steering Committee ICC Quality Committee FIT FOCUS Stakeholder Group ICC Thea does 3-4 (Input into FIT FOCUS and results of input on making implementation do-able) DEC Recommended Practices

2016 2017 2018 2019 ICC Endorsement of process and document Publish FIT FOCUS Essential Element of Quality doc. Continuation of tool pilots (EI and IFSP) Foundational work in Assessment Identification of 7 pilot sites for 2017. 2017 Develop training on tools and FIT FOCUS process Pilot FIT FOCUS with 3 Elements of Quality (Quality IFSP, EI, and TTA) Collect and analyze data gathered from pilot sites Revise tools and processes based on pilot site feedback Rate Study conducted 2018 Implement FIT FOCUS with initial cohort (5-7 sites) for IFSP, EI, and TTA Finalizing tools and criteria for Assessment Quality Element FIT conducts CQI activities to evaluate effectiveness of FIT FOCUS Cohort 1 Programs receive confidential interim Program Quality Rating. 2019 Cohort 2 starts Cohort 1 Programs receive public Program Quality Rating FIT implements on-going CQI system

Year 2 Year 1 ECN Consultants FIT Team Orientation to FIT FOCUS Orientation and FOCUS Process and Document Training Training on Quality Practices and Tools Internal Self-Assessment Process Identify Program level of Quality Building portfolio (documents and evidence to support rating Verification Interim Process (End of Year 1) EI Program given confidential interim Program Rating and support to develop plans for increasing quality level. Final Verification (End of year 2) Final Rating is published Implementation Phase Utilization of tools and support for improving practices. Year 2 Year 1

Team Work makes it possible ECN Consultant FIT Regional Manager Leadership Consultation on Quality Systems Consultation on Quality Practices Verification of Program Rating for Essential Elements of Quality Consultation on FIT FOCUS document, rubrics, tools, etc. FIT FOCUS Implemented Success support

Tiered Quality Rating Improvement System FIT FOCUS Document FIT FOCUS Tiered Quality Rating Improvement System Thea does slides 12-20 with support from Andy

Each FIT FOCUS Quality Element contains the following: Definition Rationale NM FIT Key Principles Criteria for determining Program Level of Quality Quality Practices FIT FOCUS tools: Self-Assessment Observation Interim Rating

FIT FOCUS On Young Children’s Learning Take a few minutes to become familiar with the document. Turn to the Quality IFSP Section. List on a post it note or piece of paper the following: What phrases or word made you think: “I would like to learn more about this.” “I am glad to see this in the document” Then work with your neighbors in groups of three to compare your answers and jolt down one thing you all three would like to learn and one thing you all three were glad to see. Post these on the wall.

Organizational Systems that Include: Level 2 Policies, procedures, and trainings that support Early Intervention Practitioners to embed FIT FOCUS quality practices into their everyday work. Level 3 Reflective assessments, observations, reflective conversations, and planning activities to improve early intervention practices. Level 4 On-going, strength-based feedback to Early Intervention Practitioners through reflective coaching, reflective supervision, and team/peer support. Level 5 The use of data to implement Continuous Quality Improvement (CQI) activities Program wide which support Early Intervention Practitioners to learn and improve their use of family centered evidence based practices

Quality Element Definition, Rationale and Key Principle. *Below is an example using the FIT FOCUS Essential Element of Quality of Early Intervention (p.12). 2. Quality IFSP  Definition: Functional IFSP outcomes are developed from the routines-based needs identified by families in the Routines Based Interview (RBI). Functional outcomes are developmentally appropriate for the child and reflect the family’s priorities for their child and family. Key Concepts include: Functional outcomes improve participation in meaningful activities; functional outcomes build on natural motivations to learn and do; fit what’s important to families/caregivers; strengthen naturally occurring routines; enhance natural learning opportunities.   Rationale: When functional outcomes are used, the family/caregiver understands that the strategies are worth working on because they lead to practical improvements in child & family/caregiver life; functional outcomes keep the team focused on what’s meaningful to the family/caregiver in their day to day activities (ECTA 2014). If the IFSP is written with functional outcomes and strategies that are routines based and embedded into everyday learning opportunities they are likely to lead the team to implement practices that include the modeling and coaching families need to support them in incorporating strategies into their daily lives. A strong IFSP helps the family/caregiver and their team have a clear focus on the agreed upon outcomes and the strategies needed to meet those outcomes. The IFSP guides the transdisciplinary process by including strategies that illustrate how team members will work together and across disciplines to support the functional outcomes for the child and family/caregiver. Family Infant Toddler (FIT) provider agencies will use the IFSP Quality Rating Scale to review their program’s IFSPs on a systematic basis to insure that IFSPs reflect family priorities, address functional routines-based needs, and provide supports and services to help families implement strategies during daily routines and activities. Key Principle(s) #3,4,5,7 *The FIT FOCUS practices referenced in the rubric levels below are adopted from IFSP Quality Rating Scale.

Criteria for determining Program level of Quality. QUALITY IFSPS Quality Star Levels   Level Two (Emerging) Level Three (Quality) Level Four (High Quality) Level Five (Exemplary) 4.2.1 EI Program has policies and procedures in place to assure that EIPs use the IFSP Quality Review Scale and scoring rubric, including incorporating these uses into job descriptions. u 4.2.2 EI Program assures that EIPs receive training on the use of the IFSP Quality Review l Scale and scoring rubric. 4.2.3 EIPs use IFSP Quality Review Scale to assess their own IFSPs and based on the results of that assessment develop a plan to improve practices that incorporates relevant elements from “How to Improve” sections of the scale. 4.2.4 EI Program provides ongoing support for EIPs’ use of the IFSP Quality Review Scale and corresponding plans to improve practices by providing mechanis.ms such as reflective supervision, coaching, team/peer support EI Program monitors EIPs’ use of the IFSP Quality Review Scale and corresponding plans for improvement and provides feedback via ongoing performance review and/or appraisal mechanisms 4.25 EI Program uses aggregate data from the IFSP Quality Rating Scale to support program-wide improvement of IFSP development, including setting and measuring progress goals for findings on the IFSP Quality Review Scale, and providing targeted performance support activities, e.g., training, team planning, supervision 4.2.6 EI Program’s Continuous Quality Improvement process demonstrates positive program-wide changes as evidenced by improved IFSP Quality Rating Scale findings over time Indicators Quality

IFSP Quality Review IFSP Quality Review Section A: Your Family Service Coordinator:   Child’s Name: Date of IFSP: Reviewer:   Section A: Your Family With family concurrence, there is adequate and clear information on family concerns and resources and these are linked to the child’s participation in family routines. This is a “Must Pass” Section. Check here if the family declined to share information for this area:  Review area Needs Improvement Acceptable Exemplary Item A1 With family concurrence, information about family routines is:   Information about family routines should include: Who participates in the routines? What the child does during the routine? What is enjoyable or challenging about the routine?  not described or is missing information related to the following most common routines: waking up, diapering/dressing, feeding/meals, playtime or playful interactions, bath time, bedtime  described with limited information related to the following most common routines:  described with detailed information related to the following most common routines: AND includes how family concerns/priorities impact specific routines 1 point 3 points 5 points Item A2 With family concurrence, information about family prioritized concerns is:  not adequately described  described but not connected to the challenges in the family’s everyday routines and activities  described and connected to the family’s challenges in everyday routines and activities. (How do the family’s concerns about their child’s development impact the child’s ability to participate in the routine?) Item A3 With family concurrence, information about family resources:  lists resources, though does not describe how the family’s resources provide them with support.  lists resources, and specifies how the family’s resources provide them with support.  lists resources and specifies how the family’s resources provide them with support AND connects them to challenges in the everyday routines. IFSP Quality Review Service Coordinator:   Child’s Name: Date of IFSP: Reviewer:

IFSP Quality Rating Scale   Section A: “Your Family” Everyday Routines, Activities, Places and People in Your Life (pg. 2) Section B: Summary of Relevant Health Information (pg. 78) Section C: Present Abilities, Strengths and Needs (pg. 1112) Section D: Child / Family Outcomes (pg. 1415) Section E: Child / Family Outcomes – Strategies (pg. 1718) Section F: Supports and Services Needed to Achieve Outcomes (pg. 1924) Section G: Natural Environment Justification (pg. 2227) Section H: Periodic Review of the IFSP (pg. 2329) Questions and Answers (pg. 2530)  Purpose  Family Infant Toddler (FIT) provider agencies will use the IFSP Quality Rating Scale to review their program’s IFSPs on a systematic basis to insure that IFSPs reflect family priorities, address functional routines- based needs, and provide supports and services to help families implement strategies during daily routines and activities. This training manual will demonstrate the criteria reviewed for each section of the IFSP and will provide examples to demonstrate the ratings of “needs improvement, acceptable, and best practice”. IFSP Quality Rating Scale Training Manual

Cohort III will start with the following 3 Quality Elements Quality IFSP Transdisciplinary Approach Early Intervention * Foundational work on the Quality Element of Assessment is being done. Assessment will be added as a fourth Quality Element.

TTA Intervention Outcomes Getting to Know You Transition 1st Contacts Referral Intake CME IFSPs Intervention Transition

IFSP Quality Element Activities (3-27-17)   Activities for Lead FSC = BLUE Activities for Program Coordinator = ORANGE Week Activity Support Weeks 1-2 (April 3-14) Lead FSCs Use IFSP Quality Rating Scale to rate 3 IFSPs provided by Suzanne Complete FIT FOCUS QRS Feedback form Submit Rated IFSPs to Suzanne by 4/14/2017.   Suzanne Pope Weeks 3 -4 (April 17-May 29) Suzanne certifies Lead FSCs as “Interrater reliable” by 4/28/2017 Program Coordinator By 4/24/2017 Receive training on FIT FOCUS Star Quality Level Rubric (levels 2-3) Use FIT FOCUS Star Quality Level Rubric to assess system for quality (levels 2-3) Use assessment data to develop Program-level Plan for quality improvement. Complete Pre-Feedback form from Child Trends Linda Askew, Thea Guerin and FIT Provider Manager

Ask the FSCs to complete the Coaching Session Planning Worksheet. Weeks 5-13 May 1-June 30 Lead FSCs/QA who are certified as “inter-rater reliable” do the following activities monthly: Agencies review the IFSP QRS and the purpose of the pilot with all staff prior to any reviews occurring   By 6/30/2017 Collect and review 25% of Program’s initial IFSPs/or minimum of 2 per Lead FSC. Rate the initial IFSPs using the FIT FOCUS IFSP QRS form for each initial IFSP each month Ask the FSCs to complete the Coaching Session Planning Worksheet. Hold coaching conversations to review the tool and the ratings by the FSC and the lead FSC. Use the complete the FIT FOCUS IFSP QRS form and the Coaching Session Planning Worksheet to develop the Quality Improvement Plan Worksheet Provide on-going reflective coaching conversations with FSCs. Enter data into IFSP QRS database weekly

How do we know that we have Reached our Destination? Pilot Evaluation

Goals of Evaluating the FIT FOCUS Identify implementation successes and challenges Examine the effectiveness of new processes Support short- and long-term planning, potential course corrections Document changes in practice and outcomes Source: 2016 Quality Investments: How to Use Administrative Data and Other Sources to Evaluate What is Working. National Center for Early Childhood Quality Assurance http://qrisnetwork.org/lt/2016-quality-investments-how-use-administrative-data-and-other-sources-evaluate-what-working/over

What do we want to know? ? ? Feasibility: Testing our Framework Benefits, Challenges, Training, People, Cost, Time, Scaling up Implementation: Testing our Activities Feedback/Recommendations on criteria, tools, processes, ongoing support Outcomes: Testing our Impact Change in practice, interactive process Verification: Testing our Results How verification is implemented, What are we collecting, Who is collecting information, What information is collected. How will we analyze it? ? ? ? ? ?

Evaluation Questions What would you like to know from the Pilot? What changes in practice (individual/program) and infrastructure would you expect during the pilot?

Questions? Andy does slide 21