1. WELCOME TO FIT FOCUS

2. 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)

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

4. 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)

5. 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.

6. 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

7. 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

8. 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

9. 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

10. 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

11. Tiered Quality Rating Improvement System
FIT FOCUS Document
FIT FOCUS
Tiered Quality Rating Improvement System
Thea does slides with support from Andy

12. 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

13. 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.

14. 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

15. 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.

16. 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

17. 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:

18. 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

19. 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.

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

21. 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

22. 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

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

24. 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

25. 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? ? ? ? ? ?

26. 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?

27. Questions?
Andy does slide 21