1. Using Data to Improve States' Service Coordination Infrastructure Chelsea Guillen, Illinois EI Ombudsman & Pam Thomas, Missouri Part C Coordinator October 2014, DEC International Conference, St. Louis, MO

2. Agenda  Review of state information  Illinois projects  Missouri projects  Lessons learned/Conclusions

3. Illinois At-a-Glance  Lead Agency is the Department of Human Services  25 Child and Family Connections (CFC) Offices  Eligibility  Child Count  Dedicated Service Coordinator Model  Providers and Service Delivery Model

4. Missouri At-a-Glance  Lead Agency is Education  10 System Point of Entry (SPOE) Offices  Eligibility  Child Count  Shared Service Coordinator Model  Providers and Service Delivery Model

5. Illinois- Program Integrity Project  Substantial caseload growth between 1999 and 2010  Performance contracting began in 2002  Resulted in significant program improvement  Troubling trends detected  Question : Are we serving the right kids, with the right services, in the best way?

6. Illinois- Program Integrity Project  Project Principles :  Equality  Fidelity  Stability  Project Activities :  Increased training/retraining  Change in monitoring  Evaluation of service coordination model  Employment of system ombudsman

7. Illinois- Program Integrity Project  Used data to identify concerns  Varying concerns at each CFC  Issues addressed included:  High levels of service  Reduced under 1s participation  Provider shortages  Transition challenges  Reduced service in natural environments  Strategies for addressing challenges varied

8. Illinois- Program Integrity Project Example  Issue:  High levels of service on IFSPs  Analysis:  Provider trends  Service change justification forms  Outcomes:  Created case presentation form  Provided training on effective meeting facilitation  Deliver ongoing technical assistance to avoid troubling trends  Revised monitoring tool and process for completion

9. Missouri- Eligibility Forecasting and Service Coordinator Caseload Study Purpose of the Study:  Substantial growth in child count between 2007 and 2011  5-year contract re-bid will occur in 2013-14 Critical Questions:  How many children should we expect to serve in Part C?  Are we capturing the types of data necessary for program evaluation and improvement?  What is the most efficient model to serve families in Part C?

10. Missouri’s Eligibility Forecasting Findings from the Study  Although the general population of Missouri children age birth to three indicates a declining trend, the number of children participating in Missouri Part C steadily increased between 2006 – 2012.  Given the state’s current eligibility criteria, Missouri Part C is projected to serve between 2.35% and 2.45% of the birth to three population between 2012 and 2016, an increase from prior projections of 1.65% to 1.85% in 2006. Full report available online at: http://dese.mo.gov/sites/default/files/se-fs-sicc- phillipsandassociatesreportsicc11912.pdf

11. Missouri’s Caseload Efficiency Findings from the Study  State’s Part C system should have a clear definition of service coordinator duties, based on the state’s infrastructure.  Part C caseloads should give a range to accommodate various referral and IFSP activities. For Missouri Part C service coordinators, a caseload size of 40 to 60 children is a reasonable range.  Allow flexibility in the model of service coordinator operations to accommodate geographic diversity in a state.  Consider ways to streamline state information and minimize non-essential tasks that are time-consuming. Full report available online at: http://dese.mo.gov/sites/default/files/se-fs-sicc- combocaseloaddatapresentationsiccFINAL.pdf

12. The Impact of Using Data in Missouri and Illinois Part C Programs

13. Missouri - Measuring Performance using a Needs Assessment and Benchmarks Purpose:  Need to evaluate the model selected for the region  Need to identify and evaluate best practices in early intervention  Need to collect observational data  Need to target training topics and technical assistance Practice:  Create regional plan for needs assessment (Year 1)  Develop benchmarks of essential practices (Year 1)  Implement regional plan and targeted TA (Year 2)  Document regional results compared to benchmarks (Years 2 and 3)... Repeat!  Connect theory to practice

14. Missouri – Needs Assessment*  Operational Model for Service Coordination ** – Assessment activities include, but are not limited to, evaluation of service coordinator performance, observations of intake and IFSP meeting activities from a sample of service coordinators, use of shared service coordination activities and a review of activities related to IFSP procedures. *The state provides a list of suggested tools but does not require a specific tool to collect observational data. The contractor identifies the tool to use based on regional needs. **The contract lists three needs assessment requirements. In addition to the service coordinator aspect, the contract also requires assessing the structure and activities of interagency councils and assessing the practices of service providers.

15. Missouri – Benchmarks Example (draft)

16. Illinois- Evaluating the Usefulness of a Service Coordination Checklist  Purpose  Looking for supports to improve service coordination  Aligning of activities with responsibilities  Development of training tool/file review form  Identification of training needs  Recruited two CFCs  North- 25 SCs  South- 5 SCs  Introductory webinar  FTF session at conference  Support during pilot

17. Illinois- Service Coordination Checklist  Eight checklists  Intake through Transition  Similar format emphasizing partnerships  Indicate completion of task  Make notes about clarity/confusion

18. Illinois- Service Coordination Checklist SouthNorth

19. Illinois- Service Coordination Checklist  General findings  Service coordinators critically evaluated utility of tool  Provided feedback about confusing terms and redundancies  Better performance when checklist aligned more closely with procedure manual  Lower performance for recommended (versus required) practices, i.e. spirit of the law versus letter of the law  Alternate formats were suggested  CFCs shared other documents that they use for supporting SCs  Provided information about SCs knowledge base and training emphases

20. Lessons Learned  It is critical to include stakeholders in efforts that will impact their work  Stakeholders support needs for data use vary; interpretation/understanding impacted by perspective  Need to be purposeful and focused, there is a lot of data in Part C  Using data to inform practice requires more than one data source  Quantitative data is one source of information  Qualitative data can also be important  Gathering data is only the first step in evidence-inference-action process  Data can and should be used to inform change

21. Conclusions Using data,  Gaps and overlaps can be found in service coordination systems  Early intervention competencies can be articulated  Home visiting practices can be enhanced  Improved Part C services can be delivered “If you continue to do things the way you’ve been doing them, you will continue to get the results you’ve been getting.” - Author Unknown