1. Comparing Early Childhood Systems IDEA Early Intervention Systems in the Birth Mandate States - 2013

2.  Significant underfunding for Michigan’s early intervention program – Early On (Part C and MMSE)  Lack of sufficient types and intensity of services for many children eligible under “Part C only”  Structural and implementation issues – two-tiered system Reason for the Project 2

3. Project Scope  To learn how other birth mandate states implement IDEA for infants and toddlers- Iowa, Maryland, Minnesota, Nebraska  To compare the other four states’ systems to Michigan’s  To determine ways in which Michigan’s system could be improved  To make recommendations for change 3

4. Process  Formed a MAASE workgroup to determine what information is needed and to compare the states’ systems  Interviewed IDEA Part C leaders from the other states  Created a written report, which…  Summarized states’ information based on survey questions  Compared the other birth mandate states to Michigan  Identified issues facing Michigan  Included recommendations for improvement 4

5. Significant Differences – Michigan to Other Four States  The other four states have a single system, under special education, one pool of children; Michigan has two pools of children  The other four states have one set of eligibility criteria and do not require evidence of educational need; Michigan has two sets of eligibility criteria, MMSE requires evidence of educational need  All eligible children have access to all services based on need; Michigan varies significantly across the state in type and amount of service for “Part C only”, MMSE – access to all services, type and amount based on need 5

6. Significant Differences, cont. – Michigan to Other Four States  The other four states consider all to be eligible for special education, Part C is part of SE continuum (“part of same law”), all direct education services are free due to FAPE; Michigan - approximately 28% are eligible for both MMSE and Part C, 72% eligible only under Part C  The other four states have dedicated state funding ; Michigan – only MMSE has state funding 6

7. Major System Components – Lead Agency and Structure  Iowa – Education, agency partners  Maryland – Education, agency partners  Minnesota – Education, no agency partners  Nebraska – Education/Health and Human Services co-lead; all direct services – Education (special education), service coordination – Health and Human Services  Michigan – Education, agency partners in some areas of the state 7

8. Major System Components - Eligibility  Iowa – Part C categories – DD is 25 % delay 1 or more developmental domains, established conditions  Maryland – Part C categories – DD is 25% delay 1or more domains, established conditions, atypical development  Minnesota – Part C categories and Part B categories – DD is 1.5 SDBM 1 or more domains, established conditions  Nebraska – Part B categories – DD is 2.0 SDBM 1 domain, 1.3 SDBM 2 or more domains, established conditions are covered under other Part B categories  Michigan – Part C – any degree of delay birth to 2 mos., 20% (or 1 SDBM) delay 2 mos. to 3 yrs., established conditions; MMSE – Part B categories 8

9. Major System Components – Most Common Providers  Iowa – ECSE teachers, OTs, PTs, SLPs, SWs  Maryland – ECSE teachers, OTs, PTs, SLPs  Minnesota – ECSE teachers, OTs, PTs, SLP  Nebraska – ECSE teachers, OTs, PTs, SLPs  Michigan – “Part C only” – varies widely, some areas provide all types of services, others may restrict types of services or providers may not have certification or licensure, some may have only a high school diploma; MMSE – ECSE teachers, OTs, PT’s, SLP’s 9

10. Major System Components – Funding of Services  Iowa – state funding, Part C grant, Part B, no local funds used  Maryland – state funding, Part C grant, Part B, some local  Minnesota – state funding, Part C grant, some local  Nebraska – state funding, Part B, some local (Part C grant not used for services or service coordination)  Michigan – “Part C only” – Part C grant, local in some areas; MMSE - state funding, local  All bill Medicaid for eligible services 10

11. Issues Facing Michigan  Lack of capacity to serve, generous eligibility, no state funding  Lack of agency partners across the state  Two-tiered system creates two pools of eligible children, two sets of procedures and requirements, two separate administrative offices at MDE, two or more separate provider entities in many service areas  Two sets of eligibility have resulted in inequity in access to full array of services (sometimes just general parenting topics, curricula designed for typically developing), and amounts of service 11

12. Issues Facing Michigan, cont.  Presumed 50% delay phenomenon  Inequity of eligibility within MMSE for birth to three, thus inequity in access  Two referrals, two evaluations for many  Implementation of “Part C only” services before referral to MMSE  Lack of appropriately credentialed providers  MMSE funding based on FTEs or current reimbursement rate - insufficient for this age group 12

13. Need for State Support  Birth to three is primary period of brain development  Investment in early childhood demonstrates significant savings to investment ratio  Early intervention is meant to be preventative  Michigan is developing broad early childhood system, early intervention needs to be included  Current development of at-risk home visiting programs excludes early intervention 13

14. Need for State Support, cont.  New IDEA Part C indicator (#11) requires states to develop plan for improvement to their EI systems – good timing  Auditor General report finds many problems with current system – need to act on recommendations and use information for improvement  “Great Start, Great Investment, Great Future – The Plan for Early Learning and Development in Michigan” – report identifies the following high leverage areas… 14

15. Need for State Support, cont.  Focus first on children with highest needs  Fund quality  Ensure early childhood service provider quality  Increase access to and capacity of Early On (Early On was cited several times in the report and the survey of stakeholders as significantly lacking in funding and as being of highest need for more state support) 15

16. Recommendations  Develop one cohort of children, all eligible for MMSE – streamlines system, ensures credentialed providers, provides funding base, etc.  Change eligibility – utilize the Part C categories of developmental delay and established conditions and set the DD category at 1.5 SDBM or a 25% delay, for example; remove demonstration of educational need requirement for birth to three  Creates better equity in access to full array and amount of needed services, easier to understand for referral sources, parents, etc. 16

17. Recommendations, cont.  Expand state education funding for birth to three, sustainable and sufficient source – base on child count with supplemental funding similar to system in Minnesota  Unify administration of early intervention into one office at MDE  Include early intervention in multi-tiered early childhood statewide system for birth to three- a) broad (bottom) tier – general parent education for typically developing; b) second tier – at-risk; c) early intervention – highest need, most specialized, most intensive, individualized 17

18. Recommendations for Next Steps for MAASE  Create ad hoc committee, collaborative with MDE (OGS and OSE) to discuss recommendations and begin work on process for change  Contact other professional organizations to seek support and collaboration regarding the above recommendations 18

19. Resources  “Great Start, Great Investment, Great Future – The Plan for Early Learning and Development in Michigan”, MDE, Office of Great Start, May 2013  “Audit Report – Performance Audit of Early On”, MDE, November 2013  “ITCA Tipping Points Survey – Part C Implementation: State Challenges and Responses”  “The Role of Special Instruction in Early Intervention” – Council for Exceptional Children, Division for Early Childhood webinar, July 2011  “Early Intervention for Infants and Toddlers with Disabilities and Their Families: Participants, Services, and Outcomes” – Final report of the National Early Intervention Longitudinal Study (NEILS), January 2007 19

20. Respectfully Submitted By  Stephanie Peters, Chair - MAASE EC CoP; MICC  E-mail: stephaniep044@gmail.com 20