1. 5/2010 Focused Monitoring Stakeholders May 2010

2. 5/2010 Purpose: Massachusetts Monitoring System  Monitor and evaluate program compliance with federal Part C IDEA and Massachusetts DPH EIOS  Monitor and evaluate vendor and program contract activities  Contribute to ongoing quality improvement of programs and vendors to assure a baseline of quality services for all families participating in Massachusetts EI System

3. 5/2010 General Supervision Vision Statement  General Supervision of Early Intervention in the Massachusetts system is designed to promote core values and to ensure compliance with federal and state requirements through training, technical assistance, and monitoring.  General Supervision focuses on identifying commendable practices, suggesting improvements to enhance quality of services and specifying and enforcing corrective actions in areas of non- compliance. Revised 6/30/04, MA Stakeholders Group

4. 5/2010 Process: Collecting/Verifying Data Five Components of the Massachusetts Monitoring System Annual Report/Self Assessment Focused Monitoring Site Visit Data Verification Process Dispute Resolution System Local Program Determinations

5. 5/2010 Massachusetts Focused Monitoring Components of the Massachusetts Focused Monitoring Process Analyze data –select programs Scheduling/Annual Calendar Desk Audit/ Hypothesis Setting Onsite Activities/ Exit Interview Focused Monitoring Summary Report

6. 5/2010 Analyze data: Selecting programs  Complete selection of all EI programs in priority areas  Priority areas may change based on current issues and concerns in the EI system  Used most current data First six months of FY ‘10

7. 5/2010 Priority Areas/Data Sources Data/ EIIS Issues  EIIS report on enrolled IFSP children whose eligibility was ineligible, missing or undetermined Program with the highest percentage of ineligible, missing or undetermined

8. 5/2010 Priority Areas/Data Sources Clinical Judgment  EIIS report on enrolled IFSP children whose eligibility is clinical judgment Program with the highest number of children enrolled based on clinical judgment  Information gathered in this priority area will be used to inform practice on the use of clinical judgment throughout the EI system

9. 5/2010 Priority Areas/Data Sources Transition Practices  EIIS report on children receiving services after 21 days from ineligibility determination Program with highest number of children receiving services after 21 from ineligibility determination Program with the highest number of children receiving services over 45 days from ineligibility determination

10. 5/2010 Priority Areas/Data Sources Comparison of units of service/ Number of Clients  DPH generated report through service delivery data  FY’ 09 & FY’ 10 comparison of number of clients served, number of hours of service and percent of change

11. 5/2010 Components of Focused Monitoring Scheduling Cycle  March of every year the DPH will analyze data and select programs based on indicators/data sources collected from the previous year  Programs selected for each priority area to receive an onsite visit for a total of 10 visits per fiscal year  EIPs will be notified in May/June  Onsite visits will begin in July/ August

12. 5/2010 Selection of a program for an onsite visit does not directly relate to compliance.

13. 5/2010 Team Composition DPH Regional Specialists Focused Monitoring Parent Coordinator Parent Team Member

14. 5/2010 Components of Focused Monitoring Pre-Audit Interview/ Conference Call  Meeting with the program director of selected program and focused monitoring team Discuss reason for selection Gather information from program director Identify other data sources to be reviewed at desk audit

15. 5/2010 Components of Focused Monitoring Desk Audit  Prior to the onsite visit  Pre-Onsite data collected reviewed by monitoring team  Focus on the priority area for which the program was selected What do we know now? What do we want to look at before the onsite? What do we want to learn onsite and how do we get it?  Plan for onsite visit

16. 5/2010 Components of Focused Monitoring Hypothesis forming  Infrastructure  Policies and Procedures  Professional development and training  Practices  Data  Supervision  Form hypothesis based on data submitted  Share the hypothesis with program director  Give program director opportunity to provide feedback on the hypothesis and share program thoughts about data

17. 5/2010 Components of Focused Monitoring Onsite Protocols  Interviews Families Staff Administration  Meet with program director to review onsite visit schedule  Review both team and program hypothesis  Record review Tailored to address specific priority area

18. 5/2010 Components of Focused Monitoring Onsite Protocols  Exit Interview Monitoring Team will meet with the Program Director and other interested administrative staff at end of the onsite visit to summarize the results of the visit  Focused Monitoring Summary Report Within one month of onsite visit monitoring team will send report summarizing the results and findings

19. 5/2010 Remember: The goal of focused monitoring is to develop a hypothesis, drill down by examining information in order to best provide support and technical assistance to a program and inform policy decisions

20. 5/2010 Components of Focused Monitoring Follow Up Visits  As needed, members of the team will be available to the program for Technical assistance and support as identified in the summary report