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2. Today’s Purpose 1. Familiarize participants with Early ACCESS. 2. Familiarize participants with Early ACCESS process. 3. Familiarize participants with Early ACCESS documentation requirements. 2

3. Purpose of Early ACCESS  The purpose of this system is to identify, coordinate and provide needed services and resources that will help the family assist their infant or toddler (0 to 3 years of age) to grow and develop. 3

4. Early ACCESS 4

5. What is Early ACCESS?  Early ACCESS (EA) is Iowa’s federal program under The Individuals with Disabilities Education Act (IDEA), Part C.  Part C revolves around the family’s needs 5

6. State Requirements for EA 1. Determine the Lead Agency 2. State Interagency Coordinating Council 3. Develop a Central Directory 4. Public awareness program 5. Comprehensive child find system 6. Comprehensive system of personnel development 7. Develop eligibility criteria 8. Funding 9. Early Intervention Services 6

7. Collaboration between the Departments of: Education, Public Health, Human Services and Child Health Specialty Clinics.  The Department of Education is Iowa’s lead agency Required Interagency System 7

8. Service Delivery  Primary Provider of Services: AEAs 9 Regions in the state. Each AEA has an Early ACCESS Regional Liaison  Interagency Partners CHSC Public Health DHS 8

9. Early ACCESS Regions 9

10. Title V- Public Health 10

11. Child Health Specialty Clinics 11

12. Iowa’s Eligibility Definition: Children 0 to 3 years of age Known conditions 25% or more delay  Informed Clinical Opinion 12

13. Early Intervention should be:  Community based  Coordinated  Family Centered  Interagency  Flexible  Available year around 13

14. Service Coordination  An Early ACCESS Service Coordinator is assigned to help families obtain the services and resources they want for their child.  Coordinate the evaluation, determination of eligibility, development of Individual Family Service Plan (IFSP), and linking families with services  Advocate for the family and teach the family how to advocate for their child 14

15. Interagency Partners providing Service Coordination  AEA Some community partners:  Example: Early Head Start Other Contracted Private Providers  Example: Bright Horizons  Maternal Child Health (Title V agencies)  Child Health Specialty Clinics (CHSC)  Dept. of Human Service (CAPTA, Foster Care) 15

16. Individualized Family Service Plan (IFSP)  Should reflect the family’s wishes, hopes and dreams  Family is actively engaged in the planning, implementation and review of services  The IFSP is flexible and changes as the family’s needs change  Must be written within 45 days of referral  Reviewed and/or revised at least every 6 mo  Reassessed annually 16

17. Families receive at no cost:  Comprehensive multidisciplinary evaluation  Individual Family Service Plan  On-going service coordination  Early Intervention services  Medicaid is billed in Iowa---marginal  Private insurance is not billed in Iowa but is in other states 17

18. Early Intervention Services  Assistive Technology  Audiology  Family Training/ Counseling  Health Services  Medical Evaluation  Nursing  Nutrition  Occupational Therapy  Physical Therapy  Psychological  Service Coordination  Social Work  Special Instruction  Speech and Language Pathology  Transportation  Vision 18

19. Natural Environments  Places where typically developing children would participate in activities 19

20. Transition  Begins at least 90 days prior to the child’s and up to 9 months prior to the child’s 3 rd birthday  Child may be transitioned to other community based services  Child may be transitioned to Part B Services, Early Childhood Special services Child is not automatically eligible for Part B. 20

21. One Day Count  Child Count Birth to Three: 3185 children 2.7% of 0-3 population Birth to One: 612 children and 1.54% % of 0-1 population 21

22. Federal Reporting  Indicator 1: Timely Services  Indicator 2: Natural Environment  Indicator 3: Early Childhood Outcome  Indicator 4: Family Centered Services  Indicator 5: Child Find B-1  Indicator 6: Child Find B-3  Indicator 7: Timely Evaluation and Assessment  Indicator 8: Transition C to B  Indicator 9: Monitoring  Indicator 10: Complaints  Indicator 11: Hearings  Indicator 12: Resolution Sessions  Indicator 13: Mediations  Indicator 14: Timely and Accurate Data 22

23. Questions? 23

24. Early ACCESS Process 24

25. Initial Referral  Referrals come from anyone including: parents, physicians, child care providers, WIC, foster care  Anyone can make a referral 25

26. Initial Service Coordination Activities  Gather information about child and family Concerns and resources Screening info Diagnosis info  Coordinate multidisciplinary evaluation  Inform family of rights, procedural safeguards and services 26

27. Eligibility Determination  Has a condition or disability that is known to have a high probability of later delays if early intervention services were not provided Examples: down syndrome, prematurity, lead poisoned, in foster care, drug exposed, cerebral palsy, etc. OR  Is already experiencing a 25% delay in one or more areas of development as determined by multidisciplinary evaluation. OR  As determined by Informed Clinical Opinion 27

28. Write the PLAN: IFSP  Must be done within 45 days of referral  All have Service Coordination  Services may include: EA services Non-EA services related to outcomes 28

29. Interim IFSP  Used when Early ACCESS services need to be provided to the child and family before the comprehensive multidisciplinary evaluation is completed.  The 45-day timeline must be followed and appropriate documentation completed. 29

30. Review the Plan  Periodic Review: At least every 6 months the IFSP plan will be reviewed.  Annual Review: At least once every 12 months from the date of the initial IFSP, the child will be reassessed and the plan updated  Transition Planning would occur as part of the above meetings 30

31. Exiting IFSP  Children with known conditions are eligible for Early ACCESS until their 3 rd birthday.  Children who continue to meet state eligibility requirements may continue to receive Early ACCESS until 3 rd birthday.  Parents may withdraw their children from the Early ACCESS. 31

32. Questions? 32

33. Early ACCESS Documentation Requirements aka “paperwork” 33

34. IFSP-Legal Document  An IFSP is not an IEP for little kids  IEP’s contain information about what teacher needs to do or the support the child will have while in the school building or accessing the school building.  The IFSP is Family Centered and looks at the entire child, and their family. 34

35. Intake/ Referral Form  Referrals come from many sources  Should have discussed referral with the parent prior to Early ACCESS receiving referral. 35

36. Family Information Page  Contains demographic information  Help to know who family is already involved with---who might need an exchange of information 36

37. Family Statements  Family statement must be completed; however the family may decline the family-directed assessment.  Important that parent’s perspective is a part of the over-all development of the IFSP process  Helps give service providers insight into the family and their needs. 37

38. IFSP Evaluations and Assessments  Results of the evaluation are entered based on the domain  RIOT: record review interview observation test 38

39. IFSP Outcomes  These are the “goals”  What are we going to be working on?  What will it look like?  How will we know when we get there?  How are we doing? 39

40. IFSP Early Intervention Services  Services that Early ACCESS is RESPONSIBLE for providing  What parents can expect to receive  Entry of this information may be essential for Medicaid 40

41. IFSP Other Services  Services that the child receives that are NOT the responsibility of Early ACCESS to provide.  Services must be related to an outcome. 41

42. Transition Plan  Documents the plan for the child’s transition/exit at age 3. 42

43. Early Childhood Outcomes (ECO)  Compares children to their peer group  ECO form is completed for initial and annual IFSP and exit from Early ACCESS. 43

44. Service Coordinator Log/ Service notes  This form is used by service coordinators to document contacts or attempts to contact family 44

45. IFSP Meeting Details  Documents meeting type, who is at the meeting, eligibility, and primary setting code. 45

46. Consents  Early ACCESS Evaluation with Prior Written Notice form  Consent for Early ACCESS Services form  Parent/Guardian Authorization form for Medicaid Reimbursement for IFSP Services 46

47. Authorization for Exchange of Information  Makes sure that everyone can contribute to the child’s plan  Allows communication between service providers on the IFSP team from multiple agencies 47

48. Authorization to Release of Health Information  Allows communication and sharing of written health records between IFSP team members 48

49. Meeting Notice  Notifies team about the purpose, location, invited paricipants and date of meeting. 49

50. Prior Written Notice  Written record of decisions.  Required anytime a service is changed, added, or deleted 50

51. QUESTIONS? 51

52. Contact Information Rae Miller Child Health Specialty Clinics P) 712-792-4500 rae-miller-1@uiowa.edu Gale Randall Regional Liaison/Prairie Lakes AEA8 P) 712-732-2257 grandall@aea8.k12.ia.us Cindy Weigel Early Childhood Consultant, Early Childhood Services Bureau Iowa Dept. of Education P) 515-281-8634 cindy.weigel@iowa.gov 52