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Today’s Purpose

1. Familiarize participants with Early ACCESS.

2. Familiarize participants with Early ACCESS process.

3. Familiarize participants with Early ACCESS documentation requirements.

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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.

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Early ACCESS

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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

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State Requirements for EA

1. Determine the Lead Agency2. State Interagency Coordinating Council3. Develop a Central Directory4. Public awareness program5. Comprehensive child find system 6. Comprehensive system of personnel

development7. Develop eligibility criteria8. Funding 9. Early Intervention Services

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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

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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

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Early ACCESS Regions

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Title V- Public Health

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Child Health Specialty Clinics

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Iowa’s Eligibility Definition:

Children 0 to 3 years of age Known conditions 25% or more delay

Informed Clinical Opinion

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Early Intervention should be:

Community based Coordinated Family Centered Interagency Flexible Available year around

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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

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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)

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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

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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

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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

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Natural Environments

Places where typically developing children would participate in activities

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Transition

Begins at least 90 days prior to the child’s and up to 9 months prior to the child’s 3rd 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.

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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

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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

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Questions?

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Early ACCESS Process

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Initial Referral

Referrals come from anyone including: parents, physicians, child care providers, WIC, foster care

Anyone can make a referral

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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

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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

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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

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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.

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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

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Exiting IFSP

Children with known conditions are eligible for Early ACCESS until their 3rd birthday.

Children who continue to meet state eligibility requirements may continue to receive Early ACCESS until 3rd birthday.

Parents may withdraw their children from the Early ACCESS.

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Questions?

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Early ACCESS Documentation Requirements aka “paperwork”

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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.

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Intake/ Referral Form

Referrals come from many sources Should have discussed referral with

the parent prior to Early ACCESS receiving referral.

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Family Information Page

Contains demographic information Help to know who family is already

involved with---who might need an exchange of information

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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.

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IFSP Evaluations and Assessments

Results of the evaluation are entered based on the domain

RIOT: record review interview observation test

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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?

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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

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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.

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Transition Plan

Documents the plan for the child’s transition/exit at age 3.

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Early Childhood Outcomes (ECO)

Compares children to their peer group ECO form is completed for initial and

annual IFSP and exit from Early ACCESS.

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Service Coordinator Log/ Service notes

This form is used by service coordinators to document contacts or attempts to contact family

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IFSP Meeting Details

Documents meeting type, who is at the meeting, eligibility, and primary setting code.

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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

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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

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Authorization to Release of Health Information

Allows communication and sharing of written health records between IFSP team members

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Meeting Notice

Notifies team about the purpose, location, invited paricipants and date of meeting.

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Prior Written Notice

Written record of decisions. Required anytime a service is

changed, added, or deleted

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QUESTIONS?

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Contact Information

Rae MillerChild Health Specialty ClinicsP) 712-792-4500rae-miller-1@uiowa.eduGale RandallRegional Liaison/Prairie Lakes AEA8P) 712-732-2257grandall@aea8.k12.ia.usCindy WeigelEarly Childhood Consultant, Early Childhood Services BureauIowa Dept. of EducationP) 515-281-8634cindy.weigel@iowa.gov

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