Journey into Journey into Early Steps Early Steps Phyllis Sloyer, RN, Ph.D, PAHM, FAAP Division Director Children’s Medical Services Network & Related Programs
Journey into Journey into Early StepsEarly Steps
Phyllis Sloyer, RN, Ph.D, PAHM, FAAP
Division Director
Children’s Medical Services Network & Related Programs
AuthorityAuthority
Individuals with Disabilities Education Act
(I.D.E.A), Part C – 20 USC 1431-1443
Code of Federal Regulations – 34 Part 303
Florida Statutes 391 and 393
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Who is Eligible for Early Who is Eligible for Early StepsSteps
System serves children birth to three years of age that have a developmental delay or an established condition that has a high probability of resulting in developmental delay
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Eligibility CriteriaEligibility Criteria Developmental Delay
-1.5 standard deviations below the standard meanin one or more domains on an appropriate
standardized assessment tool-At least a 25% delay in terms of months of age
Developmental Domains: -Communication
-Self-help/Adaptive- Cognitive- Physical (including fine and gross motor and vision and hearing) -Social/Emotional.
Eligibility CriteriaEligibility Criteria
Established conditions fall into one or the following categories: a) Genetic and metabolic disorders; b) Neurological disorder; c) Autism Spectrum Disorder; d) Severe attachment disorder; e) Significant sensory impairment (vision/hearing)
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Eligibility PracticesEligibility Practices
Children referred without an Established Condition must have a multidisciplinary evaluation completed to determine their eligibility.
Children referred with an Established Condition falling in the identified categories are made eligible without an evaluation.
Confirmation of an established condition must be provided by a licensed physician or a healthcare practitioner acting within his/her scope of practice including an audiologist in the case of hearing loss.
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Key ComponentsKey Components
Family Centered Services & Supports within the natural environment
Primary Service Provider Model
Service Coordination
Individualized Family Support Plans (IFSP)
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Natural EnvironmentsNatural Environments
Maximizes each child’s everyday natural learning opportunities
Provides supports and services where children live, learn, and play
Recognizes the power of the relationship between the parent and child
Utilizes a routines-based approach that leads to functional intervention planningMcWilliams 2001 8
Key CharacteristicsKey Characteristics
Individualized service delivery for each child.
Timely service delivery of identified services
Enhance the capacity of families to care for the developmental needs of their child
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IFSP Team ProcessIFSP Team Process
The family is integral member of the team. Addresses the family’s priorities and their desired
functional outcomes. Results in a written plan to authorize services
(IFSP). Determines services on IFSP based on the
individual needs of the child and family and the results of child and family evaluations and assessments.
Addresses timelines for services to begin and end.
Is an ongoing process. 10
FundingFunding
Services authorized by the IFSP team are provided at no cost to families.
There is no income requirement for the Early Steps.
Commercial insurance, Medicaid and other community resources are utilized along with Part C monies to ensure service delivery.
Part C funds must be the payer of last resort for services provided.
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Funding Funding (cont…)(cont…)
37,691 children served
249 children identified with ASD
Most children served are eligible by Developmental Delay
Early Steps spent $47,512,747 or $1,261 per child 12
ChallengesChallenges
Misinterpretation of the IFSP process
Lack of available providers and funding
Late entry of children into the program
Under identification of children13
SupportsSupports
Designated an Autism Spectrum Disorders Liaison in the Early Steps State Office.
Convened an Autism Spectrum Disorders Guidance Workgroup to make recommendations to the Early Steps State Office for the creation of guidelines for children with autism spectrum disorders.
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ResourceResource
Early Steps website:
-http://www.cms-kids.com/Early Steps
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