AEIS State Systemic Improvement Plan

Update for ICC 12-10-14

Trend data reminder:

% who substantially increased development in:

FY 2011 FY 2012 FY 2013 FY 2014

Social Emotional 75.8% 75.6% 79.0% 76.1%

Knowledge/skill 83.2% 81.1% 83.0% 82.1%

Behavior to meet needs 83.6% 83.3% 84.1% 82.6%

  2011 2012 2013 2014

% of families who know their rights 96.7% 97.3% 98.5% 99.3%

% of families who feel they have been able to communicate their child’s needs

93.7% 94.0% 95.0% 95%

% of families who feel they can help their child develop and learn 99.5% 96.0% 98.4% 94.2%

Trend data reminder:

State Identified Measureable Result (SIMR)

Based on data, feedback and discussion, AEIS is proposing the following areas of focus:

Social-Emotional development of children

Enabling families to communicate their child’s & family’s needs

Further analysis of social-emotional data

Out of our 50 programs, ten had less than 60% of their children making progress in social-emotional development

Average frequency of services for these 10 programs was 2.3 times per month

Average time in program = 19 months

Ages at entry:

0-1 = 92

1-2 = 132

2-3 = 91

These programs were in the following districts:

District 1 Huntsville ………………… 4 programs

District 2 Birmingham ……………... 1 programs

District 3 Talladega ……………….. 0 programs

District 4 Montgomery ……………. 3 programs

District 5 Dothan …………………… 0 programs

District 6 Mobile ……………………..1 program

District 7 Tuscaloosa ………………. 1 program

Diagnoses in these 10 programs (315 children)

262 with Developmental Delay13 with “other”8 with Down Syndrome8 with Severe Hearing Impairment4 with Cerebral Palsy3 with Spina Bifida3 with Autism2 with TBI2 with Profound Hearing Loss1 with Albinism

1 with CMV1 with Retinopathy of Prematurity1 with Cornelia de Lange Syndrome1 with Hydrocephalus1 with Optic Nerve Atrophy1 with Severe Vision Impairment1 with Seizure Disorder1 with DeGeorge Syndrome1 with Anencephaly

Services listed on the IFSPs of these 10 programs:

• Family Training

• Occupational Therapy Evaluation

• Occupational Therapy Services

• Physical Therapy Evaluation

• Physical Therapy Services

• Service Coordination

• Special Instruction Services

• Speech Language Evaluation

• Speech Language Services

• Vision• Psychological Evaluation (listed 1

time)

Child health index:Low birth rate; Births to unmarried teens; Single parent households; Children in poverty; HS graduation rates

Average rankings per district out of 67 counties

District 1 Huntsville ranking ………………….16

District 2 Birmingham ranking ………………19

District 3 Talladega ranking ……………….. 23

District 5 Dothan ranking …………………… 35

District 6 Mobile ranking ……………………. 42

District 4 Montgomery ranking ……………. 44

District 7 Tuscaloosa ranking ………………. 51

State population rates by race for Alabama children:

Census data:2012 - white – 59%     African American - 30%        Hispanic - 6%-----------------------------------------------------------------------------

EI December 1 Child Count on 12/1/13:  White - 57 % African American - 30%

Hispanic -9%

EI December 1 Child Count on 12/1/12:      White - 58% African American - 31%

Hispanic - 8%

EI December 1 Child Count on 12/1/11:     White - 57% African American - 31%

Hispanic - 8% 

EI stats appear to be consistent with statewide data on race

 

Gender and Medicaid

  2012 2013 2014

Total exiting with no progress in Social Emotional development (statewide)

1028 952 1107

% Female 34% 35% 36%

% Male 66% 65% 64%

% on Medicaid 61% 58% 58%

Of Note:

Consistently more males than females – differing slightly from state numbers.

Analysis of diagnosis vs. developmental delay indicates that, on average, 82% of children making no progress in Social-Emotional have DD, not a specific diagnosis.

System Strengths Identified by Stakeholder Groups

 10.Outcomes based on families’

needs  

11.Eligibility and IFSP development

12.Communication/collaboration

13.Data collection

14.Communication with monitors and programs/agencies

15.TA – support of state office  

RANK ORDER OF IDENTIFITED STRENGTHS (THOSE WITH MULTIPLE COMMENTS): 

1. Services in natural environment

2. Timely services

3. Vision, mission and purpose of EI

4. Quality of programs/services – strong network of providers

5. Child find – consistency of entry into system

6. Family involvement at state and district levels

7. PAR/monitoring

8. Service Coordination

9. Transition

Areas for Improvement Identified by Stakeholder Groups

8. Data collection system & analysis at local level

9. Eligibility – more training in test protocols and use of different tests besides the 4

10.Referrals with social-emotional developmental concerns

11.More training on outcomes

12.Need ESL materials

13.More training for professionals, beyond conference (more in-depth)

14.Seems like focus is more on paperwork at times than the family’s needs and being able to help families more

RANK ORDER OF AREAS IDENTIFIED FOR IMPROVEMENT (THOSE WITH MULTIPLE COMMENTS): 

1. Public awareness

2. Finance/funding

3. Family Involvement – more at district and local levels

4. Quantity of services in selected areas of the state

5. Transition – strengthen relationships with LEA and conduct joint training

6. Local collaboration – increased linkages with referral sources

7. Child find – increase referrals in low referring counties

Theory of Action – Leadership (part 1)

If AEIS… 

Focuses efforts on counties that have a low child health index and low referrals for EI (e.g. Tuscaloosa)

Continues to involve stakeholders

Continues to analyze data

Increases linkages with early childhood initiatives

Posts information to the ADRS website related to SE development

Enhances the family survey related to SE to gather additional data

Assists programs in the use of data in making decisions

Develops a personnel database to identify individuals by discipline, what training they’ve had, vendors, how many SIs are in the system, etc.

Then state and local providers will…

  Be guided in

targeting services in areas and in ways that will enhance the social emotional development of children in EI

Have the information and resources they need to implement AEIS’s vision for children and families

Then children and families will… 

• Have the assurance of a well-coordinated, collaborative, and state supported system of services.

• Have the opportunity to be connected early to the Early Intervention System

 

Theory of Action – Leadership (part 2)

If AEIS… Enhances the Public Awareness efforts to

increase referrals of children birth to one

Develops a PA plan based on the areas of greatest need for SE – in areas where kids are being identified with risk factors for SE development

Continues to drill down data on factors related to outcomes such as time in program, age, and diagnosis.

Develops stronger ties and collaboration with resources in the area of SE

Revises the GIFTS system to better clarify reasons why children did or did not make progress

Continues to involve the commissioner and leadership team in sharing information about the system and services

Then state and local providers will…

  Be enabled to

impact earlier referrals into the system

Have solid data from which to monitor activities and progress

Have stronger ties with other state and community leaders in impacting children and families

Then children and families will…  Have direct access to information on social-emotional development     

Theory of Action – Technical Assistance

If AEIS…  Identifies appropriate tool(s) to

measure SE needs for those children at greater risk for SE issues.

Reestablishes a GIFTS users group to look at the data system and make recommendations (stakeholder continuation)

   

Then state and local providers will… Be supported in delivering high quality and data driven services

Then children and families will… Be assured of quality services that address social-emotional as well as other developmental domains

  

Theory of Action – Professional Development (part 1)

If AEIS… Strengthens the EI mentor program

Provides monthly updates to support the activities of the SSIP around the SE area

Trains on DEC recommended practices

Focuses training on SE and family communication of need

Provides training on evidence based practice

Utilizes stakeholder input to lead training initiatives

Trains and equips families around SE issue

Trains and equips families on communicating their child’s needs

Requires district trainings with district training teams utilizing a SE training package

Identifies specific sessions at the conference around SE and family communicating needs

Reviews the evaluation and assessment procedures to determine training needs in the SE area

Then state and local providers will…  Have personnel

delivering services through AEIS who are better trained and equipped to:

o Provide strategic services that will impact social-emotional development

o Conduct targeted assessments to identify specific areas of need in the SE arena and address those needs

o Assist families in better communicating their child’s needs

 

Then children and families will… • Be better

equipped to be team members and communicate their needs in an effective manner

• Receive evidence-based services

    

Theory of Action – Professional Development (part 2)

If AEIS…  Trains community providers on the ASQ – SE

Develops CSPD linkages with higher education around the SE area

Reviews the Journey and foundational training and adds data and information on making databased decisions

Develops better training on RBI

Develops training on reasons why children don’t make progress i.e., what does time in program mean

Increases training and capacity of local providers to review data and make decisions

Conducts more training on test protocols and use of tests, especially for tools that better assess SE development

Provides guidance on SE area of development and on how to implement evidence based practice

Provides training on completing entry-exit forms

Then state and local providers will…   Have personnel

with additional expertise in the area of social emotional development

Have more precise data in identifying reasons children are and are not making progress

Then children and families will…  Be assured of quality, trained service providers   

Theory of Action - Accountability

If AEIS…  Develops and enhances the PAR to include

factors related to SE

Enhances the quality piece of the PAR

Uses data with leaders to assist stakeholders in making decisions (every committee) and generates reports at every meeting

  

Then state and local providers will…  Have monitoring

practices that can be more focused in the SE and family involvement areas

Have more data available in making service and system decisions

Then children and families will… Be assured that providers are adhering to evidence-based, recommended practice.

Timeline

• December 11 ICC Stakeholder meetingDecember 2013

• Study and preparationJanuary 2014

• Study and preparationFebruary 2014

Timeline

• March 19 ICC Stakeholder meeting• March 24 SSIP Team Meeting• March 17 Staff meeting• March 19 ICC

March 2014

• April 4 Mobile Council Conference• April 16, 21 SSIP Team MeetingApril 2014

• May 5 SSIP Team MeetingMay 2014

Timeline

• June 11 ICC Stakeholder meeting• June 5, 23, 30 SSIP Team MeetingJune 2014

• July 15-16 Journey training stakeholder feedback• July 14, 28 SSIP Team MeetingJuly 2014

• August 11, 25 SSIP Team Meeting• August 19 – Huntsville District

• August 21 – Montgomery District• August 26 – Birmingham District• August 28 – Mobile District• August 27 – Public Awareness Subcommittee Stakeholder meeting

August 2014

Timeline

• September 3 ICC Stakeholder meeting• September 22, 29 SSIP Team Meeting• September 15 Anniston and Birmingham Districts with families• September 18 Tuscaloosa District with families• September 23 Dothan District with families• September 8-10 Outcomes Conference in New Orleans• September 30 Selma District with families

September 2014

• October 8-9, 21-22 Journey training stakeholder feedback• October 6, 15, 20 SSIP Team Meeting• October 27 Program Planning and Evaluation Subcommittee Stakeholder

meeting• October 1 Personnel Subcommittee Stakeholder meeting• October 9 Huntsville District with families

October 2014

• November 3, 24 SSIP Team Meeting• November 17-19 EI/Preschool Conference stakeholder feedbackNovember 2014

Timeline

• December 1, 15 ICC Stakeholder meeting• SSIP Team Meeting• December 2 Tuscaloosa District with familiesDecember 2014

• SSIP Team Meeting• District stakeholder feedback meetings• Final preparation for APR submissionJanuary 2015

• SSIP Team Meeting• Final preparation for March submissionFebruary 2015