Kentucky’s Early Intervention SystemNovember, 2011

Kentucky’s Early Intervention System (KEIS) has been in existence since 1994. The Cabinet for Health and Family Services, Department of Public Health is the lead agency.

First Steps Regulations address CAPTA:◦ 902 KAR 30:110 (1)(a) The point of entry (POE) staff shall serve

as the local lead agency and shall coordinate child find efforts with:

◦ 6. The local Department for Community Based Services (DCBS) office for cases with a sustained or negligent complaint;

Section 5.4 of the First Steps Policy and Procedures Manual addresses referrals from DCBS in detail.

“The Individuals with Disabilities Education Act (IDEA) 2004 requires states participating in Part C to refer for early intervention services any child under the age of three (3) who is involved in a substantiated case of child abuse or neglect and/or is identified as affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure.

All children referred from DCBS/foster parents with a developmental concern must be screened with both the ASQ-3 and the ASQ: SE as appropriate for age. (ASQ: SE begins at age three (3) months, ASQ-3 begins at age one (1) month).”

Detailed procedures are found at:

http://chfs.ky.gov/NR/rdonlyres/2FA68DC3-86FD-424C-9DB3-99BE1C03021C/0/FirstStepsPolicyProceduresManual7511.pdf (page 32 of 149)

First Steps website: http://chfs.ky.gov/dph/firststeps.htm

Cabinet for Health and Family Services

Department for Public Health

Division of Maternal and Child Health

First Steps

Early Childhood Development Branch

There are fifteen (15) regional Points of Entry (POEs) who serve as the local lead agency. All serve a multi-county district.

POEs accept referrals, handle all intake activities and provide ongoing service coordination.

IFSP early intervention services are provided by a network of approximately 1500 providers (independent and agency)

First Steps Phase of Service Number of Children

Referral & Screening 903

Evaluation 220

Eligibility Determination 65

IFSP (ongoing services) 4675

Total touched by First Steps on a typical day 5863

First Steps providers are expected to understand and implement early intervention services by:

◦Focusing on the family/caregiver as the primary target for intervention

◦Coaching/consulting the family/caregiver using a Primary Service Provider (PSP)

◦Providing services and supports in settings where the family lives and plays

Anyone can call or fax the Point of Entry  (POE) office to refer a child to the First Steps service systems who may have a developmental delay or affecting medical condition.

All Referrals CAPTA Referrals

Data Source: TOTS

6628 Referrals 3754 Eligible

Data Source: TOTS

651 Referrals 515 Eligible & In

service

Note: Part C data collection changed to capture CAPTA referrals mid-year so data represents half a year.

DCBS services are administered through a network of 9 service regions and offices in each of Kentucky's 120 counties.

Programs provided by DCBS include: family support; child care; child and adult protection; and eligibility determinations for Medicaid and food benefits.

DCBS also administers the state foster care and adoption systems and an energy cost assistance program.

DCBS is a primary referral source for First Steps and is a required child find partner.

District Early Childhood Committees (DEICs) are required by the First Steps statute and mimic the state Interagency Coordinating Council (ICC). DCBS participates as a member of the DEIC in some regions of the state.

Children referred due to a suspected developmental delay are screened using two instruments:

◦Ages and Stages Questionaire-3 (ASQ-3)◦Ages and Stages Social-Emotional (ASQ: SE)

◦Established Risk Condition—list of over 240 medical conditions with high probability of disability or developmental delay

◦Significant Developmental Delay– 2 S.D. in one area of development or 1.5 S.D. in two

◦Professional judgment also allowed for eligibility determination in some cases—this is currently used for children with social-emotional disorders.

Children referred due to the diagnosis of an Established Risk Condition are not screened. These children move directly to evaluation for eligibility.

Established Risk Conditions include: Fetal Alcohol Syndrome/Effects, Shaken Baby Syndrome, Head Trauma with Neurological Sequale

What’s not included at this time:◦ Failure to thrive◦Severe Attachment Disorders◦Anxiety Disorders◦And other social–emotional disorders

Kentucky will need to add social-emotional disorders that have a high probability for developmental delay to the Established Risk Conditions as a result of the new federal regulations for Part C.

Terminology..what does Referral mean?

Who is making the referral?

When is the referral made?

Data collection—definitions/standards

Understanding eligibility for First Steps

Paula E. GoffPart C Coordinator

Kentucky Department of Public HealthPaula.Goff@ky.gov

http://chfs.ky.gov/dph/firststeps.htm