BABIES CAN'T WAIT Early Intervention Program 1999-2000 Annual Report officers STATE INTERAGENCY COORDINATING COUNCIL FOR EARLY INTERVENTION PROGRAMS Walter Black Chair Parent Lynn Feldman, MD Vice Chair Public Provider January 1, 2001 The Honorable Roy Barnes Governor 203 State Capitol Atlanta, Georgia 30334 Dear Governor Barnes: members Juanita Blount Clark Millagros Cordero Lanier Dasher Bridget Davis Blanche DeLoach, RD, LD Robert Lawrence Phil Pickens Susan Maxwell Betty Nelson Tish Seay, EdD Russ Toal Kathleen E. Toomey, MD, MPH Cindy Vail, PhD mission The mission of the Georgia ICC is to advise and assist the Department of Human Resources, Division of Public Health, and other agencies responsible for serving infants and toddlers, birth to age three with developmental delays and disabilities and their families, in providing an appropriate, family-centered, comprehensive service delivery system which promotes optimal child development and family functioning. On behalf of the State Interagency Coordinating Council (SICC) for Early Intervention Programs and the Babies Can't Wait Program, I am pleased to submit the annual report for Georgia's early intervention program. This report covers the fifteen month period from July 1, 1999 to September 30, 2000. Early intervention is a service delivery program for infants and toddlers from birth to age three with developmental delays or disabilities, and their families. Georgia calls this program Babies Can't Wait in recognition of the fact that development in the early years of a child's life is critical to his or her overall well being. Babies Can't Wait is family-centered and community-based, and works equally with all families in our culturally diverse state. The focus over the previous period has been on enhancing collaboration across all programs and services that are available for children in Georgia. This includes sharing of resources and the development of common policies which will minimize duplication and strain on Georgia's families and children. Additionally, the state continues to work closely and collaboratively with the local school systems and the Department of Education. By far the largest undertaking of the Council was our participation in Georgia's Self Assessment Report to the Office of Special Education Programs (OSEP). Members of the Council along with parents, providers, and other partners from across the state met as a Steering Committee over a seven month period to complete a comprehensive self-assessment of the Babies Can't Wait Early Intervention system. This report marked the beginning of a continuous evaluation of our system which will include improvement planning and implementation. The Council will continue to participate as a partner in the work of the Steering Committee to strive for qualtiy services for infants and toddlers with special needs and their families. The members of the SICC come from a wide variety of backgrounds and live all over the state, but we join together to bridge gaps in understanding, to cut across organizational boundaries, and to work together. We remain committed to working with state agencies, service providers, legislators, higher education faculty, and families to ensure that young children with disabilities receive appropriate, quality, individualized care. We do all of this for the children of Georgia who deserve to grow up healthy, productive, and happy. We thank you for your support of our efforts. Sincerely, Walter Black Chair State Interagency Coordinating Council contents 2 Our System 2 What is Babies Can't Wait? 3 About Us: Who is Eligible? 3 How Does a Family Find Us? 4 Contacts: How to reach your local BCW Office 6 Eligibility 6 Service Delivery 7 Resources 8 What Services Are Provided 8 Where Services are Provided 9 Funding 9 Transition 10 SICC: What is the State Interagency Coordinating Council? 10 State ICC Membership 11 LICC: What are Local Interagency Coordinating Councils? 11 1999-2000 Allocations 12 Quality Assurance 13 Georgia Child Count Data 14 Referrals 14 Credentialing System 16 Activities and Progress 18 Challenges 19 Goals: Looking Ahead to the New Millenium 20 Georgia Department of Human Resources 1 our system The Babies Can't Wait system strives to identify developmental problems in their earliest stages, enabling treatment to be administered when most beneficial to the child. 1 concerns about a developmental delay 2 referral from Family Teacher Child Nurse Social Care Doctor Worker Others 3 entry into BCW Intake/Information Gathering Evaluation Determination of Eligibility Assessment for Programming If ineligible, referral to community programs 4 IFSP (Individualized Family Service Plan) Identify team members Identify concerns, priorities, & resources of the family Determine goals and outcomes related to the child's development Identify services, providers, & fund sources Develop a written plan Begin services Review progress and changing needs 5 transition plan To local school system, Head Start, and/or other services/programs 2 what is babies can't wait? Babies Can't Wait (BCW) is a comprehensive, family-centered, coordinated, multidisciplinary system that provides early intervention services to infants and toddlers with disabilities or developmental delays and their families. The BCW system is implemented under Part C of the Individuals With Disabilities Education Act (IDEA). Georgia has participated in Part C of IDEA since 1987. BCW is administered by the Georgia Department of Human Resources, Division of Public Health, Family Health Branch. For families of eligible infants and toddlers, BCW provides a window of opportunity for their children to grow, learn, and develop to their fullest potential. For professionals, BCW is the chance to give infants and toddlers, whose brains are growing very quickly, the opportunity to gain skills, and the chance to teach families to help their children learn these skills. It is the collaboration between families and professionals that makes BCW so unique. For more information, visit the BCW web site at http://health.state.ga.us/programs/bcw/index.shtml. You can contact the State Babies Can't Wait office at 404-657-2726 or toll free at 1-888-651-8224. about us who is eligible? Part C of IDEA is designed for children from birth to age three years who need early intervention services and supports because they are experiencing a significant delay in one or more of the following areas of development: physical, cognitive, communication, social/emotional, or adaptive; or because they have a diagnosed mental or physical condition that has a high probability of resulting in a significant delay. To be eligible for BCW, children must meet one of the specific eligibility criteria defined below (NOTE: There are no income eligibility requirements for BCW): 1) ESTABLISHED CONDITION A child with a diagnosed mental or physical condition that is known to result in a developmental delay, even when no delay exists at the time of the referral; or 2) DEVELOPMENTAL DELAY A child with a significant developmental delay that is confirmed by a qualified multidisciplinary team. how does a family find us? Anyone, including a parent, who is concerned about an infant's or toddler's development may make a referral to BCW. Participation is voluntary. Referrals can be made to the BCW Central Directory at 1-800-229-2038 or 770-451-5484 in Atlanta, or to the local health department's Children 1st Coordinator. The Directory is operated by Parent to Parent of Georgia, a statewide parent-run organization. In addition to obtaining information about BCW, parents can also be matched with supporting parents whose children have similar disabilities. Visit the Parent to Parent web site at www.parenttoparentofga.org. Referrals may also be made directly to a local BCW office. There is a BCW office in each of the 19 public health districts making the program available statewide. Each district includes from one to sixteen counties. Referrals should be made to the district which includes the county where the family lives. The contact list for each health district follows. 3 contacts How to reach your local Babies Can't Wait office Health District 1-1: Rome Babies Can't Wait Program 501 Broad Street, Suite 211 Rome, GA 30161 (706) 802-5072 FAX: (706) 802-5309 Counties Served: Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker Health District 1-2: Dalton Babies Can't Wait Program 501 N. Main Street, Suite B Jasper, GA 30143 (706) 692-4540 FAX: (706) 692-4544 Counties Served: Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield Health District 2: Gainesville Babies Can't Wait Program 1856-103 Thompson Bridge Road Gainesville, GA 30507 (770) 531-4053 or 1-800-204-8731 FAX: (770) 538-2784 Counties Served: Banks, Dawson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White Health District 3-1: Marietta Babies Can't Wait Program 1650 County Services Parkway Marietta, GA 30008 (770) 514-2357 FAX: (770) 514-2803 Counties Served: Cobb, Douglas Health District 3-2: Atlanta Babies Can't Wait Program 151 Ellis Street, NE Atlanta, GA 30303 (404) 730-4027 FAX: (404) 730-4038 County Served: Fulton Health District 3-3: Forest Park Babies Can't Wait Program 7146 Southlake Parkway Morrow, GA 30260 (770) 960-9961 FAX: (770) 960-9664 County Served: Clayton 4 Health District 3-4: Lawrenceville Babies Can't Wait Program 320 West Pike Street Lawrenceville, GA 30045 (770) 339-5064 FAX: (770) 339-5345 Counties Served: Gwinnett, Newton, Rockdale Health District 3-5: DeKalb Babies Can't Wait Program 440 Winn Way/P.O. Box 987 Decatur, GA 30031 (404) 508-7981 FAX: (404) 294-6316 County Served: DeKalb Health District 4: LaGrange Babies Can't Wait Program 122 Gordon Commercial Drive, Suite A LaGrange, GA 30240 (706) 845-4035 FAX: (706) 845-4038 Counties Served: Butts, Carroll, Coweta, Fayette, Heard, Henry, Lamar, Meriwether, Pike, Spalding, Troup, Upson Health District 5-1: Dublin Babies Can't Wait Program 1835 A Highland WestGate Dublin, GA 31021 (478) 275-6841 or Toll Free 1-888-262-8305 FAX: (478) 274-7893 Counties Served: Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Health District 5-2: Macon Babies Can't Wait Program 2520 Riverside Drive Macon, GA 31204 (478) 745-9200 or Toll Free 1-888-449-0108 FAX: (478) 745-9040 Counties Served: Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson Health District 6: Augusta Babies Can't Wait Program 1916 North Leg Road Augusta, GA 30909 (706) 667-4279 FAX: (706) 667-4278 Counties Served: Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes Health District 7: Columbus/Americus Babies Can't Wait Program 705 17th Street, Suite 208 Columbus, GA 31902-00672 (706) 327-0189 FAX: (706) 327-1355 or P.O. Box 672 Americus, GA 31709 (229) 931-2980 FAX: (229) 931-2471 Counties Served: Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster Health District 8-1: Valdosta Babies Can't Wait Program 2700-C North Oak Street Valdosta, GA 31602 (229) 245-6565 or 1-800-247-6538 FAX: (229) 245-6561 Counties Served: Ben Hill, Berrien, Brooks, Cook, Echols, Irwin, Lanier, Lowndes, Tift, Turner Health District 9-3: Brunswick Coastal Babies Can't Wait/Early Intervention Program 1609 Newcastle Street, Room 307 Brunswick, GA 31520 (912) 264-3961 FAX: (912) 262-2315 Counties Served: Bryan, Camden, Glynn, Liberty, Long, McIntosh Health District 10: Athens Babies Can't Wait/Early Intervention Program 1077 Baxter Street. Suite H Athens, GA 30601 (706) 369-6101 FAX: (706) 369-5709 Counties Served: Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton Health District 8-2: Albany Babies Can't Wait Program 1306 South Slappey Blvd., Suite A Albany, GA 31707 (229) 430-2700 or (229) 522-3627 FAX: (229) 420-1156 Counties Served: Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth Health District 9-1: Savannah Babies Can't Wait Program 11706 Mercy Boulevard, Building #8 Door B Savannah, GA 31420 (912) 921-7480 FAX: (912) 921-7490 Counties Served: Chatham, Effingham Health District 9-2: Waycross Babies Can't Wait Program 1718 Reynolds Street Waycross, GA 31501 (912) 284-2552 or 1-800-429-6307 FAX: (912) 287-6689 Counties Served: Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne 5 eligibility To evaluate the developmental status in the areas listed below, the state must provide a team that includes representatives from at least two different professional disciplines, who are trained to utilize appropriate methods and procedures. Depending on the presenting needs of the child, the team may include audiologists, physical therapists, nutritionists, social workers, speech and language pathologists, and other professionals. cognitive development adaptive development communication development social and emotional development physical development, including vision and hearing service delivery One intention of the federal legislation is to support families within the context of their lives and their communities. Services received through BCW are provided in the child and family's "natural environment," which means places and situations where children without disabilities or delays live, play, and grow. These include the child's home, child care settings, community play groups, libraries, toddler gym programs, etc. Through the evaluation process, families are encouraged to talk about their daily routines and identify ways in which early intervention can be supportive of them within the context of their lifestyle, culture, and community. During this reporting period, the majority of children and families began receiving services in their "natural environments," rather than in clinic or segregated locations. 6 hailie resources All formal and informal resources, determined to be necessary for the child and family through the evaluation/assessment process, are organized in an Individualized Family Service Plan (IFSP). Parents and service providers are partners in developing this plan. It is based on each family's resources, priorities, and concerns, and includes only the early intervention activities and supports that the family chooses and which are recommended as necessary to promote progress toward outcomes on the IFSP. Part C of IDEA requires participating state programs to make the following early intervention services and supports available as appropriate for each individual child and family (and according to the IFSP): assistive technology audiology physical therapy vision services special instruction psychological services family training, counseling, and home visits health services (needed to enable a child to benefit from other early intervention activities) nutrition service coordination occupational therapy social work services speech language therapy transportation services medical services (certain diagnostic and evaluation services) nursing (needed to enable a child to benefit from other early intervention activities) Each family is assigned a service coordinator whose job is to help the family coordinate the early intervention process, to access services and resources, and to work with the family to meet their unique needs. The service coordinator is a critical link to the community and to information and resources. Beyond the federal requirements described above, family support may be available to families in BCW who need additional help in caring for children with disabilities. Some of these supports may include: respite care, support groups, and certain environmental modifications. Current information is also provided to connect families to community, state, and national resources. All supports build on existing social networks and resources; they also reflect the unique needs and strengths of each family. The goal is to empower the family to locate and utilize future supports. 7 What services are provided 1999-2000 Assistive Technology Devices 1.04% Assistive Technology Services 0.7% Audiology 0.46% EIFS Initial Program Planning Assessment 1.58% Family Training 2.43% Health 0.11% MDT/Facilitation 2.96% Medical Services 0.05% Nursing 0.27% Nutrition Occupational Therapy Physical Therapy Psychology Services 0.36% Social Work 2.24% Special Instruction/Development Special Instruction Services Speech/Language Pathology Translator Services 0.6% Transportation 1.2% Vision 1.6% 0.0% Data collection began on July 1, 2000 9.01% 10.44% 12.62% 16.2% 24% 31% 10% 20% 30% 40% Based on services provided 7/1/99 through 9/30/00 Where services are provided 1999-2000 Number of Children in Each Service Setting Developmental Disabilities Programs 100 Programs for Typically Developing Children 616 Home Hospital (In-patient) 3 Residential Facility 0 Service Provider Location 311 Other Settings 10 0 300 600 900 2594 TOTAL 3634 1200 1500 1800 2100 2400 Based on December 1, 1999 Count 8 funding Who pays for Babies Can't Wait? One of the expectations of the federal Part C legislation is that states will fund services and supports through various sources. The federal money Georgia receives for early intervention must be used to supplement funds from other sources such as state appropriations, Medicaid, PeachCare for Kids, private insurance, parent fees, etc. Service coordinators assist families in identifying resources for all needed services and supports. At no time are early intervention services denied because of a family's inability to pay, as defined by the Financial Analysis for Cost Participation (Appendix C of the BCW Program Standards). transition What happens when a child is no longer eligible for Babies Can't Wait? Some children will leave BCW before or at age three years and participate in programs and activities with or without specialized assistance and services. All children leaving BCW must have a plan for their "transition" from early intervention. The service coordinator will assist the family and serve as a link between BCW and whatever is to follow in order to ensure a smooth, seamless transition to other services or systems appropriate for the child and family. This process begins at least six months prior to a child's third birthday and enables the family to become familiar with their public preschool special education personnel, private preschool opportunities, Head Start, and other options in their community. As families prepare to leave BCW, their service coordinators make sure that appropriate community referrals are made to programs within the health department and other agencies to assure health and other needs are also addressed. david "If it wasn't for Babies Can't Wait, I don't think David's speech and special instruction would have improved as much as it has. I have met a lot of helpful and wonderful people and through them I was able to get a part-time job at a special needs school as a first grade paraprofessional. I was able to get David and his brother into a special needs preschool which will be very beneficial for David. Now I can be home at night with my family and not at work. None of this would have been possible without the Babies Can't Wait Program. Thank you and God bless." 9 sicc What is the State Interagency Coordinating Council? Under Part C of IDEA, each state must have an advisory body made up of consumers, public and private providers, legislators, and representatives from state agencies that provide or pay for early intervention services. This body is called the State Interagency Coordinating Council (SICC) and is appointed by the Governor to advise and assist the Georgia Department of Human Resources (DHR) in its early intervention responsibilities. The mission of the Georgia SICC is to advise and assist the Department of Human Resources' Division of Public Health, and other agencies responsible for serving infants and toddlers, birth to age three years with developmental delays and disabilities and their families, in providing an appropriate, family-centered, comprehensive service delivery system to promote optimal child development and family functioning. The Executive Committee is the management arm of the Council and sets the agenda for meetings, in addition to acting on the Council's behalf between Council meetings. In addition to the Executive Committee, the Council has four standing committees: Finance, Personnel Preparation, Service Delivery, and Public Awareness. These committees work to identify current issues, gather information, and make informed recommendations to the Council, and ultimately to DHR. By doing these activities, they assist DHR in developing an early intervention system of the highest quality, which seeks to balance family-centered services with fiscal responsibility. 10 State ICC Membership PARENTS OF CHILDREN WITH DISABILITIES Walter Black (Acworth) Bridget Davis (Columbus) Betty Nelson (Statesboro) PUBLIC PROVIDERS OF EARLY INTERVENTION SERVICES Blanche DeLoach, R.D., L.D. (LaGrange) Lynne D. Feldman, M.D. (Valdosta) PRIVATE PROVIDERS OF EARLY INTERVENTION SERVICES Milagros Cordero, E.d.D, OTR/L (Atlanta) Tish Seay, Ed.D. (Milledgeville) STATE AGENCY REPRESENTATIVES Phil Pickens Department of Education Division for Exceptional Students Russ Toal Department of Community Health Lanier Dasher Office of the Commissioner of Insurance Kathleen E. Toomey, MD, MPH Department of Human Resources Division of Public Health Juanita Blount-Clark Department of Human Resources Division of Family and Children Services PERSONNEL PREPARATION Cindy Vail, PhD Department of Special Education University of Georgia, Athens HEAD START Robert Lawrence, PhD Head Start State Collaboration Project Office of School Readiness CHILD CARE Susan Maxwell Georgia Child Care Council PERMANENT REPRESENTATIVES Charles Hopkins Department of Human Resources Division of MH/MR/SA Eve Bogan Department of Human Resources Division of Public Health Sheila Langston Department of Education Division for Exceptional Students Argartha Russell Department of Community Health Division of Medical Assistance Jon M. Anderson Right from the Start Medicaid Outreach Project jamaria lorenzo malerie morgan noah licc What are the Local Interagency Coordinating Councils? In an effort to develop and maintain an effective, family-centered, community-based early intervention system, each of Georgia's 19 health districts has at least one local interagency coordinating council (LICC). No two communities are alike, therefore, collaborative efforts evolve and operate differently from one location to another. As independent groups, these local councils play a key part in the collaborative process. Modeled in membership after the State ICC, LICCs advise and assist the local health district on all aspects of the local BCW system. They take into consideration both state and local policies, as well as the provision of direct services. LICCs are an integral part of Georgia's early intervention system. 1999-2000 Allocations Fund Sources: July 1, 1999 September 30, 2000 State Funds (SFY 00): $11,108,461 Federal Funds (FFY 98): $9,421,547 State Funds (SFY 01): $2,572,782 Carryover to FY 00: $650,000 Carryover to FY 01: $650,000 TOTAL FUNDS : $24,402,790 EXPENDITURES: July 1, 1999 September 30, 2000 STATE OFFICE Operations Training & Technical Assistance State ICC TOTAL STATE OFFICE EXPENDITURES $1,013,688 $ 280,699 $ 251,476 $ 1,545,863 % OF TOTAL 4% 1% 1% 6% LOCAL PROGRAMS (GIA) Service Coordination Administrative/Infrastructure Evaluation & Assessment Family Support Early Intervention Services TOTAL GIA EXPENDITURES $6,959,880 28% $5,017,838 21% $2,141,773 9% $ 910,265 4% $7,827,171 32% $22,856,927 94% 11 quality assurance Reaching new standards of service and care Babies Can't Wait (BCW) has entered its second three-year program review cycle. Each district is reviewed once every three years by a team comprised of family members and public and private providers of early intervention services. During this reporting period, BCW conducted on-site reviews in six Health Districts: Brunswick, Athens, Macon, Floyd, Valdosta, and Waycross. Four new review team members were trained, including two parents. BCW also began an extensive process of self-assessment in anticipation of the upcoming federal monitoring of the Part C early intervention system. A thirty-six member steering committee, comprised of representatives from a broad stakeholder group, met over a six month period to engage in the self-assessment process. Participating as a full steering committee and in four work groups, the committee identified, modified, and achieved consensus on sixty-nine indicator statements which make up the core of the self-assessment instrument. The BCW system was found to have strengths on eighty-three percent of the indicators, suggesting that a strong system is in place. The Steering Committee further characterized the system as being highly family-centered, noting the Lead Agency's involvement of families in every major segment of the state-wide system. 12 Unduplicated Child Count by Age 1999-2000 Unduplicated Child Count By District 3000 2832 2500 2046 2000 1701 1500 1000 500 0 Under Age 1 Ages 1-2 Ages 2-3 July 1, 1999 through June 30, 2000* 254 337 351 712 724 522 769 224 322 448 528 July 1, 1999 through September 30, 2000 Total=7,499 354 280 365 87 268 268 355 331 The Child Count on December 1, 1999 was 3,731. faith "I would like to say how much I appreciate this program `Babies Can't Wait.' My daughter Faith was diagnosed with right side Facial Palsy and Ptosis of both upper lids of her eyes. With the help of surgery and the help of all her therapists, Faith has come a long way, from where she could not even sit or hold her hand out. She has come to enjoy being with all her therapists on a one-to-one basis. The program has provided a stander for my daughter to help her walk, also a bench to help her play and sit up straight. Our service coordinator, Linda McEndree has helped Faith with great support from this program, and also our family. We are so proud to be involved with this wonderful program and all the people involved. They are not just friends to us, we consider them family. Thank you for all your help." 13 referrals During this reporting period (7/1/99 - 9/30/00), 29% of referrals to BCW came from the Children 1st system, which includes hospitals, physicians, and electronic birth certificates. The remaining referrals came from other community sources, such as families, child care providers, health care/early intervention providers, and other organizations. During the reporting period, the BCW Central Directory referred 479 calls to the BCW program, added 354 providers and referred 7768 callers to early intervention providers. The Central Directory Website also received an average of 654 daily hits, with 428 families accessing information about the BCW program. credentialing system As a component of Georgia's Comprehensive System of Personnel Development, training modules in six areas of early intervention competencies have been developed to ensure that personnel have a basic knowledge foundation and an understanding of "best practice" in early intervention when working with infants and toddlers and their families. The six skill areas, known as Project SCEIs (Skilled, Credentialed Early Interventionists), include typical and atypical development in infants and toddlers, family systems and family involvement, evaluation and assessment, program implementation and evaluation, administrative and team processes, and professionalism in early intervention. Modules are provided at two training levels: paraprofessional and professional. Training is offered at no cost and is available to anyone providing services through Babies Can't Wait (BCW) and to families of children in BCW. Completion of the modules within two years of employment and/or contracting is required for paraprofessionals, service coordinators, and persons providing and/or supervising special instruction in BCW. 14 referrals Upon completion of the six modules, a voluntary early intervention credential may be completed by individuals. Credentialing involves a mapping process that synthesizes the content of the six modules through the application of case study and is specifically linked to the individuals' role in the BCW system. In addition, continuing education requirements become effective for individuals upon completion of the six modules, regardless of whether or not a credential is pursued/obtained. Paraprofessionals are required to complete ten contract hours per year specific to children birth to eight and/or their families; five of these hours must be specific to young children with disabilities. Professionals must complete twenty contact hours every two years specific to children birth to eight and/or their families; ten of these hours must be specific to young children with disabilities. kiefer "Our experience with Babies Can't Wait has to be extraordinary! Words can't express our gratitude to Service Coordinator, Vicki Corn for her guidance, support and most of all caring. We have seen incredible results in my son's developmental and cognitive skills, which surely are direct results of this early intervention. We couldn't believe how helpful everyone was. I am a working mom, working for a company that has little or no tolerance for absenteeism. Babies Can't Wait and all of the therapy specialists were more than willing to work around my schedule, always putting Kiefer's needs first. It is so important that people know how helpful this program is for our children. My family and I will always be grateful for this program. Kiefer is living proof that miracles do happen! All you have to do is provide bunches of love, early intervention...and most of all, trust in GOD." 15 activities & progress BCW is concerned about the availability, accessibility, and quality of child care within a "natural environment" for the delivery of early intervention services and as an option for parents who need to work. During the reporting period, BCW addressed this issue by collaborating on the following initiatives: Healthy Child Care Georgia - A project to improve health and safety in child care settings. Project Exceptional - A train-the-trainers approach to promote inclusive child care for children with disabilities. Georgia Association on Young Children (GAYC) Annual Conference - Co-sponsored this large staff development opportunity for providers of child care, preschool special education, Head Start, early education, human services, and early intervention. Publicized Babies Can't Wait training in the Georgia Child Care Training Calendar sent to all child care providers. Governor's Council on Developmental Disabilities (DD Council) Task Force on Child Care a group of key stakeholders with the mission of ensuring quality access/programming in child care programs for children with disabilities. Collaborating partners include the DD Council, Georgia Child Care Council, Department of Education, Babies Can't Wait, State ICC, Child Care Licensing, child care providers, Office of School Readiness, Division of Mental Health/Mental Retardation/Substance Abuse, GA Association on Young Children, Parent-to-Parent, GA Assocation of Child Care Resource and Referral Agencies, Division of Family and Children Services, and parents of children with disabilities. Autism Initiative - Through the BCW Technical Assistance (TA) Unit, regional Autism Teams, trained in the last reporting period, continue to be active. The purpose of the Teams is to assist local BCW programs and service providers in developing and implementing programming strategies to best meet the needs of a child with Autism Spectrum Disorders and his/her family. 16 Strategic Planning - Based on requests from the field, the TA Unit developed an intensive two-day strategic planning session, which was provided to 17 districts at the request of the early intervention coordinator. The issues addressed included: 1) linking assessment information to IFSP outcomes; 2) writing functional, measurable, and family sensitive outcomes that are effectively linked to functional activities/strategies; 3) identifying procedures/techniques for addressing the new IDEA regulations regarding natural environment and procedural safeguards; and 4) utilizing team-building and collaboration techniques. Professional Development - Professional development opportunities were offered by the BCW TA Unit in the priority areas of evaluation and assessment, coordinating services for families in natural environments, child care and the Americans with Disabilities Act, and facilitating family involvement in play routines. Ongoing TA was provided in various content areas, including fiscal policies, implementation of natural environments, eligibility, report writing, functional outcomes and strategies, personnel qualifications, and transition. Continued analysis of data and IFSPs suggest that TA activities have resulted in more appropriate outcomes for children. michael Telehealth - Video conferencing technology continues to enable providers to work with children in their homes from a remote site, thereby eliminating the costs and time associated with travel. This technology is used for IFSP development, therapy consultations, and supervision of paraprofessionals. Programs for children with rare conditions are also made available via video conferencing. State Agencies - Through the leadership of the State ICC, BCW addressed Medicaid transportation issues. Access to Medicaid transportation became more difficult when the state changed the financial reimbursement methodology for nonemergency transportation. Through the activities of the ICC, the Department of Medical Assistance was given specific information regarding access problems so that solutions could be developed. Natural Environments To continue to assist and support local BCW programs olivia and providers in effectively implementing early intervention services in natural environ- ments, the following activities occurred during this reporting period: Individual/District technical assistance regarding natural environments. Districts developed and implemented Natural Environment Implementation Plans from July 1, 1999 through June 30, 2000, with support and assistance from TA Unit personnel. Statewide conference - Early Intervention Services in Natural Environments, August 13-14,1999 Higher Education Research Institute - Key Issues in Preparing for Service Delivery Within the Natural Environment, September 9-10, 1999 Facilitating Family Involvement in Play Routines, September 24, 1999 Coordinating Services for Families in Natural Environments, January 14, 2000 Early Intervention Services in Natural Environments: "How am I supposed to do this?", March 1, 2000 Higher Education Research Institute - Toddler Social Development in Inclusive Child Care Settings, June 8-9, 2000 andarius 17 challenges A lack of available personnel, particularly speech-language pathologists and occupational therapists, continues to make access to services a challenge. The use of telehealth video conferencing technology has been one approach to address this issue. However, the federal mandate to serve children in natural environments is made more difficult by these issues. This challenge is compounded by the fact that third party reimbursement is often unavailable for services provided outside of clinic settings. The mandate to serve children in natural environments, unless their developmental outcomes cannot be achieved in that setting, has been the focus of extensive training and service delivery reconfiguration in order to effectively meet the needs of children and families. In order to continue to improve the quality of the service delivery system, training continues through the involvement of families, childcare providers, therapists, special instructors, and BCW Staff. matthew Georgia coordinates and uses existing community resources to make early intervention services available. Because team members are usually not co-located, the establishment and recruitment of a true multidisciplinary team is a challenge. BCW has explored technical assistance, training, and rate structures as strategies to ensure the integrity of the team process. This continues to be a challenge. rate the early childhood special education mandates of Part C in a health agency. State and local BCW staff participate on a number of work groups to ensure that integration occurs within the context of the legislative intent of IDEA. To ensure that services are streamlined and families are given access to the full range of available public health services, health department services for children are being restructured at the state and district levels. While this benefits families, it is a challenge to incorpo- Georgia is geographically large and continues to struggle to provide effective teams to serve children and families. The Technical Assistance Unit, along with local BCW programs, continues to develop strategies for more effective teaming among professionals. 18 goals looking ahead to the new millennium As we move into the new millennium, a major goal for the Department of Human Resources is better integration of the Babies Can't Wait Program with other public health programs that serve children with special needs and their families. This integration will ensure the most comprehensive services possible for the child and family without unnecessary duplication. Activities include: development of a data system with common elements; improved utilization of fund resources; joint program policy; cross training of staff; and comprehensive, population-based training/technical assistance and monitoring. Another major focus for BCW is outreach to underserved populations in Georgia. Awareness and referral information about the program is being translated into the state's three top identified languages. In addition to translation activities, Georgia is addressing other, non-written methods for accessing these population groups, including ways to make English As a Second Language (ESL) more readily available and accessible to those who are interested. alexis "Alexis was diagnosed at birth as hydrocephalic, VATER Syndrome. Shortly after birth she was experiencing feeding problems and had to have a V.P. shunt. A specialist referred the family to Babies Can't Wait. At the time Alexis was less than one month old. She is currently in BCW, receiving services in and out of the home. She continues to have problems with feeding. She recently had surgery for hand deformities and is receiving occupational therapy. She is not crawling or walking. At the age of one year she was unable to sit without support. She can now do this and also is able to bear weight on her legs. She is tolerating more food textures and gaining weight. Mom is pleased. Alexis is now a whopping 22 pounds." 19 Georgia Department of Human Resources Jim Martin, Commissioner DIVISION OF PUBLIC HEALTH Kathleen E. Toomey, MD, MPH, Director FAMILY HEALTH BRANCH Rosalyn K. Bacon, MPH, Director OFFICE OF CHILDREN WITH SPECIAL NEEDS Wendy Sanders, M. Ed., Team Leader Wendy Miller, MPA, CSN Operations Support Manager BABIES CAN'T WAIT PROGRAM State Office Staff Stephanie Moss, MA Program Manager Helen Dulock, RN, DNS CSN Nursing Specialist Bob Herrin Quality Assurance Coordinator Carol Vasbinder CSN Program Associate/ Public Awareness Assistant Ethel Curtis Susie J. Rhoden State ICC/ CSN Program Public Awareness Coordinator Associate SeQuoyah Johnson CSN Program Assistant CONTRACTED TECHNICAL ASSISTANCE STAFF Marti Venn, PhD Valdosta State University Karla Hull, PhD Valdosta State University Mary Rugg University of Georgia Sharon Meek Assistive Technology Consultant To receive a copy of this Stephanie Moss, BCW Program Director Report, please contact: 2 Peachtree Street, N.W., Atlanta, GA 30303-3186 404-657-2726 skmoss@dhr.state.ga.us 20 Website: http://www.ph.dhr.state.ga.us/programs/specialneeds/ DPH Tracking # DPH01.124H DHR GEORGIA DEPARTMENT OF HUMAN RESOURCES