Using Data to Improve States' Service Coordination Infrastructure

Chelsea Guillen, Illinois EI Ombudsman & Pam Thomas, Missouri Part C Coordinator

October 2014, DEC International Conference, St. Louis, MO

Agenda

Review of state information Illinois projects Missouri projects Lessons learned/Conclusions

Illinois At-a-Glance

Missouri At-a-Glance

Illinois- Program Integrity Project

Substantial caseload growth between 1999 and 2010 Performance contracting began in 2002 Resulted in significant program improvement Troubling trends detected

Question: Are we serving the right kids, with the right services, in the best way?

Illinois- Program Integrity Project

Project Principles: Equality Fidelity Stability

Project Activities: Increased

training/retraining Change in monitoring Evaluation of service

coordination model Employment of

system ombudsman

Illinois- Program Integrity Project

Used data to identify concerns

Varying concerns at each CFC

Issues addressed included:

High levels of service

Reduced under 1s participation

Provider shortages

Transition challenges

Reduced service in natural environments

Strategies for addressing challenges varied

Illinois- Program Integrity Project Example Issue:

High levels of service on IFSPs

Analysis:

Provider trends

Service change justification forms

Outcomes:

Created case presentation form

Provided training on effective meeting facilitation

Deliver ongoing technical assistance to avoid troubling trends

Revised monitoring tool and process for completion

Missouri- Eligibility Forecasting and Service Coordinator Caseload Study

Purpose of the Study:

Substantial growth in child count between 2007 and 2011

5-year contract re-bid will occur in 2013-14

Critical Questions:

How many children should we expect to serve in Part C?

Are we capturing the types of data necessary for program evaluation and improvement?

What is the most efficient model to serve families in Part C?

Missouri’s Eligibility Forecasting

Findings from the Study

Although the general population of Missouri children age birth to three indicates a declining trend, the number of children participating in Missouri Part C steadily increased between 2006 – 2012.

Given the state’s current eligibility criteria, Missouri Part C is projected to serve between 2.35% and 2.45% of the birth to three population between 2012 and 2016, an increase from prior projections of 1.65% to 1.85% in 2006.

Full report available online at: http://dese.mo.gov/sites/default/files/se-fs-sicc-phillipsandassociatesreportsicc11912.pdf

Missouri’s Caseload EfficiencyFindings from the Study

State’s Part C system should have a clear definition of service coordinator duties, based on the state’s infrastructure.

Part C caseloads should give a range to accommodate various referral and IFSP activities . For Missouri Part C service coordinators, a caseload size of 40 to 60 children is a reasonable range.

Allow flexibility in the model of service coordinator operations to accommodate geographic diversity in a state.

Consider ways to streamline state information and minimize non-essential tasks that are time-consuming.

Full report available online at: http://dese.mo.gov/sites/default/files/se-fs-sicc-combocaseloaddatapresentationsiccFINAL.pdf

The Impact of Using Datain Missouri and Illinois Part C Programs

Missouri - Measuring Performance using a Needs Assessment and Benchmarks

Purpose: Need to evaluate the

model selected for the region

Need to identify and evaluate best practices in early intervention

Need to collect observational data

Need to target training topics and technical assistance

Practice: Create regional plan for

needs assessment (Year 1)

Develop benchmarks of essential practices (Year 1)

Implement regional plan and targeted TA (Year 2)

Document regional results compared to benchmarks (Years 2 and 3) . . . Repeat!

Connect theory to practice

Missouri – Needs Assessment* Operational Model for Service Coordination ** –

Assessment activities include, but are not limited to, evaluation of service coordinator performance, observations of intake and IFSP meeting activities from a sample of service coordinators, use of shared service coordination activities and a review of activities related to IFSP procedures.

*The state provides a list of suggested tools but does not require a specific tool to collect observational data. The contractor identifies the tool to use based on regional needs.

**The contract lists three needs assessment requirements. In addition to the service coordinator aspect, the contract also requires assessing the structure and activities of interagency councils and assessing the practices of service providers.

Missouri – Benchmarks Example (draft)

Illinois- Evaluating the Usefulness of a Service Coordination Checklist

Purpose Looking for supports to

improve service coordination

Aligning of activities with responsibilities

Development of training tool/file review form

Identification of training needs

Recruited two CFCs North- 25 SCs

South- 5 SCs

Introductory webinar FTF session at

conference Support during pilot

Illinois- Service Coordination Checklist Eight checklists

Intake through Transition

Similar format emphasizing partnerships

Indicate completion of task

Make notes about clarity/confusion

Illinois- Service Coordination Checklist

South North

Illinois- Service Coordination Checklist General findings

Service coordinators critically evaluated utility of tool

Provided feedback about confusing terms and redundancies

Better performance when checklist aligned more closely with procedure manual

Lower performance for recommended (versus required) practices, i.e. spirit of the law versus letter of the law

Alternate formats were suggested

CFCs shared other documents that they use for supporting SCs

Provided information about SCs knowledge base and training emphases

Lessons Learned

It is critical to include stakeholders in efforts that will impact their work

Stakeholders support needs for data use vary; interpretation/understanding impacted by perspective

Need to be purposeful and focused, there is a lot of data in Part C

Using data to inform practice requires more than one data source

Quantitative data is one source of information

Qualitative data can also be important

Gathering data is only the first step in evidence-inference-action process

Data can and should be used to inform change

Conclusions

Using data,

Gaps and overlaps can be found in service coordination systems

Early intervention competencies can be articulated

Home visiting practices can be enhanced

Improved Part C services can be delivered

“If you continue to do things the way you’ve been doing them, you will continue to get the results you’ve been getting.”

- Author Unknown