MINUTES OF UTAH INTERAGENCY COORDINATING COUNCIL (ICC)UTAH
INTERAGENCY COORDINATING COUNCIL
FOR INFANTS AND TODDLERS WITH SPECIAL NEEDS AND THEIR FAMILIES
Utah Department of Health, Division of Community and Family Health Services
44 North Medical Drive, Salt Lake City, Utah
May 16, 2003
Attendance (alphabetical): Jill Adams, Caroline Bass (via video), GleeAnn
Clayton, Kris Fawson, Barbara Fiechtl, Chris Giacovelli, Sherry Hancock,
Meredith Mannebach, Judi Nielsen, Jill Oberndorfer, Susan Ord, Gina Pola-Money,
Diana Sagers, Fan Tait.
Excused Absences: Cathy Nelson, Lynette Rasmussen, Patty Van Wagoner,
and Shelley Wiseman.
Absentees: Timothy Floyd, Kristina Hindert, and Marcela Rafide.
Visitors Present: Joyce Dolcourt and Sue Olsen.
Baby Watch Staff: Lori Brady, (equip.), Vanya Mabey, Kimberly Morris,
Ellen Parrish (minutes), and Janet Wade.
I. WELCOME/INTRODUCTIONS. The meeting commenced at 9:40
AM, conducted by Barbara Fiechtl. Introductions were made.
II. APPROVAL OF MINUTES. A MOTION made by Chris Giacovelli
and seconded by Judi Nielsen to accept the Minutes of March 21, 2003 was
unanimously approved.
III. BABY WATCH REPORT.
- New Brochure. Susan Ord announced that the state’s Baby Watch
brochure, used for Child Find activities, has been completed and printed.
The brochure is directed toward a parent audience and now includes information
on parent fees and the sliding scale. GleeAnn Clayton’s daughter,
Harmony, is pictured on it. Individual programs also have their own
brochures explaining their services.
- Special Education Law Conference. This will be held July 30 - 31
at the Eccles Center in Ogden. There is an early intervention track
in it and it is free. Anyone interested in attending can get a registration
form from Susan.
- IDEA reauthorization. This is up for vote this year. The House version
is Bill 1350. The Senate is also working on theirs. Hopefully they’ll
vote on IDEA before the spring recess. There are some new themes that
are of interest. Family Therapy may be added to the list of services.
We would have to offer it through staff or pay someone else to do it.
They may add language that at the state’s discretion a child age
three to five who previously received services under Part C and is eligible
for Preschool could maintain themselves in the part C program with all
of the rights and privileges of Part C, so long as their educational
component included preliteracy, language, and numeracy skills. There
is no language about who will pay for this and which agency would do
it, so it could be that Part B would take the Part C regulations and
apply them to the three to five age group. There is an addition that
emphasizes the family’s involvement; that things are to be more
family-centered; there is new language for Natural Environment, regarding
the “most appropriate” setting as determined by the parent
and the IFSP team. Part B language may change to require that the child
have a medical diagnosis, but no one knows yet, because regulations
haven’t yet come out. Would a physician have to then diagnose
LD? There are children who don’t have a medical diagnosis but
who need Part B. Susan sits on Senator Hatch’s committee on IDEA
and they have written a position paper for Senator Hatch on this. Anyone
interested in more in-depth information can get the list serve address
or the website where the bill can be downloaded from Susan.
New required members to the state ICCs will include agency representatives
from: the state agency responsible for children’s mental health,
Child Protective Services, and the office of the coordinator for the
education of homeless children.
Changes to the State application must now include state policy on child
abuse or neglect, and fetal alcohol syndrome referral. It adds new requirements
that state that the provider has to put a policy and procedure in place
for these things.
- Changes to eligibility. Susan thanked the ICC for its advice and
assistance during this process. The diagnosis list has been changed
to omit automatic qualification of premature infants and fetal drug-exposure;
however, if those factors result in other conditions, the child can
be brought in under informed clinical opinion. There are three ways
to qualify: a condition on the diagnosis list, testing to determine
the level of delay, or two professionals can determine that a child
is eligible for early intervention through informed clinical opinion.
- The NICU project. Vanya Mabey explained how she brought together
seven staff therapists from Level 3 area NICUs including LDS Hospital,
Utah Valley, University Medical Center, and Primary Children’s
Hospital. McKay Dee was not represented at the meeting, but a NICU staff
person from there has worked closely with Vanya on writing the report.
Early intervention staff members from eight programs were also involved
in this work. The group worked on developing a list of characteristics
and medical conditions present in NICU patients that indicate a need
for early intervention. All NICU babies are referred to Neonatal Follow
Up when they leave the hospital. Hospitals are also being encouraged
to refer families to the Prenatal-to-Five program. IFSPs are being written
in the hospitals. This is a good way to share information, and to know
where these babies are going after they graduate from the NICU. All
of these professionals agree that this system of collaboration is a
better way to serve NICU graduates.
- Rules. Baby Watch recently filed Rules for the Department of Health
and Baby Watch. The rules don’t cover everything early intervention
does, but they do cover eligibility changes and fees. Once filed, there
are thirty days for comment. The rules are based on decisions that have
been made by the ICC. We will be sending the rules to other groups including
DSPD, UMA, and the Intermountain Pediatric Society. Susan explained
that the rules go through the Department of Health and its legal system
for review. The Department has never had to change any rules they’ve
established before.
After reviewing the handout of the rules, there was a discussion about
what should be included in the rules and what is policy and/or procedure.
We don’t want to start down the slippery slope of trying to put
everything into the rules. Better to refer to the State Plan in the
rules and include policy in the State Plan. What is included in the
state plan is what the state may require of a program. A review of the
Rules language identified a couple of words that should be omitted or
changed for clarification and precision.
- Early intervention Billing. Susan informed the group that the department
has hired a billing person. Staff is working on creating forms, procedure,
and instructions, in anticipation of beginning to use fees in July.
- OSEP Monitoring. The system that OSEP (The Office of Special Education
Programs) the federal funding agency for our program, uses to monitor
states has recently changed. In 1998 there was a term called “continuous
monitoring” which is now called “focused monitoring.”
This involves OSEP visiting our program. The next step is for the state
to create an improvement plan. OSEP targets the states they perceive
to be the most in need. They recently came out with a report on how
many children are being served which is approximately 2% of the population.
Utah is at 1.93%. OSEP also looks at how many children are at age one.
We are .07% off their benchmark in that area. In settings, or natural
environments we are about in the middle. In the Child Find area according
to ethnicities and age, we are serving the right children.
The ICC will need to reestablish the OSEP Steering Committee to work
on a Self-Assessment and a Continuous Monitoring Process. The use of
data sources to verify compliance is key to this process. OSEP will
hold two summer institutes and one will be in Salt Lake City on July
21st and 22nd. This is great, because we can send a large contingent.
Those who want to serve on this committee should go to the OSEP conference.
Staff from Baby Watch will attend.
The OSEP conference and the monitoring process will be interesting and
informative. OSEP will create a matrix based on the state’s old
improvement plans. For those who are involved this time around, we will
send out the information and documents from last time. It was a lot
of work and people need to see what the effort entailed. Each state
arranges its own format and will need to name the data sources. GleeAnn
was the first to volunteer for the re-instituted OSEP committee.
IV. FINANCE SUBCOMMITTEE ON PARENT FEES
- Sliding fee scale. The process to determine fees has been completed
and we are fine-tuning it. The providers are looking for the fee determination
sheet that families will fill out. Programs are beginning staff trainings.
A discussion about the format of the fee scale resulted in the consensus
that it be adjusted down a penny to clarify accurate beginning and ending
amounts. Baby Watch will incorporate other fine-tuning to the wording
of the form suggested by the group. Last time parent fees were mandated,
lack of support by the providers was an issue, but now providers are
committed to carrying out fees and intend to show the legislature that
they are doing all they can.
- Verification of Income. It was decided that families must be required
to furnish verification of income. There is some concern about ease
of implementation for providers who must collect this information, but
income verification is a safeguard that will ensure that the data on
families is accurate, and that fees are fair. Diana Sagers pointed out
that families who receive many services are accustomed to this. It is
also a demonstration of our commitment to the process that may be useful
for purposes of answering to the legislature. We may need to know income
to qualify for other funding sources such as TANF. The information will
be valuable for determining our demographics. Income information will
be collected on all families receiving services whether they are exempt
from fees or not.
V. LEADERSHIP TEAM REPORT
- Nomination and Voting in New Leadership Team Member. Sherry Hancock
has completed her term and is retiring from her seat on the Leadership
team, but will remain a member of the ICC. A NOMINATION was made by
Sherry Hancock and seconded by Fan Tait to invite GleeAnn Clayton to
join the Leadership team. A VOTE in favor carried unanimously.
- ICC Accomplishments. A handout was provided that contained a summary
of the ICC and its subcommittees meeting dates and accomplishments by
meeting. There were 25 ICC related meetings this past year that addressed
parent fees, eligibility changes, infant toddler mental health, and
family issues.
- Member Composition. Chris stated that the ICC will need to add or
replace the following members in order to be in compliance with the
Bylaw requirements: a legislative representative, a State Office of
Education Preschool representative, and two or three provider representatives.
Several suggestions were made to fill these vacancies. The leadership
team is calling for nominations to be submitted by mid-June. Jill Adams,
who has completed her term as a parent representative was thanked for
her service.
- ICC Themes for the coming year. Barb suggested that the ICC pursue
the goals of finding funding, promoting the Medical Home, supporting
efforts to strengthen families, and continuing to develop interagency
collaboration, which is already one of our strengths. She proposed that
at the September meeting the ICC discuss these goals.
VI. USDB PARENT INFANT PROGRAM (PIP) REPORT
Judi Nielsen, Program Director for PIP, shared how collaboration between
agencies works with Baby Watch and PIP. Nine years ago, PIP proposed to
the ICC a collaborative effort. Before that, the agencies were sort of
like children who are “parallel playing” as opposed to playing
together. The resulting collaboration has enabled PIP and early intervention
to access each other’s resources in a mutually beneficial way. PIP
staff was added to each early intervention program to provide vision and
hearing services. PIP is responsible for hiring and training. Early intervention
provides the service coordination and IFSP development. Utah is the only
state that has this collaborative model. Other states have to contract
with each other. With guidance from IDEA, two years ago they developed
an interagency agreement that is in effect today.
PIP eligibility is defined by IDEA section 1402. PIP is responsible for
hearing and vision impairments including deafness and blindness. In Utah,
by legislative mandate, Code 53 A 25 states that children with vision
and hearing loss should be served by USDB and are entitled to a free and
appropriate education. It doesn’t say where children must be served,
just that they must be served. The USDB was started in 1896.
Initial evaluation procedures are as follows: first, eligibility of the
child is determined; second, the needs of the child are determined. USDB
children are the first to have services and the referral process is automatic.
Eligibility determination is accomplished through formal assessments,
parent reports, and observation. The needs of the child are determined
as are the parent education needs. The early intervention funding portion
of PIP has been reduced from 5% to 3.5% of the overall budget. $3600/year
per child is the PIP cost, and $133/year per child is the Baby Watch share.
Fan noted that at a recent national conference she attended, a big issue
was that parents didn’t feel that they received early intervention
information that looked at the whole picture to make decisions for their
child. Judi gave an example that deaf PIP uses the Ski-Hi curriculum,
which trains the team to present all methodologies regardless of their
own bias, because every family needs to know about each option. We have
to bring this to the Medical Home. Families should hear this from their
physician and many of them do not.
VII. MISCELLANEOUS ITEMS. Janet Wade stated that another
positive outcome from the ICC is that Baby Watch is coordinating a week-long
mental health track at the U of U Graduate School of Social work July
7th -11th again this year.
VIII. NEXT SCHEDULED ICC MEETING. September 19, 2003
at 9:30 AM at DOH Children with Special Health Care Needs, 44 North Medical
Drive, Salt Lake City, Utah.
IX. ADJOURNMENT. The meeting was adjourned at 12:20
PM.
APPROVED AS TO FORM:
____________________________________
Barb Fiechtl, Chair for ICC
MINUTES SUBMITTED BY:
_____________________________________________
Ellen Parrish, Executive Secretary for ICC
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