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MINUTES OF THE UTAH INTERAGENCY COORDINATING COUNCIL (ICC)
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 21, 2004
Attendance (alphabetical): Kris
Fawson, Barbara Fiechtl, Chris Giacovelli, Debbie Justice, Nancy
Murphy, Judi Nielsen, Connie Nink, Susan Ord, Marcela Rafide, Mark
Valentine, and Patti Van Wagoner.
Excused Absences: Cheryl Alexander, Sherry Hancock,
Cathy Nelson, Lynette Rasmussen, and Fan Tait.
Absentees: Caroline Bass, Representative Calvin
Bird, GleeAnn Clayton, Mary Lou Emerson, Kristina Hindert, Jill
Oberndorfer, Gina Pola-Money, and Krissie Summerhays,
Visitors Present: Joyce Dolcourt and Elizabeth
Kuhlman (for Patti VanWagoner).
Baby Watch Staff: Theresa Christensen, Patrice
Isabella, Vanya Mabey, Kimberly Morris, and Janet Wade.
I. WELCOME/INTRODUCTIONS.
The meeting commenced at 9:30 AM, conducted by Chris Giacovelli.
Introductions were made.
II. MINUTES.
A MOTION made by Dr. Mark Valentine to accept the minutes
of March 19, 2004 as written passed unanimously.
III. LEADERSHIP TEAM REPORT.
1. Summary of the year’s accomplishments.
Chris reviewed the handout put together by the Executive Committee
regarding ICC accomplishments. It was a busy year. One of the big
issues this year was Expanding Options for Infant Mental Health.
Janet worked to get a good base for developing infant mental health
services. Accomplishments in this area include the incorporation
of UAIMH (Utah Association for Infant Mental Health), reviewing
and placing the Utah State Practice Model on the web, and tool kit
development. Accomplishments for the Family United Network include
a newsletter, parent survey, and Parent Mentor Training.
The finance committee is an ongoing entity, and is always looking
for financing. The Baby Watch program did not go to the legislature
this year for additional funds, but will probably go next year,
which will require a lot of parent support. The program has also
worked closely with Part B on transition issues, changed the eligibility
criteria, and worked with the Executive Committee to fill vacancies
on the ICC. They provided information regarding conferences attended
in Washington. Debbie congratulated them on their good work.
2. Membership and Leadership nominations.
Barb informed us that it was time to nominate new leadership. It
is Chris’s last day leading the meeting. Cathy Nelson from
the University of Utah has agreed to serve on the Executive Committee,
is excused today. She is in the Early Childhood Special Education
Department at the University of Utah, and works with dual sensory
issues. She recently got her Ph.D. Barb called for a vote to elect
her to leadership, which was unanimously in favor.
The law dictates our membership, and it is mandatory that we have
a certain number of providers on our committee. Sue Olsen was nominated
for the vacant provider position. She has been a provider for many
years, was formerly with the state Baby Watch program, and is now
at Utah State University, one of the Baby Watch contractors. A vote
was unanimously in favor of electing Sue to the ICC.
There is also a parent opening. To apply, parents should talk to
GleeAnn. For information on serving on the ICC, they can speak to
Marcela at 435-649-5263.
IV. BABY WATCH REPORT
1. Office of Special Education (OSEP) visit and Annual Performance
Report.
Susan Ord reported on the OSEP verification visit. Three persons
from the OSEP did a site visit on April 27th and 28th. OSEP has
recently changed their oversight process. Their purpose was to understand
our system and to determine the extent they can rely on our data.
They concentrated on the child count data and the “general
supervision” process the state has for assuring that all early
intervention programs are in compliance with IDEA regulations. The
staff from OSEP concluded that with some minor changes we have effective
measures to assess compliance and ensure accountability. We cover
all Part C requirements consistent with federal regulations. They
feel we have a system for corrections of non-compliance.
Susan asked for approval of the Annual Performance Report with changes
that the OSEP staff discussed during their visit. We cannot have
a target for ethnic or age groups, as it is discriminatory, but
can break out the ethnic data to describe progress or slippage in
serving underserved populations. We make every effort to serve all
children who are eligible, and we should have an equivalent increase
with the population growing in the state. We also cannot have a
goal of less then 100% in any area. Debbie motioned to approve the
APR changes the state will be working on. Chris seconded the motion,
and it was unanimously approved.
The Part B program (State Office of Education) received a verification
visit at the same time as the Part C, Baby Watch program. Connie
Nink briefly reviewed their visit. She reported that OSEP also told
them that we couldn’t focus on one ethnic group; we need to
serve all who are eligible. They wanted to know if we have a process
that is being implemented correctly by school districts in order
to correctly identify all children. If we find gaps or needs we
need to have a mechanism in place to address them. One area she
is working on is a stronger collaboration with Part C regarding
transition at age three. Also, some children who qualify for Part
B are not being identified in Part C. This is an important issue.
We need the State and local providers to work together on this.
Connie wants to organize a discussion group regarding this issue
at the statewide preschool special education conference at the Provo
Marriott on October 14th and 15th.
2. Vision Screening.
The early intervention providers asked the state to review the current
vision screener and policy regarding who can administer it. Vanya
reviewed the work of the committee, which has met three times. The
committee has developed a new screener. She explained that the Parent
Infant Program has volunteered to be a referral source for further
vision assessment if the screener indicates that a child may have
a problem. The second step would be a referral to an ophthalmologist.
Chris suggested that it be an early intervention team decision to
refer, as a result of information gathered on the screener, rather
than a decision made solely by the person administering the screener.
This is the policy that the committee recommends. If it is a team
decision, there shouldn’t be excessive referrals to the Parent
Infant Program. Debbie mentioned that the family should consult
with their medical home for medical management. The committee has
had considerable discussion regarding the use of vision related
motor skills on the screener, and for considering developmental
age rather than chronological age when determining tasks that a
child can complete. The committee has reviewed information from
several other states as they have designed the screener. Their intent
is that a qualified person, other than a nurse, can administer the
screener. The committee’s next task is to work on the training
module that needs to accompany the new screener.
Susan expressed appreciation for the work of the committee. The
two pediatric ophthalmologists on the committee were very helpful.
They shared information from the American Academy of Pediatrics
as well as their own knowledge.
3. Parent Fees.
Susan reported on the first 9 months of implementing Parent Fees.
Eight months of information are available. We have billed $145,720
and have collected $103,208. The main reason for the gap between
billing and collections is that we bill at the end of the month
so we are always a month behind in collections. There are also some
adjustments regarding non-payments due to families leaving the program
when a child turns three or for refusal to pay. Last month there
were 21 families that did not pay, which was a high month. We have
a system in place for dropping children from the program when the
parent doesn’t pay. It often takes three months for this to
happen, because of the timing of billing, we need to be more consistent
in following the policy. Debbie suggested individualizing the report
so she can put the information in each child’s file. It is
felt that the families who have entered early intervention after
the fee program was established will more likely be consistent payers.
If we project an average collection of $14,744 a month, for the
rest of the 12 months we could collect about $162,000 this year.
It costs the state $50,000 a year to collect the fees. This does
not account for the local costs for determining parent fees or communications
with parents about the fee program.
Susan recommended that we continue to look at the parent fee policy.
The first year of implementation has gone fairly smoothly. We may
receive more income the second year, as the provider costs level
off. The questions are: why parents are leaving because of fees,
the percentage of families who don’t have to pay, and continued
focus on implementation of policy. Theresa Christensen needs all
the programs to give her the forms for the Medicaid children. They
don’t qualify for a fee, but we are collecting income information.
Susan reported on early intervention enrollment trends. Enrollment
declined from July to December 2003 but then began to climb, and
is now back up to where it was 9 months ago, in August 2003. The
decrease in enrollment could be attributed to the change in eligibility,
the exit policy, and the implementation of parent fees.
Chris said that there is a proposal to remove the asset test for
Medicaid, we will want to follow this. Gina Pola-Money suggested
that we continue to look at CHIP and Medicaid expansion changes
every year.
V. CAPTA UPDATE.
Liz Kulman, a staff person from DCFS, reported on the
Keeping Children Safe Act (CAPTA), which now requires all children
who have a case of substantiated abuse or neglect be referred to
early intervention. This has serious implications for Part C since
it could substantially increase the number of children that early
intervention is required to evaluate. Many ICC members have volunteered
to participate on a committee to study this issue and make recommendations
for implementing the new regulation. Liz will be organizing the
effort and setting up the first meeting for the near future. Patti
Van Wagoner, Liz, and Susan participated in a conference call sponsored
by NECTAC. It laid out many issues we should consider. The two federal
agencies involved are beginning to work on policy clarifications.
Meanwhile, states are working on how this will play out in their
systems. The intent of the new regulation is to develop state policy
and procedures. Our goal will be to develop state and local interagency
agreements.
VII. INREACH GRANT UPDATE.
Glenna Boyce has been working with Baby Watch since 1998 on the
InReach project. Two purposes of the program are to support the
competence of the parent/infant dyad and to provide a supportive,
seamless transition from the NICU to home and community intervention.
The program has worked with 4 hospitals: UUMC, LDS, PCMC, and McKay-Dee.
An increasing number of extremely low birth weight infants are surviving.
Many are eligible for early intervention services. In order to cut
down on time spent by both early intervention and parents, information
generated by the hospital is used for the initial assessment. The
goal is to have all new parents seen in the first week they are
home. A beautiful story on video of one of the parents in the program
was shared.
InReach has several support technologies. The first is a DVD-Video/ROM.
This introduces InReach procedures to parent and staff. The second
is desktop video conferencing. This allows the family, NICU staff,
and Early Intervention staff to work together to plan community
service goals before discharge. The third is a project worksite
www.In-Reach.org.
This website provides resource information and pictures of the baby.
They are now conducting research on the effectiveness of using these
technologies through phone interviews, activity/time diaries, resource
cost information, and DVD and website questionnaires.
CONCLUSION
Susan thanked the ICC and Executive Committee for their work and
support this year. She also thanked Chris Giacovelli for all her
time, energy and effort.
VI. PARENT MENTOR TRAINING REPORT AND UPIC MEDICAL HOME.
Were deferred to another time, due to lack of time.
VIII. NEXT SCHEDULED ICC MEETING.
September 17, 2004 at 9:30 AM at DOH Children with Special Health
Care Needs, 44 North Medical Drive, Salt Lake City, Utah.
IX. ADJOURNMENT.
Chris Giacovelli adjourned the meeting at 12:00 PM.
____________________________________
Chris Giacovelli, Chair for ICC
MINUTES SUBMITTED BY:
_____________________________________________
Becky
Forman, Executive Secretary to the ICC
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