Brown County Birth to Three Program

1. Brown County Birth to Three Program

2. Most common referrals are for communication, sensory, and feeding issues • Premature babies are the most referred • Majority of referrals are through pediatricians as child’s growth and development is monitored through well child check ups. However referrals can be done by parents or caregivers. • General referrals require follow-up with parents within a week of referral. • Assessment is completed and then meeting is held with parents as to whether an evaluation is needed. • If evaluation is needed, then just like the school system, the county has 45 days to complete the evaluation. • Once completed, the family meets with the coordinator to discuss options for the child. • Brown County contracts with the following agencies for services: Cerebral Palsy Center, ASPIRO, Rehab Resources, and St. Vincent Home Health Care. Coordinator works with parents to determine what facility would best serve the child’s needs. • Some referrals come directly from the NICU. Once this is received the 45 day process begins immediately. • NICU refers children who have Down’s Syndrome, sucking issues, sensory problems, feeding tubes, heart defects, motor skill concerns, and those that weighed less than 1000 grams at birth. • All services need to be in place and IEP written by the day after the child’s third birthday so that the school system can then take over for services. Interview with Dawn Roder – Brown County Birth to 3 Coordinator

3. Referrals to Birth to 3 can be made by: • Parents • Physicians • Caregivers • Relatives • Other programs/supports working with families with young children • (copy of referral) Who can make referrals?

4. Child's name, date of birth, address where child resides; • Parent/caregiver name, address and phone number; and • Reasons for concern, name of current physician. Information Needed for Making a Referral

5. Child must have a developmental delay of at least 25% in one area as noted through Birth to 3 evaluation or other records, or diagnosis with a high probability of a developmental delay, or atypical development (such as asymmetrical movement, variant speech and language patterns, delay in achieving significant interactive milestones). • Eligibility is not based on income guidelines and there is no waiting list. Although some services may need to be paid for by the parents. Eligibility Criteria

6. Wisconsin Department of Health Servicesdhs.wisconsin.gov/bdds/birthto3/Waisman Center - Wisconsin Birth to Three Program Training and Technical Assistancehttp://www.waisman.wisc.edu/birthto3/index.phpCollaborating Partners of Wisconsinhttp://www.collaboratingpartners.com/Wisconsin Alliance for Infant Mental Healthhttp://www.wiimh.org/ Related Information Websites

7. Birth to 3 Program- Information from DHHS

8. Birth to 3is Wisconsin’s early intervention program for infants and toddlers with developmental delays and disabilities and their families. A federal law, the Individuals with Disabilities Education Act (IDEA), provides a framework for a comprehensive program and coordinates developmental, health and social services within the community. The Department of Health Services oversees the Birth to 3 Program in Wisconsin and has developed rules (DHS 90) that specify the program requirements. What is the Birth to 3 Program?

9. The earlier a child’s developmental delays are discovered, the more opportunities there are for a child to increase skills and abilities. The goal is to help children participate in their communities. • In addition to the skills the child develops, Birth to 3 Programs are committed to providing services in a way that makes sense for each family. This "family centered" program recognizes the importance of parents, family and friends in a young child’s life. The early intervention team will provide ideas and techniques to help a family enhance their child’s development and learning potential. HOW WILL THEBIRTH TO 3 PROGRAM HELP?

10. Specific rights for children and families are built into the Birth to 3 Program. These procedural safeguards are legal requirements. They assure that the Birth to 3 Program will follow specific procedures that protect the rights of children and families. Some of these rights include: • Parents must give written consent for any evaluations, assessments or services. • Participation is voluntary, so parents can refuse any services, evaluations or assessments. • Records will be kept confidential. • Parents can review or request corrections to their child's and family's records. • Parents have a right to disagree with decisions regarding their child's eligibility or the provision of appropriate services to their child and family. HOW ARE FAMILIES' RIGHTSPROTECTED?

11. The Birth to 3 Program is for children ages birth to 36 months. Eligibility is based on a diagnosed disability or significant delay in one or more areas of development. • The team will evaluate the child’s ability to: learn (cognitive development); move, see and hear (physical/motor development); communicate and understand other’s communication (speech and language development); respond to and relate with others (social and emotional development); and eat, dress and care for daily living needs (adaptive development). • A Birth to 3 service coordinator helps the family understand and participate in the evaluation process. • Services and supports a child and family receive are based on individual needs. Eligibility for this program is not affected by the family’s income; however, parents may need to contribute to the costs of services. WHO IS ELIGIBLE TO RECEIVE SERVICES?

12. If the child is eligible for the program, the service coordinator works with the family to see that the family and their child receive the services and supports they need within the family’s natural environment. • The service coordinator and other early intervention staff meet with the family to discuss the child’s developmental strengths and needs. This team, including the parents, determines what services and supports would enhance the child’s development and prepares a plan to provide supports and services within the family’s typical routines and activities. • This plan is called an Individualized Family Service Plan or IFSP. WHAT SERVICES AND SUPPORTSMIGHT BE AVAILABLE?

13. Family Education • Developmental Education Services • Communication Services • Related Health Services • Occupational Therapy • Physical Therapy Services and Supports Provided to Meet the IFSP (Individualized Family Service Plan)

14. The Birth to 3 Program is available in every county in Wisconsin. Each county has designated an agency that is responsible for the operation of the program in that county. The program may be called by a different name, but it is available to provide services to children with delays or disabilities. WHERE ARE PROGRAMS LOCATED?

15. 1-800-642-STEP/ • http://www.mch-hotlines.org/?id=4576&sid=33 • Wisconsin First Step serves as the Central Directory for Wisconsin's Birth To 3 Program. As the Central Directory, Parent Specialists who have specialized disability expertise and who are parents of children with special health care needs, provide information and referrals to county Birth To 3 Programs and other disability-related resources. • This is a 491 document filled with resources in every county. These resources include, but not limited to: clinics, hospitals, social services, where to obtain wheelchairs, family resources, support groups, etc. Wisconsin First Step

16. DHS contracts with two, statewide projects - The Wisconsin Personnel Development Project and Birth to 3 RESource for assistance to implementing Wisconsin’s Birth to 3 Program. Staff of these two projects partner with the DHS staff from the Birth to 3 Program and the Area Administrative Offices to offer a variety of training and technical assistance resources to county Birth to 3 Programs. • Other major partners include Wisconsin Department of Public Instruction, DHS Program for Children with Special Health Care Needs Public Health, Wisconsin Medical Assistance Program , Wisconsin First Step, Great Lakes Inter-Tribal Council, Wisconsin Assistive Technology Initiative, Wisconsin Early Childhood Collaborating Partners, Head Start, and Wisconsin Sound Beginnings. Waisman Center –Wisconsin’s Birth to 3 Resources for Training and Technical Assistance

17. What's New • Using Site • Policy & Guidance • ARRA Initiative • Monitoring & Self Assessment • Newsletter • Professional Development • On-Line Learning • Employment & Licensure • Family Resources Waisman Center –http://www.waisman.wisc.edu/birthto3/index.php

18. Provide training and technical assistance to county Birth to 3 programs and their local partners to support the implementation of the Wisconsin Birth to 3 Program so that families have access to appropriate early intervention services. Mission

19. System Building • Support • Relationships • Ecological • Leadership • Family-Centered • Strengths-Based Guiding Principles

20. Waisman Center, in coordination with the three partners, DHS Birth to 3 Program, RESource and WPDP provide resources to Wisconsin’s early intervention system in a planed and collaborative fashion. Some functions are unique to each of the entities, while many are shared among the three statewide resources. About Their Work

21. Provides a dedicated staff person for each of the five DHS regions. Resource facilitators work closely with the State Birth to 3 staff, WPDP, regional DHS personnel, and the Assistant Area Administrators (AAA) to provide supportive training and technical assistance in collaboration with local county programs and their community partners. The primary contacts for RESource are county program leaders and the Birth to 3 program staff. The primary goals of RESource include: • Building strong, ongoing relationships with Birth to 3 staff at the state and local level in order to understand the unique assets, issues and concerns for programs; • supporting continuous quality improvement of Birth to 3 programs through participation in the Birth to 3 program systematic review, development of Programs In Partnership (PIP) plan and the facilitation of appropriate training and technical assistance; and • facilitating community and statewide collaboration and the development of learning networks among leaders of programs serving families and young children. Birth to Three RESource

22. The (WPDP) role is to assist the Department of Health Services in meeting the state’s needs for a well-qualified early intervention workforce and providing parent perspectives throughout statewide Birth to 3 activities. WPDP provides the infrastructure for a wide variety of educational opportunities for parents, service providers from all disciplines, and program leadership through a multifaceted program. Training activities are planned and carried out in partnership with RESource, and State Birth to 3 staff, with guidance and input from county early intervention programs. Activities include: statewide and regional workshops, materials development and dissemination, the development and maintenance of a training and technical assistance website-including interactive learning options, a video lending library, publication of Birth to 6 EVENTS, collaborative planning with other programs/agencies, and active participation on statewide workgroups. Additionally, Parents as Leaders (PALs), offered annually, supports a group of 25 parents who commit to a five-weekend training and networking series. Wisconsin Personnel Development Project

23. Our Vision

24. Wisconsin Early Childhood Collaborating Partners components include: • Access to Health & Medical Home • Early Care and Education • Mental Health and Social Emotional Development • Parent Education • Family Support Collaborating Partners organization: • Participation Levels • Structure • Infrastructure • Steering Committee • State Action Team: Roles and Membership • Regional Action Teams: Roles and Membership • Committees Wisconsin Early Childhood-Collaborating Partners

25. Access to Health & Medical Home • Access to medical homes providing physical and child development services for all children in early childhood including special health care needs and assessment, intervention, and referral of children with developmental, behavioral and psychosocial problems. Early Care and Education • Services for children from birth through first grade that support children's early learning, health, and development of social competence. Focus on childcare, Head Start, Early Head Start, 4K and 5K services to children with disabilities as well as children who are homeless or in poverty. Mental Health and Social Emotional Development • Availability of services to promote healthy social emotional development, services to address the needs of children with mental health problems and service delivery pathways to facilitate entrance of at-risk children into appropriate child development and mental health delivery systems. Parent Education • Parent education services that provide support to parents in their role as prime educators of their children. Family Support • Family support services that address the stressors impairing the ability of families to nurture and support the healthy development of their children. Collaborating Partners Components:

26. Participation Levels • Endorsing Partners: State, regional, and local state departments, agencies, associations, or groups that have formally endorsed the WECCP vision and mission. • Participating Partners: State, regional, and local state departments, agencies, associations, groups, and individuals that are committed to membership on WECCP state or regional teams, participate in events, and actively work toward the vision and mission. • Interested Partners: State and local agencies, associations, groups and individuals that are not able to commit to endorsement or participation but are interested in the efforts and want to receive information through the state or regional list serve. The Structure: The WECCP operates within a structure that includes: State level: action team, steering committee, and overall state wide network; • Regional level: action teams, team facilitators, and regional networks. • Communication and networking systems include: state and regional action team meetings, networking conferences (video conferences/web casts), a Web site, state and region specific list serves and collaborative conferences; and a work plan with goals, objectives, and action steps. Collaborating Partners includes:

27. Infrastructure Steering Committee • Jill Haglund, jill.haglund@dpi.wi.gov • Loraine Lucinski, Loraine.Lucinski@dhs.wisconsin.gov • Therese Ahlers, tahlers@wiaimh.org • Jennifer Jones, jennifer.jones@wisconsin.gov • Ann Stueck, Ann.Stueck@dhs.wisconsin.gov • Linda Leonhart, Linda.Leonhart@dwd.state.wi.us State Action Team: Roles and Membership Infrastructure

28. Act as identified "leaders" for the State Action Team • Develop agendas for State Action Team meetings • Oversee implementation of State level support mechanisms • Share information within WECCP and among the State Action Team • Assure communication and networking within the defined structure • Oversee development and use of supporting materials • Monitor and promote implementation of work plan • Promote mechanism to enhance the effectiveness of the regional teams Steering Committee members demonstrate state level commit to the structure by committing state staff time and designating programmatic responsibility for participation, direct funding, resource allocation, and other means to support implementation of work plans including: • Maintaining communication and network structures • Funding Community Collaboration Coaches to facilitate and support regional teams and networks • Providing Mini-grants to each region to assist in the implementation of their efforts Roles of the Steering Committee are to:

29. Bringing state and local information, evidence-based research and best practices, and federal expectations/trends including mandates and priorities to participants of WECCP. • Bringing information, experience and identification of statewide trends and issues to the Department Secretaries, State Superintendent, the Governors Office, Federal Partner Agencies and Statewide Organizations. • Synthesizing local information, best practices, and recommendations from regional teams to inform state level priorities, policy and evidence-based practices. • Supporting and promoting communities in the development of a collaborative approach to service delivery for young children and their families. • Working in collaboration to align efforts, initiatives, grant programs and consistent child and family-centered policies across systems. • Identifying and promoting evidence-based practice and new research literature that supports state and local programming. State Action Team: Roles

30. Sharing information with their organizations and constituencies. The State Action Team utilizes a steering committee to guide direction, priorities, and work plans and is comprised of representatives of the state departments of Health and Family Service, Public Instruction, and Workforce Development and each of the early childhood components of mental health, parent education, family support, medical home, as well as care and education.

31. Early Learning Standards • Stories: Using WMELS • Alignment with Curriculum • Alignment w/Standards • Training Description • Training Opportunities • Find a Trainer • Training Reports • Trainers Login • Social Emotional Competence • SEFEL Pyramid Model • UW Certificate Program • Competency and Endorsement System • Screening/Early Identification Resources • Curriculum and Assessment • About Curriculum and Assessment • Play and Learning • Program Evaluation • Response to Intervention for Preschool • Language Development/Emergent Literacy Resources • Serving Dual Language Learners • Serving Children with Disabilities • OSEP Indicator #3/7 Child Outcomes • OSEP Indicator #8/12 Transition  • OSEP Indicator #2/6 Environments • Child Find • Eligibility Criteria • Parent Support • Technical Assistance Resources • 4K Community Approaches • Collaboration Coaches • Showcases • Program Evaluation • Professional Development • Career Guide • Core Competencies • Find a Professional Development Opportunity • DPI License Renewal • Training and Technical Assistance Directory • Initiatives • Resources • Family Support/Parent Education Resources • Homelessness and Poverty Resources • Health and Medical Home Resources • Economic Development Resources Other information available on Collaborating Partners

32. Wisconsin Alliance for Infant Mental Health (WI-AIMH) promotes the healthy social and emotional development of Wisconsin children from birth through age 5. Our goal is to weave infant mental health practices and principles into the everyday activities of individuals who touch the lives of infants, young children and their families. Wisconsin Alliance For Infant Mental Health

33. We are working on a competency-based system of endorsement to recognize infant mental health knowledge and training among professionals across disciplines. Infant Mental Health Endorsement

34. All professionals that touch the life of a young child can use relationship-based infant mental health principals to foster their healthy social and emotional development. By joining WI-AIMH, you will be able to connect with other professionals in the field, stay informed on professional development opportunities, share your expertise through submission of newsletter articles, and much more. (brochure) Become a Member of WI-AIMH!

35. Here you will find a variety of resources pertaining to infant mental health. These include: • Our "Ask the Expert" service • Infant mental health Provider Directory for Wisconsin • Infant mental health Brochures in English and Spanish • Useful, free Downloads • Many online resources for parents and professionals in the Link Library Resources for parents and professionals

36. ResourcesLink Library • Help for Wisconsin Parents and Caregivers • BadgerCare Plus is a new program for children and families in Wisconsin who need and want health insurance. Central Wisconsin Moms • An online community for parents in the Marshfield, Stevens Point, Wausau, and Wisconsin Rapids areas. • Child Care Information Center • Children's Health Alliance of Wisconsin • Collaborating Partners • An online community for parents, administrators and staff of early education programs throughout Wisconsin. • Dane County UW-Extension Family Living Program • Drugwatch.comDrugWatch.com is a comprehensive Web site database featuring extensive information about thousands of different medications and drugs currently on the market or previously available worldwide. • The Exchange Center for the Prevention of Child Abuse • Family Enhancement (Madison) 608-241-5150 Education, information and support for parents and families in the Madison area. • Licensed Childcare Search new Web site from the Wisconsin Department of Children and Families (DCF). • Madison Wisconsin Institute for the Healing of Racism • Mental Health America of Wisconsin • Moms in Madison • Parent to Parent Wisconsin provides parent support to parents of children with special needs through a one-to-one connection with another parent who has similar experience and who knows firsthand about the feelings and realities that come with having a child with special needs. • Parental Stress Center (Madison) 608-241-4888 Services to prevent child abuse and neglect and strengthen families in the Madison area. • Parenting Newsletters from UW-ExtensionFree email newsletters matched to your child's age. • The Parenting Network (Milwaukee) 414-671-0566 Parent Helpline Confidential, 24-hour child abuse prevention hotline providing counseling for parents and other child caregivers in the Milwaukee area. Links

37. Prevent Child Abuse Wisconsin • Rainbow Project (Madison) 608-255-7356 Provides specialized services to children and families experiencing stress related to domestic violence, child abuse/neglect, social-developmental and behavioral problems, or family relationship issues. • The Resource House (La Crosse)From the Information and Referral Center in La Crosse, this database contains information on community services such as health care and childcare, education and social service information. • Respite Center (Madison) 608-244-5730 Crisis child care 24 hours a day, seven days a week, to parents experiencing high levels of stress. • Supporting Families Together Association supports groups that promote quality early care, resources and education to enrich the lives of children and strengthen families. • UW Waisman Center Early Childhood Unit • Publications and programs for families with young children. • Wisconsin Association for Perinatal Care/Perinatal FoundationA source of information about the time before pregnancy (preconception), pregnancy, labor and delivery, infants and infant care. • Wisconsin Child Care Improvement ProjectA statewide non-profit agency dedicated to helping improve child care by helping child care professionals give the best care possible to your children. • Wisconsin Children's Trust Fund • Free positive parenting kit. • Wisconsin Council on Children & Families • Wisconsin Department of Health and Family Services Birth to 3 Program • Wisconsin Family Ties provides support for families including children with emotional, behavior or mental disorders. • Wisconsin Maternal and Child Health Hotline • Wisconsin United for Mental Health • Wisconsin Early Childhood Association More Links

38. Ensuring a Smooth Transition from Birth to 3 to Special EducationOverview of options and shared expectations in transitioning youngsters between systemsLink: http://media2.wi.gov/DPI/Viewer/?peid=aafef695-68e1-497a-9fd7-42a2fc34c39c Ready – Set – Go!

39. Ready! • Set! • GO!

40. Birth to 3 (Part C) • Referral into Birth to 3 • Screening/Evaluation • Determine Eligibility • IFSP Development • Services Begin • LEA Notification • IFSP Transition Steps • Transition Planning Conference • Referral to LEA Special Education and Related Services (Part B) • Notice from Birth to 3 • Transition Planning Conference • Referral to LEA • Screening/Evaluation • Determine Eligibility • IEP Development • Services Begin

41. B-3 Transition Timeline Prior to Part C Regulation Changes 9/15/2008 • Transition Planning Conference • B-3Schedules Transition Planning Conference with parents and LEA • LEA Documents attendance at the TPC • Referral to the LEA • B-3 makes referral of potentially eligible children • LEA (1) Proceeds with the referral to placement process, (2) informs the parent that B-3 may be invited to the IEP, and (3) with the parent’s approval invites B-3 to the IEP Notification B-3sends Non-identifiable information to LEA for child find and planning Child’s 3rd Birthday • Parent provides consent to evaluate (AND make the child available) OR receive notice that no additional evaluation is needed No more than 9 months prior and not later than 90 days prior to the 3rd birthday. At least 9 months prior to the third birthday At least 90 days prior to the third birthday 15 + 60 30 B-3 transition planning activities and IFSP documentation Within 30 calendar days After parent consent Transition Planning Conference Referral Received Up to 15 business days Within 60 calendar days Undefined; up to parent. Request Parent Consent for Evaluation Request Parent Consent for Evaluation • Parent Declines the TPC • B-3 • documents in the IFSP & with the LEA • provides parent with information on how to contact the LEA & informed consent. • Parent Declines referral and/or release information • B-3 provides family with information on potential benefit, impact of denial, & how to make a referral in the future. • B-3 provides LEA with documentation that parent declined referral and/or release of information. • LEA has met the Child Find requirements related to this child. Receive Parent Consent for Evaluation Receive Parent Consent for Evaluation IEP Team Meeting to Determine Eligibility IEP Team Meeting to Develop IEP and Determine Placement IEP Implemented OR Notice sent that no additional data are needed 60 Within 60 calendar days • Parent Declines • Consent to Evaluate • LEA provides information on how to make a referral in the future. • LEA has met the Child Find requirements related to this child. • Parent may request a Transition Planning Conference with B-3 at a later date, AND/OR may pursue a referral with the LEA at any time. Parent may pursue a referral with the LEA at any time.

42. State Regulations • Part C - Birth to 3 early intervention • Department of Health Services • HFS 90, WI Admin. Rules: Birth to 3 Early Intervention • Part B – Special Education and Related Services • Department of Public Instruction • Special Ch.115 Subchapter V, WI Statutes: Children with Disabilities – April 5, 2006

43. Birth to 3 helps the parent: • Think about the future for their child • Explore resources and services • Understand the transition process • Decide who will participate in transition planning • Birth to 3 Transition Planning

44. Developed from discussions with families about dreams and next steps • Designed to outline options available to support child and family • Outlines who will do what, when and how • Developed over multiple meetings or discussions Birth to 3 Transition Planning-- IFSP Transition Steps

45. Written information sent by Birth to 3 to the LEA regularly • Provides non-identifying information about children in Birth to 3 close to turning 3 • Assists Birth to 3 and LEAs in fulfilling child find requirements • Assists LEAs in planning LEA Notification

46. Conference must occur at least 3 months (90 days) before child’s 3rd birthday. • Interagency agreements should consider establishing timelines to assure that the process is completed in a timely manner. • IDEA states that the invited LEA will participate in transition planning conferences arranged by the designated Birth to 3 lead agency. Transition Planning Conference

47. Who will attend? • Family • Birth to 3 staff • School special education staff • Others: • Friends, relatives or support providers who know the child • Therapists, medical professionals • Head Start or other community programs Transition Planning Conference

48. Is focused on the child • Reviews present services • Discusses future options and possible changes in service delivery • Discussion the transition process and roles • Discusses Birth to 3 staff participation in the first IEP meeting Transition Planning Conference

49. Referrals to LEA for Special Education and Related Services When the family, at the TPC, decides that a referral by Birth to 3 is appropriate … • Birth to 3 will then send the referral to the school (LEA) which includes the child’s name, date of birth, parental contact information, and area(s) of concern.

50. When the family, at the TPC, can not yet decide if a referral by Birth to 3 is appropriate… The IFSP transition page is updated by Birth to 3 to define the process for providing the family with additional information to assist them in making their decision about referral, and the procedures for when and how the LEA (school) will be informed of the parents decision. Referrals to LEA for Special Education and Related Services