 Hello, this birth to three provider update is being provided as the result of a file review for Planning Region Team 8 in 2020. In the spring of 2020, the co-leads, the Nebraska Department of Education and the Department of Health and Human Services conducted a file review for Planning Region Team 8. We received commendations and recommendations for improvement. We had enough recommendations for improvement that we do have a corrective action plan. Let's start with the commendations. We had an excellent verification statement on a CAPTA referral using informed clinical opinion. Kudos. NDE actually used kudos in their report. Great job, Heidi Atkinson at Boyd County, and thank you to Heidi who has graciously agreed to allow me to share that statement with all of you who are involved in CAPTA referrals and evaluations. The other commendation was for Wheeler Central Schools. It was the first time that the reviewers have seen childcare as part of an ISSP. The team at Wheeler decided to help a child build social skills and language skills through enrolling the child in the district owned daycare center. I'm happy to report he made such good progress last year that Wheeler Central is moving towards having another child enrolled as part of their IFSP in this school year. Our recommendations for improvement need to be made to our multidisciplinary team reports, our evaluations, and our IFSP's. The Planning Region Team 8 leadership team will be reviewing MDTs and IFSP's throughout this school year to ensure that changes have been made. Let's start with the MDTs. Make sure that you are referencing Rule 52. Rule 52 governs the services and qualifications for children birth to three in the state of Nebraska. Oftentimes, providers were cutting and pasting the qualification statement from their Part B reports and had Rule 51. So please make sure that you are referencing Rule 52. Do not say the child does not qualify for early childhood or does not qualify for speech, and then have that service listed on the IFSP. Instead, give the results of the evaluation for each area that was assessed, including the scores, your observations, and then have an overall qualifying statement. This child qualifies for early intervention services according to Rule 52. Again, the statement should say, qualifies for early intervention services according to Rule 52, not for special education. I know you're working in a special education field, but Rule 52 refers to all services for children in Part C as early intervention services. And so the qualifying statement needs to say the child qualifies for early intervention services. Evaluation should be completed in all areas of development, regardless of the reason for the referral. As we have started to assess and evaluate a child birth to three, we're going to look at their strengths and weaknesses in all five areas of development and reflect that evaluation in the MDT report. How are they doing with their cognitive, their adaptive behavior, their communication, physical development, social and behavioral skills. All of those things should be reflected in the MDT report. And the MDT must be signed. That report needs to be signed by all members of the MDT team, multidisciplinary team who participated in the meeting. In this days of zooming for meetings to keep everyone healthy, that signature may be a follow up email stating that you participated in the multidisciplinary team meeting and you agree with the team's decision. Send that email to the person who has been in charge of the evaluation, whether that be the early childhood special education teacher, or the speech language pathologist. Once the MDT report is finalized, signed, that signed copy will be sent from our service provider to the early development network services coordinator. If you are using informed clinical opinion to qualify a child who was referred under CAPTA, here is a statement that covers everything that the colleagues would like to see you have considered as a team when making that informed clinical opinion. And again, thank you to Heidi Atkinson for sharing her informed clinical opinion statement. RBIs, whether you think of them as routine based interviews or routine spaced intervention, make sure that that routine spaced interview was conducted with the family prior to the provision of services. It needs to be conducted prior to our first IFSP meeting so that we can build our goals and objectives around the family's desired priorities and the needs that they've identified. RBIs can be conducted via Zoom if the timeline does not allow for providers to travel to the home, or if COVID concerns are preventing the timely scheduling of the RBI. If a group of RBIs is being conducted before the child has their initial IFSP, the team might also do an RBI if the family has moved, if there has been a change in the child's health status, or in the event that a child has moved from the foster family back to the biological family. Those are all times of transition that might warrant a new RBI. Delays and evaluations was a concern on two or three files, much to our dismay. Family delays are allowed and will be documented in the services coordinator notes. Provider delays are not allowed. If you are struggling to complete an evaluation within the 45-day calendar timeline, contact your supervisor so we can problem solve how the evaluation can and will be completed on time. Here are some IFSP recommendations. The family needs and desired priorities that were identified through the RBI should be included in the IFSP. The IFSP goals should be measurable and easily understood by the family and the caregivers. Remember the old saying they should be able to hang it on the refrigerator, and grandma and grandpa, or aunts and uncles, would be able to read that outcome and know what the child is working towards. They should also be easily measured by the caregivers. Often they're tracking whether the child is participating in a routine or working on a skill during the time that they're spending together. And so we need to keep it easily understood and easily measured. Here are some new templates that were shared this fall from the co-leads. First one, the child's name is stated first to start the outcome. We're looking at our eco map at RBI to see what the family's concern and priority is, what's happening now, what the family's desire is, and then we use that information to write the outcome and determine how to measure it. The priority is that Darcy will be eating finger foods by herself during meals when the family is at home during lunch and supper. We would say Darcy will participate in lunch and supper times by feeding herself with her fingers. We'll know she can do this when she eats half of the food from her plate using her fingers at lunch and supper for five consecutive days. Could we hang that on the refrigerator? Would grandma know what we're working towards? Would mom, dad, or grandma measure whether she's eaten half of her food in five consecutive days? The other template starts with the routine. So during lunch and supper Darcy will feed herself with her fingers. Same information, same desired priority, just changing up the order of the components so that not every outcome starts with the child's name. Here's an example of a family outcome template. Although the services coordinators usually focus on the family outcome, sometimes they need some help from the rest of the team in composing an outcome based on the concerns that the family has shared. So Candy wants little Jared to sleep in his own bed all night. The outcome might be Candy will have a plan of how to get Jared to stay in bed by April 2016. Or the priority is that Dennis and Candy want the boys to have their own beds to sleep in. Outcome two, Dennis will make beds for the children in two months. If a child is turning three during the IFSP, you may include pre-literacy and language skills that are developmentally appropriate for the child. This is to help them prepare for preschool. It's to help the parents start to think about what skills are needed for transition to think beyond their own home or childcare. When your child is going to preschool, what are your concerns? You might do a mini RBI. Well, I'm concerned because someone will ask her name and Candy doesn't say her name when we ask. Or I know she's not going to be ready for letters because she doesn't even match colors. Again, we might build in matching colors or stating name when asked, identifying pictures in a book as it's read, as some of those pre-literacy and language skills that could be worked on as the child is approaching three years old. Progress towards each goal must be reported at each IFSP meeting. So, going back to Darcy's goal of eating finger, eating finger foods may say at the six month update Darcy uses fingers at lunch but is too distracted by her siblings to feed herself at supper. Have we made progress since the initial IFSP? Yes, she's starting to use her fingers for finger foods, but have we met the goal? No, but we'll show what the progress is. If you mark a goal met, you must list how the goal was met. So you must have your data there. Joni pulled herself to standing and walked along the couch three feet on five consecutive nights during playtime with her parents. Or during three out of four sessions with the SLP, Roberta used five words to name objects as she played. When we get to the services page, do not use other when you describe services on the IFSP. The list of services that's provided through SRS has been determined by NDE and DHHS to match the available services that are listed in Rule 52. The projected starting date for each service must be on the IFSP, and this should be as soon as possible, but not more than 30 days after the IFSP was written. So, for those of you who are using the frequency of services as twice in six months, that first visit needs to be within 30 days of the IFSP meeting. The services must be provided as stated in the IFSP, and we must document the provision of these services, including the date and amount of time. You might be doing your documentation as part of your billing sheet for your school for the ESU or for the organization that employs you. You might have the date, time and service that was provided in your service provider notes. Make sure that you include, that you keep this documentation for at least three years. It may be called upon for you to prove that you provided those services at any time within those three years. If you miss a session, let the services coordinator know. Quick email or a quick phone call that says, hey, family canceled our session today. Everyone is in quarantine for the next two weeks. So we agreed that I'll give mom a call in two weeks and try to do the sessions that are scheduled for this month. Or, hey, I missed a session with the family today because I'm home with a fever. I have called to reschedule and we'll be making up the sessions. It's the end of November. I can't get two more sessions in this month. So I'm going to do additional sessions in December and I'll let you know when those were held. So that the services coordination notes include. Yes, we knew that the session was being missed. Yes or no it's being made made up and the family knows what the plan is. There is a concern from a family about services not being provided. And they call the co leads, the co leads will check with the services coordinators first to see what they've documented in their notes about service provisions so please keep them in the loop, keep them informed. The educational surrogate is rarely used with children ages birth to three, but it might be used if the services coordinator is not able to contact the biological parent due to incarceration or treatment center rules. In that case, when the services coordinator finds out that mom cannot have outside contact with anyone outside of prison or the treatment center. The services coordinator will notify the district and the district can then appoint the foster parent as the educational surrogate during the time of the incarceration or the treatment that there's no special form for that appointment of this surrogate. It might simply be an email back to the services coordinator saying district a has appointed foster parent be to be the educational surrogate for Child C during the time of mom's incarceration, or they might type it up as a letter on letterhead. Transition plans, the services coordinators must provide the annual transition notice to family at the transition conference which contains all the required elements, all of those elements are in the SRS form now. The IFSP must contain transition steps and services. Those transition steps include confirmation that child find information has been transmitted to the school that will be serving the child when they transition to an IEP. In Nebraska, that is very easy to do because in 99% of the cases that superintendent or principal in the district where the child will be attending preschool and have an IEP has been attending the IFSP meetings and knows that the child is living in his or her district. In other states, there isn't that seamless transition. So we are very lucky to be in Nebraska. The transition plan must describe the steps that the family is going to take and how they're involved. Are they doing the research to find preschools in the area? Are they doing the applications or do they need assistance from services coordinators or some other member of the team in order to make that transition for the child. The transition plan should be established not fewer than 90 days nor more than nine months before the child's birthday. The services coordinators have an ongoing list of when that timeline occurs for each of the children, excuse me, on their caseloads. So thank you for listening to today's training. The training was provided as part of the Planning Region Team 8 Corrective Action Plan for 2020. As it is part of the Corrective Action Plan, we need to be able to show that all services coordinators and services providers within Planning Region Team 8 participated in the training. So please click on the link that is provided here within the webinar and will be provided in the accompanying email to provide feedback and give an example of an outcome that you have written with a new format. I would appreciate if you would complete this by December 8th so that I can compile a follow-up report to NDE and DHHS regarding our Corrective Action Plan. Thank you.