using data to improve states' service coordination infrastructure chelsea guillen, illinois ei...
TRANSCRIPT
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