initiative inventory for the state systemic improvement plan...adapted by the southeast regional...
TRANSCRIPT
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 1
Initiative Inventory for the State Systemic Improvement Plan
This inventory can be used to identify current and previously implemented initiatives that relate to the focus area for improvement identified in the statersquos State
Systemic Improvement Plan (SSIP)
Previous Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
System
TransformationMedicaid EI Services Program (Beth Tolley Tammy
Whitlock)
Improve access to services
Improve quality and consistency of service delivery
Meet federal requirements for timelines and personnel
Increase number of EI providers
Expand funding resources for EI
Standardize processes
Iimprove data collection and reporting to meet state and federal reporting requirements
All infants toddlers and their families
who are eligible for EI
1 2 3 4 5
Yes
No
1 2 3 4 5
DBHDS ndash low DMAS ndash high Local - low
1 2 3 4 5 1 2 3 4 5
Increased Medicaid revenue
Increase in of providers
Increase in children served
Development of Practice Manual
Medicaid EI Services requirements aligned with both Medicaid requirements and Part C requirements
Establishment of standard personnel requirements (regulations)
ABCD Project
(Beth Tolley Tammy Whitlock)
Increase developmental screening by referrals from and communication with physicians
Physicians Medical Practices
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Standardized MD referral form (optional) with place for consent for exchange of information adopted statewide
Research as part of the initiative contributed to recommendation about
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 2
acceptable screening tools
Increased developmental screening (evidenced by increased claims for screening)
IFSP Outcome Training
(Cori Hill)
IFSP outcomes will be based on child and family assessment information and will be functional and address acquisition context and criteria
Local system managers
service providers including service
coordinators
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Also beefed up that outcome
section of Kaleidoscope
and added IFSP prompts so
hard to know impact of each
thing
Strength of outcome statements inconsistent across state
Each group generated a list of good questions to ask families about their everyday activities and routines ndash now available as handout
Led to development of additional resources like the IFSP 101 Module and Outcome Development Mini Lesson
Medicaid EI TCM
Expand Medicaid reimbursement for service coordination and align Medicaid case management requirements with Part C requirements and with the type of support that is appropriate for families of infants and toddlers
Infants and toddlers
covered by Medicaid and their families
1 2 3 4 5
Yes
No
SC is mandatory for Part C EITCM designed to meet Part C and Medicaid regs for SCCM
1 2 3 4 5
More children have payment source for SC but rate is much lower than IDMH TCM Small increase in Medicaid cost for EI SC
1 2 3 4 5
1 2 3 4 5
Rate does not yet meet cost
Reimbursement sources for SC for all children with Medicaid
Reimbursement available during the initial process from referral to determination of eligibility for all child with Medicaid
Expansion of Virginiarsquos
Comprehensive System of Personnel Development
(CSPD)
Expand the number type and accessibility of professional development resources and opportunities
Early intervention
service providers including service
coordinators and local system
managers
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
EIPD website
Blog
Online modules
Talks on Tuesdays
Videos
Positive user evaluations
Website blog and resources have also been used by colleges and universities out of
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 3
state EI personnel and international early childhood providers
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Of the previously implemented initiatives are there any initiatives that should be re-initiated and included in the SSIP
The changes that were instituted as part of the System Transformation Medicaid Initiative and the Medicaid EITCM continue and ongoing assessment and adaptation in response to external changes and quality improvement initiatives should continue
Are there components of the above initiatives that could be incorporated into the improvement strategies in the statersquos SSIP
What were some of the challenges experienced in implementing the previous initiatives
System Transformation - The scope of the initiative was very broad and resulted in changes to many aspects of our service delivery system all at once for all local systems
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 4
What lessons were learned from these previously implemented initiatives that could potentially enhance development and implementation of the statersquos SSIP
Implementation Work Group to ensure consideration of all stakeholder perspectives when planning and implementing changesndash state and local families
Follow-Up webinars and online QampAs after implementation ldquostart daterdquo to support consistency and fidelity in implementation
Frequent 1-page written System Transformation Updates to keep all stakeholders informed about plans decisions training opportunities etc (twice a month) helped reduce stress and misinformation about changes
Importance of using case vignettes and an activity-based hands-on approach to training
Quik reference guides as follow-up to training (having a teaching tool to take back with them)
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 5
Current Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
Integration of Child
Indicators in EI Process (Beth Tolley)
Improve outcomes for children
Improve consistency and accuracy of indicator ratings across teams and across local systems
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Assessment of outcomes is in process preliminary assessments include
More comprehensive integrated assessments
Individual child outcomes more integrated specific to childfamily
Coaching and Natural Learning Environments
(Cori Hill)
Improve outcomes for children and families through consistent implementation of evidence-based practices
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No
1 2 3 4 5
Collab with TTACs for
funding (about half)
1 2 3 4 5 1 2 3 4 5 Canrsquot answer
yet
Training still underway Outcomes to date
Development of additional resources like the coaching page on eipd website follow-up webinars
3 regions have established communities of practice to support implementation of coaching and natural learning practices
Locally driven initiatives (like Fairfax)
Early Childhood Mental Health
(Bonnie Grifa) Screening competencies credentialing professional
development through training on social and
emotional evidence based practices
Build capacity to identify and address mental health issues early
EI Providers Local System
Managers Service
Coordinators 1 2 3 4 5
Yes
No
1 2 3 4 5 EI providers financially
supported for endorsement through Early
Childhood Comp
Systems Federal grant
1 2 3 4 5
1 2 3 4 5 Success with awareness of
EI providers of VArsquos new IMH competencies
and endorsement and the of EI
applicants
Training at the local level in all 5 regions of VA for ASQ-3 screening tool and the CSEFEL Pyramid Model to begin in August 2014 so donrsquot know impact yet however there were a total of 19 EI providers trained as Trainers and
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 2
acceptable screening tools
Increased developmental screening (evidenced by increased claims for screening)
IFSP Outcome Training
(Cori Hill)
IFSP outcomes will be based on child and family assessment information and will be functional and address acquisition context and criteria
Local system managers
service providers including service
coordinators
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Also beefed up that outcome
section of Kaleidoscope
and added IFSP prompts so
hard to know impact of each
thing
Strength of outcome statements inconsistent across state
Each group generated a list of good questions to ask families about their everyday activities and routines ndash now available as handout
Led to development of additional resources like the IFSP 101 Module and Outcome Development Mini Lesson
Medicaid EI TCM
Expand Medicaid reimbursement for service coordination and align Medicaid case management requirements with Part C requirements and with the type of support that is appropriate for families of infants and toddlers
Infants and toddlers
covered by Medicaid and their families
1 2 3 4 5
Yes
No
SC is mandatory for Part C EITCM designed to meet Part C and Medicaid regs for SCCM
1 2 3 4 5
More children have payment source for SC but rate is much lower than IDMH TCM Small increase in Medicaid cost for EI SC
1 2 3 4 5
1 2 3 4 5
Rate does not yet meet cost
Reimbursement sources for SC for all children with Medicaid
Reimbursement available during the initial process from referral to determination of eligibility for all child with Medicaid
Expansion of Virginiarsquos
Comprehensive System of Personnel Development
(CSPD)
Expand the number type and accessibility of professional development resources and opportunities
Early intervention
service providers including service
coordinators and local system
managers
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
EIPD website
Blog
Online modules
Talks on Tuesdays
Videos
Positive user evaluations
Website blog and resources have also been used by colleges and universities out of
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 3
state EI personnel and international early childhood providers
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Of the previously implemented initiatives are there any initiatives that should be re-initiated and included in the SSIP
The changes that were instituted as part of the System Transformation Medicaid Initiative and the Medicaid EITCM continue and ongoing assessment and adaptation in response to external changes and quality improvement initiatives should continue
Are there components of the above initiatives that could be incorporated into the improvement strategies in the statersquos SSIP
What were some of the challenges experienced in implementing the previous initiatives
System Transformation - The scope of the initiative was very broad and resulted in changes to many aspects of our service delivery system all at once for all local systems
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 4
What lessons were learned from these previously implemented initiatives that could potentially enhance development and implementation of the statersquos SSIP
Implementation Work Group to ensure consideration of all stakeholder perspectives when planning and implementing changesndash state and local families
Follow-Up webinars and online QampAs after implementation ldquostart daterdquo to support consistency and fidelity in implementation
Frequent 1-page written System Transformation Updates to keep all stakeholders informed about plans decisions training opportunities etc (twice a month) helped reduce stress and misinformation about changes
Importance of using case vignettes and an activity-based hands-on approach to training
Quik reference guides as follow-up to training (having a teaching tool to take back with them)
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 5
Current Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
Integration of Child
Indicators in EI Process (Beth Tolley)
Improve outcomes for children
Improve consistency and accuracy of indicator ratings across teams and across local systems
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Assessment of outcomes is in process preliminary assessments include
More comprehensive integrated assessments
Individual child outcomes more integrated specific to childfamily
Coaching and Natural Learning Environments
(Cori Hill)
Improve outcomes for children and families through consistent implementation of evidence-based practices
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No
1 2 3 4 5
Collab with TTACs for
funding (about half)
1 2 3 4 5 1 2 3 4 5 Canrsquot answer
yet
Training still underway Outcomes to date
Development of additional resources like the coaching page on eipd website follow-up webinars
3 regions have established communities of practice to support implementation of coaching and natural learning practices
Locally driven initiatives (like Fairfax)
Early Childhood Mental Health
(Bonnie Grifa) Screening competencies credentialing professional
development through training on social and
emotional evidence based practices
Build capacity to identify and address mental health issues early
EI Providers Local System
Managers Service
Coordinators 1 2 3 4 5
Yes
No
1 2 3 4 5 EI providers financially
supported for endorsement through Early
Childhood Comp
Systems Federal grant
1 2 3 4 5
1 2 3 4 5 Success with awareness of
EI providers of VArsquos new IMH competencies
and endorsement and the of EI
applicants
Training at the local level in all 5 regions of VA for ASQ-3 screening tool and the CSEFEL Pyramid Model to begin in August 2014 so donrsquot know impact yet however there were a total of 19 EI providers trained as Trainers and
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 3
state EI personnel and international early childhood providers
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Yes
No
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Of the previously implemented initiatives are there any initiatives that should be re-initiated and included in the SSIP
The changes that were instituted as part of the System Transformation Medicaid Initiative and the Medicaid EITCM continue and ongoing assessment and adaptation in response to external changes and quality improvement initiatives should continue
Are there components of the above initiatives that could be incorporated into the improvement strategies in the statersquos SSIP
What were some of the challenges experienced in implementing the previous initiatives
System Transformation - The scope of the initiative was very broad and resulted in changes to many aspects of our service delivery system all at once for all local systems
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 4
What lessons were learned from these previously implemented initiatives that could potentially enhance development and implementation of the statersquos SSIP
Implementation Work Group to ensure consideration of all stakeholder perspectives when planning and implementing changesndash state and local families
Follow-Up webinars and online QampAs after implementation ldquostart daterdquo to support consistency and fidelity in implementation
Frequent 1-page written System Transformation Updates to keep all stakeholders informed about plans decisions training opportunities etc (twice a month) helped reduce stress and misinformation about changes
Importance of using case vignettes and an activity-based hands-on approach to training
Quik reference guides as follow-up to training (having a teaching tool to take back with them)
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 5
Current Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
Integration of Child
Indicators in EI Process (Beth Tolley)
Improve outcomes for children
Improve consistency and accuracy of indicator ratings across teams and across local systems
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Assessment of outcomes is in process preliminary assessments include
More comprehensive integrated assessments
Individual child outcomes more integrated specific to childfamily
Coaching and Natural Learning Environments
(Cori Hill)
Improve outcomes for children and families through consistent implementation of evidence-based practices
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No
1 2 3 4 5
Collab with TTACs for
funding (about half)
1 2 3 4 5 1 2 3 4 5 Canrsquot answer
yet
Training still underway Outcomes to date
Development of additional resources like the coaching page on eipd website follow-up webinars
3 regions have established communities of practice to support implementation of coaching and natural learning practices
Locally driven initiatives (like Fairfax)
Early Childhood Mental Health
(Bonnie Grifa) Screening competencies credentialing professional
development through training on social and
emotional evidence based practices
Build capacity to identify and address mental health issues early
EI Providers Local System
Managers Service
Coordinators 1 2 3 4 5
Yes
No
1 2 3 4 5 EI providers financially
supported for endorsement through Early
Childhood Comp
Systems Federal grant
1 2 3 4 5
1 2 3 4 5 Success with awareness of
EI providers of VArsquos new IMH competencies
and endorsement and the of EI
applicants
Training at the local level in all 5 regions of VA for ASQ-3 screening tool and the CSEFEL Pyramid Model to begin in August 2014 so donrsquot know impact yet however there were a total of 19 EI providers trained as Trainers and
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 4
What lessons were learned from these previously implemented initiatives that could potentially enhance development and implementation of the statersquos SSIP
Implementation Work Group to ensure consideration of all stakeholder perspectives when planning and implementing changesndash state and local families
Follow-Up webinars and online QampAs after implementation ldquostart daterdquo to support consistency and fidelity in implementation
Frequent 1-page written System Transformation Updates to keep all stakeholders informed about plans decisions training opportunities etc (twice a month) helped reduce stress and misinformation about changes
Importance of using case vignettes and an activity-based hands-on approach to training
Quik reference guides as follow-up to training (having a teaching tool to take back with them)
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 5
Current Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
Integration of Child
Indicators in EI Process (Beth Tolley)
Improve outcomes for children
Improve consistency and accuracy of indicator ratings across teams and across local systems
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Assessment of outcomes is in process preliminary assessments include
More comprehensive integrated assessments
Individual child outcomes more integrated specific to childfamily
Coaching and Natural Learning Environments
(Cori Hill)
Improve outcomes for children and families through consistent implementation of evidence-based practices
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No
1 2 3 4 5
Collab with TTACs for
funding (about half)
1 2 3 4 5 1 2 3 4 5 Canrsquot answer
yet
Training still underway Outcomes to date
Development of additional resources like the coaching page on eipd website follow-up webinars
3 regions have established communities of practice to support implementation of coaching and natural learning practices
Locally driven initiatives (like Fairfax)
Early Childhood Mental Health
(Bonnie Grifa) Screening competencies credentialing professional
development through training on social and
emotional evidence based practices
Build capacity to identify and address mental health issues early
EI Providers Local System
Managers Service
Coordinators 1 2 3 4 5
Yes
No
1 2 3 4 5 EI providers financially
supported for endorsement through Early
Childhood Comp
Systems Federal grant
1 2 3 4 5
1 2 3 4 5 Success with awareness of
EI providers of VArsquos new IMH competencies
and endorsement and the of EI
applicants
Training at the local level in all 5 regions of VA for ASQ-3 screening tool and the CSEFEL Pyramid Model to begin in August 2014 so donrsquot know impact yet however there were a total of 19 EI providers trained as Trainers and
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 5
Current Initiatives Initiative Name and
Contact Person Expected Outcome Target
Population Scale of
Implementation
1=Few Districts 5=All Districts
Mandatory Regulatory
Activity
Financial Commitment
1=Low 5=High
Relationship to Focus Area for Improvement
1=Low 5=High
Level of Success
(Outcomes)
1=Low 5=High
Evidence of Outcomes
Integration of Child
Indicators in EI Process (Beth Tolley)
Improve outcomes for children
Improve consistency and accuracy of indicator ratings across teams and across local systems
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Assessment of outcomes is in process preliminary assessments include
More comprehensive integrated assessments
Individual child outcomes more integrated specific to childfamily
Coaching and Natural Learning Environments
(Cori Hill)
Improve outcomes for children and families through consistent implementation of evidence-based practices
All EI System Managers SC and providers for their work
with all children and families
1 2 3 4 5 Yes
No
1 2 3 4 5
Collab with TTACs for
funding (about half)
1 2 3 4 5 1 2 3 4 5 Canrsquot answer
yet
Training still underway Outcomes to date
Development of additional resources like the coaching page on eipd website follow-up webinars
3 regions have established communities of practice to support implementation of coaching and natural learning practices
Locally driven initiatives (like Fairfax)
Early Childhood Mental Health
(Bonnie Grifa) Screening competencies credentialing professional
development through training on social and
emotional evidence based practices
Build capacity to identify and address mental health issues early
EI Providers Local System
Managers Service
Coordinators 1 2 3 4 5
Yes
No
1 2 3 4 5 EI providers financially
supported for endorsement through Early
Childhood Comp
Systems Federal grant
1 2 3 4 5
1 2 3 4 5 Success with awareness of
EI providers of VArsquos new IMH competencies
and endorsement and the of EI
applicants
Training at the local level in all 5 regions of VA for ASQ-3 screening tool and the CSEFEL Pyramid Model to begin in August 2014 so donrsquot know impact yet however there were a total of 19 EI providers trained as Trainers and
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 6
with Virginia Department of Health under Project SEED
Includes all endorsement
fees and Reflective
Supervision State ECMH Coordinator
partially funded with EI
funding
selected as part of the 1st VA cohort for endorsement
out of the total of early childhood
providers that applied
Coaches on the CSEFEL model to bring back to their local systems
4 of the 10 providers selected for the VA Infant Mental Health Endorsement for 2014 are EI providers (40) Began endorsement process June 2014 and will finish June 2015
40 of those that applied for 2014 Endorsement in VA were EI Providers so awareness of initiative exists and supported
Plan to provide training on the new ASQ Social Emotional tool in 2015
Act Early
(Deana Buck)
Early identification of children on the autism spectrum and referral to EI services
Physicians and local system managers child care providers (early childhood professionals)
1 2 3 4 5
Awareness level
Yes
No 1 2 3 4 5 1 2 3 4 5
1 2 3 4 5
Just starting implementa-
tion
Not yet hellip but would look at increase in child find with diagnosis atypical category
Nationally looking at measuring professional development physician awareness
Infant-Toddler Specialist
Network (Deana Buck Karen Durst)
Promote excellence in early care centers and family care homes by increasing the educational level and skills of those who work with infants and toddlers
Infant and toddler caregivers in family homes centers and religiously exempt providers
1 2 3 4 5 Yes
No
1 2 3 4 5 Free to
caregivers Funded with federal block grant money
1 2 3 4 5 Still pretty
separate from EI right now
1 2 3 4 5
Change in caregiving setting and caregiver knowledge on Infant-Toddler Environmental Rating Scale
Just started 5th
year of operations New thing ndash emphasis on inclusion
Home Visiting Consortium (Catherine Hancock)
Improve the quality efficiency and effectiveness of early childhood home visiting services in Virginia through interagency collaboration
Birth - 6
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Increased collaboration among agencies and providers who do home visiting (training hellip)
Shared planning
Virginia Cross-Sector
Establish strong working relationships
Birth ndash 5 anything early
1 2 3 4 5 Yes 1 2 3 4 5
3 agencies 1 2 3 4 5 1 2 3 4 5
Have a coordinator
Regional programs
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 7
Professional Development (Cori Hill)
and interagency collaborative planning and funding around professional development
childhood related
No fund coordinator position and
CCSS Conference
established across Virginia
Increased collaboration in planning funding and delivering professional development
CoPA
(Cori Hill)
Share knowledge and information about evidence-based strategies in natural environments focusing on infants toddlers and young children diagnosed or suspected of having Autism Spectrum Disorders (ASD) and their families to enhance supports and services in the Commonwealth of Virginia
Birth - 3
Anyone who interacts with children with autism and
their families
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Participants have taken ownership
Have been in place and functioning for 7 years
They figure out how to get answers to their questions
Shared resources
Development of new resources Autism document and modules and How to Talk to Families if You Suspect Your Child May Have Autism
EHDI
(Terri Strange-Boston)
Identify congenital hearing loss in children before three months of age and assure enrollment in appropriate early intervention services before six months of age
Infants with hearing loss
and those who identify that
loss and provide
services to these children
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
All 40 local systems accept referrals from VEHDI
Electronic referral system will go LIVE in September statewide through which VEHDI will send referrals and necessary documents for automatic eligibility in Part C Local systems will also report back electronically whether childrenfamilies have accepted or declined EI services thereby speeding up the timeframe children are beginning EI services and increasing positive results for 1-3-6 goals
ldquoCall to EIrdquo campaign was created during the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 8
last year and will be implemented in JuneJuly reaching 1000 professionals who are trained to work with infantstoddlers with hearing loss
Smart Beginnings (Deana)
Ensure community conditions for a strong healthy start for young children and their families in order to support school readiness
Coalitions formed at regional level (11 in development stage 3 at full implementa-tion 8 at sustained level 4 in transition)
1 2 3 4 5 Yes
No 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
Coalitions at varying levels with diff expectations at each level But very successful in meeting expectations
Lots of support from Governor and General Assembly Working on support from business community
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 9
Should any of the above initiatives be incorporated in the statersquos SSIP If yes which ones Integration of child indicators coaching Cross-Sector Professional Development Be aware of new initiatives coming (state and national) ECMH Initiative to assist in meeting child outcomes within EI related to social and emotional development
When considering the current initiatives are there any core components that should be incorporated into the improvement strategies in the statersquos SSIP
Birth to Five Watch me Thrive national effort hellip Finding kids earlier
Collaborative activities between Infant-Toddler Specilaist Network and EI
Components of the early implementer process such as o Selecting those systems who wanted to be a part of the early implementation process o Having representatives from each region o Monthly meetings using online component as well as phone o Individual follow up with local systems for work between monthly sessions o Individual review of local system data (assessment narratives) and individualized feedback
Consider incorporating the IDEA Infant amp Toddler Coordinators Association (ITCA) recommendations from their Position Paper July 2005 to the extent that they apply to Virginiarsquos state-identified measurable result (taking action to meet needs)
1 Train EI personnel in the areas of social and emotional development including attachment theory and parent-child interactions 2 Utilize screening tools and procedures that specifically address early social and emotional development as part of statersquos child find efforts 3 Include mental healthinfant mental health professionals on evaluation teams especially when evaluating children who are homeless wards of the
state who have experienced traumatic separations from their primary caregivers or who may have been traumatized by domestic violence child abuse or neglect
4 Use the Diagnostic Classification of Mental Health and Other Developmental Disorders in Infancy and Early Childhood (DC0-3R) as diagnostic processes and codes for Medicaid and primate health insurance reimbursement
5 Promote reimbursement by Medicaid of the full range of early intervention services that include family counseling psychological and social work services if listed on the IFSP
6 Use of relationship-based and family-focused intervention strategies by early intervention personnel regardless of professional discipline or the
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 10
service being provided 7 Partner with states infant mental healthchildrenrsquos mental health efforts to effectively utilize resources coordinate efforts and enhance the know
ledge and practice base of all professionals interacting with families of infants and toddlers 8 Work across state agencies and service systems to increase the pool of counselors social workers psychologists and other clinical staff who are
trained and competent in infant mental health intervention practices 9 Make available mental health consultation to early intervention teams in order to support their intervention with specific children and families as
well as to promote the capacity of personnel to use appropriate mental health approaches and promote reflective supervision opportunities for direct early intervention staff that recognize the potential stress of providing relationship based practices and allows for adequate reflection Clinical supervision is necessary for early intervention personnel who are providing clinical services to families
FYI The ECMH VA Initiative is working on getting training in place for 1 2 4 amp 6 and working on getting 5 7 8 in place in VA Local systems should be participating in training offered on 1 2 4 amp6 and addressing 2 3 4 6 and 9 within their local systems
What were some of the challenges experienced in implementing the current initiatives
Integration of indicators ndash perception by some that they ldquowere already doing itrdquo
Coaching ndash not clear up front about our expectations for participation (required) and implementation
Wasnrsquot clear up front how various initiatives fit together and that it all connected back to EBP so it was perceived as constant disconnected change
Maintaining consistency and fidelity of implementation through time and with staff turn-over
Having enough money to make resources available to everyone
Helping local systems individualize national or state materials to their community
Infant-Toddler Specialist Network ndash capacity issues Still way more providers who need the service than the network can provide
Inclusion of children with disabilities in broader early childhood community (has come out in working with some providers in Infant-Toddler Specialist Network)
Having enough resources (staff funding) to do the level of follow-up we want to do
Communities of Practice ndash tremendous amount of work requires strong facilitation skills and significant time commitment
Questions about state lead agencyrsquos abilitywillingness to make trainingprofessional development mandatory when that seems critical to ensuring evidence-based practices are consistently implemented statewide
Capacity issue for VAIMH (Infant Mental Health) Endorsement at this time Just beginning the endorsement process in Virginia in 2014 Limited number of applicants can be accepted at this time until more are endorsed and able to assist in mentoring new endorsees reviewing portfolios for endorsement and scoring exams for higher levels of endorsement Although there is a limited capacity 40 of those accepted for endorsement were from EI and also 40 that applied were EI providers Awareness is there as well as support for endorsement within the VA EI system
Lack of Medicaid funding for a continuum of social and emotional services needed to meet needs of children with significant issues
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five
Virginia
Adapted by the Southeast Regional Resource Center (SERRC) from the District Initiative Inventory developed by the Scaling ndashup of Evidence-based Practices Center (SISEP) and the National Implementation Research Network (NIRN) The SISEP-NIRN District Initiative Inventory is available at httpimplementationfpguncedu October 2013 It is
based on the draft SPPAPR package disseminated by the Office of Special Education Programs US Department of Education in Spring 2013 Page 11
What lessons were learned from these current initiatives that could potentially enhance development and implementation of the statersquos SSIP
Value of early implementer process
Value of being part of a national effort linking to other states (Act Early)
Take advantage of existing well-researched evidence based materials
There is variability of implementation especially when not mandated
So many caregivers have no idea that EI exists (Infant-Toddler Specialist Network)
Structured roll-out and structured data systemcollection lead to more consistency
Easier to ensure everyone gets the same information when you target a smaller numbers of people
There are benefits to working at a regional level
Smart Beginnings ndash articulating why investing in early childhood is a benefit bringing in private partners
Collaborative funding
Having national experts who are real EI providers and from difference disciplines
Structured 6-month TA calls for master coaches coaching logs to ensure consistent implementation fidelity to model
Follow-up training and support after initial ldquokick-offrdquo
Having things accessible on the web is helpful
Value of face-to-face at least once a year (networking generatingmaintaining interest) ndash CoPA
Early brain development research identifying the critical need to support social and emotional development in the first 3 years of life identify issues early and intervene with appropriate relationship based intervention by competent infant mental health providers
Use of a promotion prevention and intervention model for training professionals working with children birth to five