Guidelines for the Implementation of Help Me Grow in Cuyahoga County. November, 2010

Transcription

1 Guidelines for the Implementation of Help Me Grow in Cuyahoga County November, 2010

2 Table of Contents Letter from Melissa Manos, Project Director Forms Listing and Procedures Overview of Help Me Grow of Cuyahoga County Central Coordinating Site Contact Information and Hours of Operation Background, History and Timeline Organizational Chart Committee Structure Governance Laws and Requirements The Early Childhood Coordinating Committee (ECCC) Community Partners Child Find and Public Awareness Materials order form Procedures from hospital to home Help Me Grow of Cuyahoga County Intake and Assignment Part C State At Risk / Home Visitation County At Risk / Home Visitation MomsFirst / Ohio Infant Mortality Reduction Initiative (OIMRI) Children involved with the Department of Children and Family Services (DCFS) Children not eligible Assignment process Referral follow up FORMS Help Me Grow of Cuyahoga County Central Coordinating Site Data Quality Assurance Plan Early Track 3.0 (ET 3.0) data collection system Early Track System Administrator Early Track guidance Technical guidance Payment Information Management System (PIMS) Help Me Grow reimbursement FORMS 1 Guidelines revised 11/02/10

3 Table of Contents Page Two Help Me Grow of Cuyahoga County Child Records Central Coordinating Site record Agency record Transferring records Confidentiality Parents Rights and Consent Accessibility of records Record retention FORMS Personnel Changes in staff Credentialing Training Adequate supervision Back up plans FORMS Expectations for Home Visits and Other Contacts with Families Contacting new referrals Ongoing contact Caseloads Expectation for home visits Screenings Program evaluation Parents as Teachers, Born to Learn FORMS Part C Children with a diagnosis Informed written consent Scheduling developmental evaluation and assessments If child is determined not Part C eligible Ongoing Part C assessments Child Outcomes Summary Form (COSF) Part C services Bureau of Children with Medical Handicaps (BCMH) EI system of payment The role of the Service Coordinator and the role of the Developmental Specialist Cuyahoga County Board of Developmental Disabilities (CCBDD) FORMS 2 Guidelines revised 11/02/10

4 Table of Contents Page Three Family Support Help Me Grow Family Council Family representation on ECCC Part C families Home visiting families Family Information Network (FIN) FORMS Transition FORMS Miscellaneous Parents Rights / Local Complaint Process Parent, guardian and custody issues DCFS protocols Reporting suspected cases of child abuse and neglect Reporting Incidents Child Fatality Review Reporting Incidents and Contacting Help Me Grow in an emergency Public transportation Interpreter services County family emergency funding Children s Trust Fund Literacy services Parenting Plus at Home Services FORMS INDICATES AN ACCOMPANYING FORM INDICATES A REFERENCE TO THE CHILD S FILE INDICATES POLICY REFERENCE 3 Guidelines revised 11/02/10

5 Letter from Melissa Manos Dear Help Me Grow Colleague: We are pleased to share with you the Guidelines for the Implementation of Help Me Grow in Cuyahoga County. This document is a culmination of the efforts from many of our HMG stakeholders. Information includes references to the Ohio Help Me Grow Policies developed by the Ohio Department of Health/Bureau of Early Intervention Services and guidance on how Cuyahoga County implements these policies and provides HMG services locally. We encourage you to use this document to assist you in following best practices and in understanding the Help Me Grow comprehensive system of services. Through a collaborative and interactive process involving many entities, we have produced the Guidelines with the following intentions: To offer a historical perspective on the development of the Help Me Grow system and the countywide early childhood system of services. To provide an understanding of the structure of the Help Me Grow of Cuyahoga County organization. To offer the most up-to-date information about Ohio HMG Policies and county implementation guidance. To share information that will assist you in participating in the Help Me Grow system of services. This is an exciting as well as a challenging time for Help Me Grow. You have an important role in the present and future of Help Me Grow of Cuyahoga County. Help Me Grow is a very special organization made up of people working together to ensure young children and their families receive the services that they need to grow and thrive. We thank you for your commitment and contribution to making a difference in the lives of our youngest children and their families. Sincerely, Melissa Manos Project Director Help Me Grow of Cuyahoga County 4 Guidelines revised 11/02/10

6 Overview of Help Me Grow of Cuyahoga County Forms Listing and Procedures HELP ME GROW FORMS AND PROCEDURES Note: Where not otherwise indicated, the form is the responsibility of the Service Coordinator/Home Visitor Adult Adolescent Parenting Inventory Assessment (AAPI-2, Form A): Required for Home Visiting only Program Evaluation Form to be used at required intervals Measures parenting and child-rearing attitudes Ages and States Questionnaire (ASQ): Required for At Risk and Home Visiting Developmental Screening form to be used at required intervals Ages and Stages Questionnaire Social Emotional Version (ASQ:SE): Required for all HMG: Part C, At Risk and Home Visiting Social Emotional Screening form to be used at required intervals Case Notes: Required for all HMG: Part C, At Risk and Home Visiting Must use ODH required form for all children and families Child Information and Referral Data Collection Form: Required for all HMG: Part C, At Risk and Home Visiting Must use and have the required form in the record Completed by Help Me Grow Intake Consent for Services and Parent s Rights in the Help Me Grow Part C Program: Required for Part C (See related consent form for Home Visiting and At Risk) Must use Cuyahoga County Form Consent is required before eligibility can be determined for Part C or State At Risk (While consent is required for County At Risk, eligibility is determined prior to consent) Consent for Services and Parent s Rights in the Help Me Grow Home Visiting Program: Required for Home Visiting and At Risk (See related consent form for Part C) Must use ODH required form Consent is required before eligibility can be determined for State Home Visiting (While consent is required for County Home Visiting, eligibility is determined prior to consent) 5 Guidelines revised 11/02/10

7 Overview of Help Me Grow of Cuyahoga County Forms Listing and Procedures Developmental Summary Report Form: Cuyahoga County form used to document the findings from developmental evaluations and assessments The long form is used for the initial evaluation and assessment The short form is used for ongoing assessments Completed by evaluators Edinburgh Postnatal Depression Scale (EPDS) Form: Required for all HMG: Part C, At Risk and Home Visiting that meet the criteria below unless the family opts out Required for all birth mothers whose program eligible child is 6 months old or younger Must be completed prior to the first IFSP or FP review Identifies women who are at risk of depression during the perinatal period Evaluation Scheduling Card: Cuyahoga County form used to document initial evaluation and IFSP appointments Top half of form is for the parent and bottom half of form is for the child s record Evaluation Snapshot: Cuyahoga County form used to document the abbreviated findings from developmental evaluations and assessments Used when the developmental evaluation and assessment date is close to the 45 day timeline Completed by evaluators Family Plan: Required for Home Visiting only Must use ODH required form 45 Day Collection Form: Required for Home Visiting only Cuyahoga County requires the use of the ODH form Hearing Status Questionnaire: Required for all HMG: Part C, At Risk and Home Visiting Must be completed unless a hearing screening has been administered by a qualified health professional within 90 days prior to the date of referral (and results are in child s record) or the child has had a Universal Newborn Hearing Screen within 180 days Hearing Screening to be completed once within initial 45 days IFSP (Individualized Family Service Plan): Required for Part C and At Risk family Must use ODH required form 6 Guidelines revised 11/02/10

8 Overview of Help Me Grow of Cuyahoga County Forms Listing and Procedures Infant/Toddler HOME Summary Sheet and Record Form: Required for Home Visiting only prior to the first Family Plan Review Families have the right to opt out Measures how stimulating the home environment is for the infant or toddler Interpersonal Support List (ISEL) Form: Required for Home Visiting only Program Evaluation Form to be used at required intervals Measures the perceived availability of a family s social support Maternal Behavioral Health Referral Fax Form: Cuyahoga County Form to be used to make a referral for maternal mental health services Used with a variety of programs in Cuyahoga County Multisystem Release of Information Form or Authorization & Consent for Release of Information: Required for all HMG: Part C, At Risk and Home Visiting Must be completed before HMG can request or release information about a family Either form may be used Ongoing Home Visit Data Collection Form: Required for Home Visiting only Cuyahoga County requires the use of the ODH form Used to document Home Visiting activities and required data Parental Prior Notice Form This form is to be used for Part C families only to document: Written Prior Notice, IFSP Meeting Notice and the waiver for IFSP updates. It replaces the Written Prior Notice Form, IFSP Meeting Notice Form and the ODH created Parental Prior Notice Form. SC can use this form (middle section only) for AR families or can use the old IFSP meeting notice form. Not required for HV families. Top Part of form (Written Prior Notice) required when initiating or changing an evaluation or Part C service unless the change happens at an IFSP meeting. Parenting Stress Index: Short Form (PSI-SF): Required for Home Visiting only Program Evaluation Form to be used at required intervals Measures a parent s stress PEACH (Parent Eating and Nutrition Assessment for Children with Special Health Needs) Survey: Required for all HMG: Part C, At Risk and Home Visiting Must be completed unless child is receiving WIC or a Nutrition screening has been administered by a qualified health professional within 90 days prior to the date of referral (and results are in child s record) Nutrition Screening to be completed once within initial 45 days 7 Guidelines revised 11/02/10

9 Overview of Help Me Grow of Cuyahoga County Forms Listing and Procedures Referral Follow-Up Form: Required for all HMG: Part C, At Risk and Home Visiting Must use ODH required form for all children and families Must be sent to referral source within 45 days of referral Sent to all referral sources except self referrals Completed by intake when not assigned to an agency. Otherwise, completed by the Service Coordinator, Home Visitor or Transition Liaison Request for Service Form: Required for all HMG: Part C, At Risk and Home Visiting Cuyahoga County form Completed by Referral sources and/or by Intake for new referrals Completed by SC/HV for families that are currently being served and referred to a different category in Help Me Grow (ie. At Risk to Part C) Safety Checklist: Required for all HMG: Part C, At Risk and Home Visiting While ODH only requires this for Home Visiting families, Cuyahoga County requires it for all families Must use ODH required form for all children and families Must be completed prior to the IFSP or FP review and then annually Taking a Look Checklist: Required for all HMG: Part C, At Risk and Home Visiting Must be completed unless a vision screening has been administered by a qualified health professional within 90 days prior to the date of referral (and results are in child s record) Vision Screening to be completed once within initial 45 days Template Exit Letter: Required for all HMG: Part C, At Risk and Home Visiting Required when there has been successful contact This meets the policy requirement of Written Notification of Exit Notification to parents and all service providers listed on the most recent IFSP. Must include (for parents) a mechanism for requesting and reviewing their child s record as well as information that the child s record may be destroyed when the child turns three. For Part C children, it must also include a statement about services listed on the IFSP (if applicable) ending Transition Planning Conference Meeting Notice: Required for Part C and At Risk Cuyahoga County Form 8 Guidelines revised 11/02/10

10 Overview of Help Me Grow of Cuyahoga County Central Coordinating Site Central Coordinating Site Hours: 8:30 a.m. - 4:30 p.m. Help Me Grow of Cuyahoga County 8111 Quincy Avenue, Suite 34 Cleveland, OH (216) Phone; (216) Fax Evaluation Team Fax: (216) Help Me Grow of Cuyahoga County website: Help Me Grow Staff Roster Name Title Phone Anderson, Yolanda Intake Specialist Bixel, Missy Lead Data Specialist Brahim, Nadia Quality Assurance Specialist Broadnax, Kim Evaluation Team Leader Browning, Teresa Family Literacy Specialist Carissimi, Jill Part C Evaluator Clellen, Cheryl Part C Evaluator Cleugh, Michelle Part C Evaluator Conway, Caryn Intake Specialist Davis, Kristine Family Literacy Specialist Edwards, Susan Human Resource Consultant Fagin, Sharon Lead Family Literacy Specialist Hickey, Marie Technology Coordinator Hunter, Marti Communications Coordinator TBD Administrative Assistant II Kerfonta, Christina Family Literacy Specialist Lowder, Angela Finance Manager Mago, Lori Quality Assurance Team Leader Manos, Melissa Project Director Mintzer, Karen Services Manager Mitchell, Myrtle Transition Liaison O'Dale, Kelly Accounting Assistant Prokesh, Victoria Data Entry Specialist Sawyer, Gale Evaluation Scheduler Schultz, Nancy Part C Evaluator Tadsen, Mary Jo Bilingual Part C Evaluator Walker, Toni Quality Assurance Specialist Whiteaker, Anne Billing Specialist Williams, Mary Records Specialist Zentarski, Kayann Lead Family Support Specialist Guidelines revised 11/02/10

11 Overview of Help Me Grow of Cuyahoga County Background and History Background and History Help Me Grow (HMG) is a statewide program that supports families with newborns, infants, and toddlers by providing child development and health information, positive parenting education and connecting families to community resources. Every county in Ohio has a Help Me Grow program that provides services. These services include parenting education through home visiting, early identification of children who may have developmental delays or disabilities, service coordination linking families to community resources and early intervention services, and family service plans for all Help Me Grow families. Services are voluntary and designed around the family s goals and concerns. Help Me Grow in Cuyahoga County has a long history of collaboration for the benefit of young children and families. Early Intervention In 1986, with the passage of an amendment (Part H, now Part C) to the Individuals with Disabilities Education Act that created an Early Intervention Program for Infants and Toddlers, the Ohio Department of Health became the lead agency in Ohio for overseeing a statewide, coordinated system of services for children (birth to three) with developmental delays and disabilities. Local Collaborative Group Under the Ohio Department of Health s direction, each county established a local collaborative group to oversee early intervention services in that county. In Cuyahoga County, representatives from three agencies Achievement Centers for Children, Sight Center, and the Board of Mental Retardation/ Developmental Disabilities came together to begin the local collaborative group (known then as the Cuyahoga County Early Intervention Local Collaborative Group, CCEILCG) which grew to include a multitude of community organizations, early childhood stakeholders, and caregivers. The mission of the Collaborative was to oversee the implementation of early intervention services for children birth to three. Ohio Early Start In 1995, the Ohio Department of Health, Bureau of Early Intervention Services, began Ohio Early Start to address the needs of families with infants and toddlers who may be at risk of developmental delays because of environmental risk factors. Cuyahoga County was a pilot county for Ohio Early Start, serving 282 families in its first year. The Cuyahoga County Early Intervention Local Collaborative Group was given the task to oversee the implementation and administration of the Early Start program in the county. A system of home visits was established using community-based organizations. The focus was on helping families to achieve family-driven goals and address the developmental needs of their young children. 10 Guidelines revised 11/02/10

12 Overview of Help Me Grow of Cuyahoga County Background and History (continued) Welcome Home In 1999, the Ohio Department of Health, Bureau of Early Intervention Services began the Welcome Home Program to provide a nurse visit to newborns after leaving the hospital. Again, the Cuyahoga County Early Intervention Collaborative (the CCEILGC renamed CCEIC) was asked to implement and administer this program. All birthing hospitals provided a Welcome Home visit to first time and teen parents and their newborn. Cuyahoga County Early Childhood Initiative (Invest in Children) In 1999, inspired by the new research showing the importance of the first five years of life, 23 private foundations and corporations joined with county government and redesigned the face of human services for young children and their families. Working together, the Early Childhood Initiative (ECI) launched a plan to ensure that all children in the county received the best possible start in life. The three goals of ECI were 1) effective parents, 2) healthy children, and 3) quality childcare. This network of services reached out to families at birth, offering home visits, enrollment in health insurance, quality child care, and information about the importance of early years. An expanded network of services was recommended through the Strategic Planning process, conducted in Now called Invest In Children (IIC), the expanded goals, services, and accountability measures built upon the first five years and include the goals of effective parents and families, safe and healthy children, children prepared for school, and a community committed to children. Ohio Help Me Grow In 2001, the Ohio Department of Health integrated Early Intervention, Early Start, and Welcome Home under the umbrella of Help Me Grow. Throughout Ohio, Help Me Grow was to be identified as the system of services provided previously by Early Intervention, Early Start, and Welcome Home. The intent of the integration was to create a seamless system of developmental, parenting, and health services for families with newborns, infants, and toddlers. In 2009, Ohio Help Me Grow was restructured to include only home visiting and Part C. Two workgroups at the state level have been evaluating and making policy recommendations to the Help Me Grow program components (home visitation and Part C, Early Intervention). Center for Early Childhood Development Presently, Ohio is redesigning and implementing a new administrative structure for the early childhood development system. Am. Sub. HB1 authorized Ohio to create a Center for Early Childhood Development within the Ohio Department of Education to improve the coordination and integration of early childhood development programs, services and funding sources. The Help Me Grow Program will be a part of the Center for Early Childhood Development, with the Ohio Department of Education formally designated as the lead agency for Help Me Grow. For more information about the Center for Early Childhood Development, visit the Build Ohio website at 11 Guidelines revised 11/02/10

13 Overview of Help Me Grow of Cuyahoga County Historical Timeline 1976: Federal law provides for the free and appropriate education for children with disabilities (from age five) through the Individuals with Disabilities Education Act (IDEA). 1986: IDEA amendments (research shows that even earlier use of health, social, and educational services improve children s chances of reaching potential) establish Early Intervention Services for children birth to 3. Ohio Department of Health becomes Ohio s lead agency for Early Intervention. Established 88 Local Collaborative Groups (County) to oversee Early Intervention Services in Ohio counties Planning Committee is established to begin the Cuyahoga County Early Intervention Local Collaborative Group (CCEILCG). 1988: CCEILCG begins. 1988: Interlink is founded by the Achievement Centers for Children to help families find services for children with special needs (ages birth-22). 1992: Interlink is designated as the county s Central Coordinating Site for Early Intervention (Birth to Three) with the Cuyahoga County Early Intervention Local Collaborative Group. 1995: Ohio opts to serve children and families at risk for developmental delays due to environmental factors through the Early Start Program. 1996: CCEILCG becomes Lead Agency for Early Start Program. 1997: Services of early intervention for children birth to three are reaffirmed as Part C of the IDEA. 1998: Cuyahoga County Early Intervention Local Collaborative Group changes name to Cuyahoga County Early Intervention Collaborative (CCEIC). Decade anniversary celebrated. 1999: Interlink moves to William Patrick Day Early Childhood Center. Interlink is central coordinating site for Early Intervention and Early Start, administered through the CCEIC. Interlink focuses on families with children birth to three with or at risk of having special needs. 1999: Cuyahoga County Early Childhood Initiative begins. Public-Private partnership committed to promoting and improving effective parenting, healthy children and quality child care in order to assure the well being of all children birth through age five in Cuyahoga County. 1999: Welcome Home Program begins. CCEIC is designated Lead Agency. 1999: Kids Interfaced Data System (KIDS) begins, coordinating data from Welcome Home, Early Start and Early Intervention. 1999: Early Start and Welcome Home are included in Cuyahoga County Early Childhood Intiative. 2000: Programs under the auspices of the CCEIC include: Early Intervention, Early Start, Welcome Home, Interlink at Starting Point, Parent Partners, and Resource & Referral. 2001: Under the leadership of the Ohio Department of Health and Ohio Family & Children First Council, Help Me Grow integrates three 'birth to three' programs (Welcome Home, Early Start, Early Intervention) on a statewide basis. 2001: The Cuyahoga County Early Intervention Collaborative becomes the Help Me Grow Collaborative and is a Standing Committee of the Family & Children First Council. Interlink becomes Interlink-Help Me Grow, and is the Central Intake and Referral site for Help Me Grow services. 12 Guidelines revised 11/02/10

14 Overview of Help Me Grow of Cuyahoga County Historical Timeline (continued) 2002: Help Me Grow Collaborative of Cuyahoga County Code of Regulations approved. Community Advisory Council begins with new representation and increased family involvement. Interlink-Help Me Grow becomes Help Me Grow and is the Central Intake and Referral site for Help Me Grow services. 2003: Local taskforce is charged with developing and recommending a model for Cuyahoga County's Help Me Grow service delivery that integrates Early Start and Early Intervention services : Transition plan to new service delivery model underway. 2004: Cuyahoga County Early Childhood Initiative becomes Cuyahoga County Invest in Children with a 5-year strategic plan. 2004: Individuals with Disabilities Education Act (IDEA) reauthorized as Individuals with Disabilities Improvement Education Act (IDEIA) 2005: Cuyahoga County Board of Mental Retardation and Developmental Disabilities provides developmental evaluations to determine eligibility for Part C services of IDEIA. 2006: The Office of Early Childhood is established under the Cuyahoga County Board of Commissioners. Invest In Children is a program of the Office of Early Childhood. 2006: Invest In Children establishes Goal Committees and Subcommittees to oversee Invest In Children s Strategic Plan. The structure of the Help Me Grow Collaborative concludes. 2007: Ohio Department of Health Policy establishes Early Childhood Coordinating Committee to oversee local Help Me Grow programs. 2007: Partnership between Help Me Grow, MomsFirst, and Ohio Infant Mortality Reduction Initiative begins. A system of prenatal services in the county is established. 2008: Services provided by Help Me Grow of Cuyahoga County include: Child Find and Public Awareness Service Coordination/Individualized Family Service Plan Family Support Multi-disciplinary Evaluation Home Visiting Services Linkages to Specialized Services Referrals for lead screening and evaluation Early literacy home visits and activities Maternal Depression Screening Ages & Stages Questionnaire Social-Emotional and linkages to Early Childhood Mental Health providers 2009: Local restructuring of the Help Me Grow Program takes place to accommodate 40% reduction in funding : Ohio is redesigning and implementing a new administrative structure for the early childhood development system. Am. Sub. HB1 authorized Ohio to create a Center for Early Childhood Development within the Ohio Department of Education to improve the coordination and integration of early childhood development programs, services and funding sources. The Help Me Grow Program will be a part of the Center for Early Childhood Development, with the Ohio Department of Education formally designated as the lead agency for Help Me Grow. In addition, two workgroups at the state level are evaluating and making policy recommendations to the Help Me Grow program components (home visitation and Part C, Early Intervention). New Help Me Grow policies are finalized (see 13 Guidelines revised 11/02/10

15 Overview of Help Me Grow of Cuyahoga County Committee Structure 14 Guidelines revised 11/02/10

16 Overview of Help Me Grow of Cuyahoga County Governance Ohio Department of Health: 246 N. High Street, 5 th floor Columbus, Ohio ADMINISTRATIVE AGENT AND USE OF HMG FUNDS POLICY CAN BE FOUND AT The Ohio Department of Health/Bureau of Early Intervention Services establishes the policies, standards, and procedures for the statewide Help Me Grow Program. The HMG Program is supported through various funding sources: State General Revenue Funds (GRF), and Part C federal funds under the Individuals with Disabilities Education Act (IDEA) which ODH distributes to the 88 counties for the local Help Me Grow Program. The ODH distributes Part C federal funds through the Grants Administration Policy and Procedure Process. The ODH distributes State General Revenue Funds through Subsidy Agreements, Contracts or Grants which define the use of funds and required reporting. Locally, Help Me Grow receives additional funding from the Board of County Commissioners through the Office of Early Childhood/Invest in Children, Family & Children First Council s Children s Trust Fund grant, and Cuyahoga County Board of Developmental Disabilities. Ohio Family & Children First Council: Office of the Governor 77 S. High Street, 30 th Floor Columbus, Ohio Ohio Family & Children First Council is a partnership of government agencies and community organizations committed to improving the well being of children and families. The Help Me Grow Program is a part of Ohio s Family & Children First Council s commitments to child well being: Expectant parents and newborns thrive. Infants and toddlers thrive. Children are ready for school. Children and youth succeed in school. Youth choose healthy behaviors. Youth successfully transition into adulthood. These commitments serve as a continual barometer of progress in improving the lives of Ohio's children. 15 Guidelines revised 11/02/10

17 Overview of Help Me Grow of Cuyahoga County Governance (continued) In Cuyahoga County: Cuyahoga County Family & Children First Council: 1801 St. Clair Avenue Cleveland, Ohio (216) ; (216) fax Robin Martin, Director In Cuyahoga County, the Family & Children First Council, under the Board of Commissioners, promotes a collaborative system of care emphasizing coordination across a continuum of family-centered, neighborhood based services to ensure the well being of every child, and to preserve and strengthen families in their communities. Funding through Children s Trust Fund grant is used to support child abuse prevention through Help Me Grow home visiting. Cuyahoga County Family & Children First Council (FCFC) Child Well Being Initiative is a collaborative system for addressing the needs of all children as early as possible. Invest in Children 310 W. Lakeside Avenue, Suite 565 Cleveland, Ohio (216) or (216) Rebekah Dorman, Ph.D., Director Invest in Children/Office of Early Childhood (formerly known as the Early Childhood Initiative) is responsible for the implementation of a multi-strategy broad community initiative to comprehensively address the needs of children prenatal-five. The strategic goals of Invest in Children are: Effective Parents and Families Safe and Healthy Children Children are Prepared for School A Community Committed to Children Help Me Grow works closely with Invest In Children/Office of Early Childhood in evaluating services, determining gaps in services, addressing needs, expanding and improving services, and engaging in new initiatives focused on infants and toddlers and their families. Additional local funding through Invest In Children enables Help Me Grow to provide services to scale, ensure high risk families receive Help Me Grow home visiting, provide early literacy home visits, support stress management home visits for families with medically fragile children, and begin new initiatives to meet existing needs. 16 Guidelines revised 11/02/10

18 Overview of Help Me Grow of Cuyahoga County Governance (continued) The Cuyahoga County Board of Developmental Disabilities 1275 Lakeside Ave. East Cleveland, Ohio (216) FAX (216) Terrence M. Ryan, Ph.D., Superintendant The Cuyahoga County Board of Developmental Disabilities (CCBDD) supports more than 8,000 boys and girls and men and women in finding a better place in life. CCBDD offers a full range of services for children and adults with developmental disabilities. CCBDD provides funding to Help Me Grow for service coordination and Part C children, and partners with Help Me Grow to provide global evaluations/assessments for children referred to Help Me Grow Part C. CCBDD also conducts ongoing assessments for Part C children and provides a variety of services to meet their needs. The Educational Service Center of Cuyahoga County: 5811 Canal Road Valley View, OH Ph Fax Robert A. Mengerink, Ph.D., Superintendent The mission and goals of the Educational Service Center of Cuyahoga County are to provide assistance to contracted school districts and agencies in order to offer a broad range of resources to support their mission to serve all learners. The Educational Service Center of Cuyahoga County acts as the fiscal agent for Help Me Grow of Cuyahoga County. 17 Guidelines revised 11/02/10

19 Overview of Help Me Grow of Cuyahoga County Laws and Regulations In 2001, Ohio began the Help Me Grow System. The system has a set of laws, rules and regulations that govern the program. These rules define the operation of Ohio's statewide, comprehensive, coordinated, interagency system of services for expectant parents, newborns, infants and toddlers at risk for developmental delay or disabilities. (from Federal Law for Help Me Grow Part C On the federal level, Part C is governed by the Early Intervention Program for Infants and Toddlers with Disabilities enacted in 1986 under the Individuals with Disabilities Education Act (IDEA; 20; U.S.C., Section 1431 et seq.). IDEA has been updated about every five years since its beginnings, the latest of which is the 2004 reauthorization. The Program for Infants and Toddlers with Disabilities (Part C of IDEA) assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through 2 years, and their families. In order for a state to participate in the program it must assure that early intervention will be available to every eligible child and its family. Also, the governor must designate a lead agency (Ohio Department of Health) to administer the program and appoint an Interagency Coordinating Council, including parents of young children with disabilities to advise and assist the lead agency. For more information about IDEA, Part C: The National Early Childhood Technical Assistance Center: The Federal Office of Special Education Programs (OSEP) under the Office of Special Education and Rehabilitative Services State and Local Law for Help Me Grow programs On the State and Local level, the Help Me Grow program is governed by rules and policies. These policies cover both the Part C and Home Visiting components of the Help Me Grow program, as well as general policies for the program. In , two state workgroups evaluated and made recommendations to the governor concerning Part C and Home Visiting in Ohio. Work continues at the state level to ensure evidenced-based, best practice services for young children and their families. Current Ohio Department of Health Help Me Grow Policies are available on the Ohio Department of Health, Help Me Grow website at 18 Guidelines revised 11/02/10

20 Overview of Help Me Grow of Cuyahoga County The Early Childhood Coordinating Committee The Early Childhood Coordinating Committee (ECCC) The ECCC assists the FCFC in the design, coordination and implementation of a comprehensive, coordinated, interdisciplinary, family-centered Help Me Grow system of services for families with an infant or toddler at risk for or with developmental disabilities/delays. The main purposes of the ECCC is to collaborate with families, community agencies and public systems to ensure a coordinated delivery of Help Me Grow services; to build effective linkages between systems of services for the benefit of infants and toddlers and their families; and to identify gaps in services for young children. The ECCC is composed of required Ohio Department of Health members and designated representatives. Membership on the ECCC will include: 1. Parent Representatives (20%) 2. Cuyahoga County Department of Children and Family Services 3. Cleveland Metropolitan Schools 4. Cuyahoga County Alcohol, Drug Addiction & Mental Health Services 5. Education Service Center of Cuyahoga County 6. Provider Agency Representative (2) 7. Cuyahoga County Employment and Family Services 8. Cuyahoga County Board of Developmental Disabilities 9. Community Endeavors 10. State Support Team-Region Family and Children First Council 12. Suburban School District 13. Cleveland/Cuyahoga County Office of Homeless Services 14. Council for Economic Opportunities of Greater Cleveland 15. Office of Early Childhood/Invest In Children 16. WIC 17. Starting Point 18. Physician/Medical Provider EARLY CHILDHOOD COORDINATING COMMITTEE POLICY CAN BE FOUND AT The State Fiscal Year 2011 ECCC meetings will be held on October 14, 2010, January 13, 2011, and April 14, Guidelines revised 11/02/10

21 Overview of Help Me Grow of Cuyahoga County Partners Help Me Grow of Cuyahoga County has a history of working with many public partners to create a system of services for young children and families. These partnerships include: Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County (ADAMHS): On July 1, 2009, the Alcohol & Drug Addiction Services Board of Cuyahoga County consolidated with the Cuyahoga County Community Mental Health Board to form the ADAMHS Board of Cuyahoga County. The ADAMHS Board is responsible for the planning, funding and monitoring of public mental health and alcohol and other drug addiction services delivered to the residents of Cuyahoga County. The ADAMHS Board contracts with many agencies to provide services to children and adults with mental health and/or alcohol and drug addiction services. The 24 hour mental health crisis, information and referral hotline is The ADAMHS Board specifically contracts with the following six agencies to provide Early Childhood Mental Health Services. Help Me Grow Service Coordinators can connect families to these services to assist with children s behavior, children s social-emotional delays and/or to assist with parent bonding or the parent-child relationship. Achievement Centers for Children - The Achievement Centers early childhood mental health treatment model emphasizes engagement with the family, and each family works with the same clinician from assessment through treatment. Children are served in home, childcare or preschool settings and services can be provided jointly with rehabilitation therapy. The average treatment period is nine to 12 months and families often continue involvement in other Achievement Centers programs. Contact: Kristine Snell (216) , Applewood Centers, Inc. - Applewood believes that the needs of both parent and child must be met in order to make positive changes in the relationship, which is the key to helping the child. Therapeutic approaches combine psychodynamic therapy, developmental guidance, concrete assistance, and emotional support as well as more traditional behavioral interventions and parenting techniques. Children are served primarily in the family home, but families can choose office visits at their discretion. Contact: Carolyn Welker, Erzsi Vesei, (216) ; Beech Brook - Beech Brook s early childhood mental health treatment is home-based, short-term and goal focused. The intervention model addresses the child s behavior and relationship difficulties that are interfering with relationships in the family and with the child s social, emotional, and cognitive development. Beech Brook s program is based on the evidence-based Homebuilder s family preservation model. Beech Brook therapists can also provide early childhood mental health services to families who are in homeless shelters. Contact: Intake Department , Ext. 3202; Chris Winsberg, intake@beechbrook.org 20 Guidelines revised 11/02/10

22 Overview of Help Me Grow of Cuyahoga County Partners (continued) Bellefaire Jewish Children s Bureau - Bellefaire Jewish Children s Bureau bases its intensive, in-home early childhood mental health treatment model on its long history with a strength-based family systems framework grounded in the belief that all individuals have the power to learn, change and grow. Bellefaire clinicians provide intensive, home-based services each week for 90 days. Families who are struggling with multiple identified issues may extend services. Contact: Sally Struk, Gabriela Trybus, ; bellefairejcb.org/ Berea Children s Home and Family Services - Berea Children s Home s family-centered and childfocused treatment fosters the primary therapeutic relationship the relationship between parents and children. BCHFS s early childhood mental health treatment model is grounded in clinical research, infused with evidence-based practices and includes a strong understanding of behaviorism and behavioral therapy. Families typically receive services in home and preschool for three-six months, with greater intensity in the earlier part of treatment. Contact: Andy Cooper, ; ecmh@bchfs.org Positive Education Program (PEP) - PEP s early childhood mental health treatment work is based on Re-Education, a strength-based ecological approach that targets and builds on personal strengths. PEP also incorporates other evidence-based practices and their treatment philosophy focuses on client strengths, family involvement and data-driven decision-making. Parents are supported by both professional staff and parent coaches through center-based experiences designed to increase the parent s understanding of child development. The program s minimum expectation is twice weekly participation; this participation may be primarily center-based or include home/communitybased sessions. Contact: Ann Bowdish, Laurie Albright ; info@pepcleve.org Cuyahoga County Board of Developmental Disabilities (CCBDD): CCBDD provides a full range of services to over 8,000 individuals. These services range from in-home early intervention programs for very young children and their families to leisure programs for seniors. Help Me Grow Service Coordinators can help connect families to Early Intervention and Family Support Services. Early Intervention Services that are available include: specialized instruction; speech, occupational and physical therapy; and assistive technology services. Additionally, CCBDD has toddler programs throughout Cuyahoga County as well as the PLAY project for children with a diagnosis of Autism spectrum disorder or with concerns in that area. Children receiving these services from CCBDD may also receive health, nursing, nutrition or psychological services. Contact either Kathy Wojciak ( ) or Celeste Bajorek ( ) for information about specialized instruction services, Autism services or the Toddler program. Contact Kathy Zielinski ( ) for questions about speechlanguage pathology services or Janet Cimino ( ) for information about occupational or physical therapy services. CCBDD also has Family Support Services (FSS). FSS can provide respite services and/or some financial assistance to support specific things related to a child s special needs. For questions about Family Support services, contact Tim Lewiski ( ). 21 Guidelines revised 11/02/10

23 Overview of Help Me Grow of Cuyahoga County Partners (continued) Cuyahoga County Employment & Family Services (EFS) Virgil E. Brown Center 1641 Payne Avenue Cleveland, Ohio Employment and Family Services is responsible for the administration of Ohio Works First/Cash Assistance, the Food Assistance, the Prevention, Retention and Contingency Program/Emergency Cash, Healthy Start/Healthy Families, Medicaid for the aged, blind and disabled and child care assistance programs as well as a variety of other services to assist families in achieving employment. Employment and Family Services helps to identify families who could benefit from Help Me Grow services. Employment and Family Services ensures information about Help Me Grow services is widely distributed throughout the EFS system and caseworkers are aware of the Help Me Grow referral process. In turn, Help Me Grow makes appropriate referrals to Healthy Start and other EFS services. Through the Temporary Incapacitated Persons (TIP) program at EFS, pregnant women contact Help Me Grow to learn more about HMG prenatal services. EMPLOYMENT & FAMILY SERVICES Central Office Virgil E. Brown Building, 1641 Payne Avenue, Room 390, Cleveland, OH (fax); (Automated Information Line) Valerie Baker, Manager Sabina Ingram, Analyst Gloria J. Jones, Administrative Assistant Phone, Fax Customer Relations Specialists: SPECIALIST NFSC PHONE# FAX# Donna Hursh BOCC Admin Bldg James Jones Fairfax Cynthia Walker Glenville/VEB Jose Figueroa Jobs, Education & Training (JET) La-Tresia Smith Mt. Pleasant (M/T/W) Southgate (Th/F) Marilyn Bagley Old Brooklyn Karen Zolar HCR VACANT Westshore Revised 9/11/09 22 Guidelines revised 11/02/10

24 Overview of Help Me Grow of Cuyahoga County Partners (continued) Early Head Start is a comprehensive educational program funded through the Federal government, which serves pregnant women, infant and toddlers, ages 6 weeks through 3 years of age from families with low-income. The Council for Economic Opportunities (CEOGC) and West Side Ecumenical Ministry (WSEM) are the grantees for Cuyahoga County. Contact Person CEOGC: Mrs. Peggie Price (216) WSEM: Carol Valley (216) ext.260 Head Start is a comprehensive education program funded through the Federal government, which serve children 3 through 5 years of age from low-income families. The Council for Economic Opportunities operates the Head Start program in Cuyahoga County directly as well as in concert with delegate agencies. Contact Person: Mrs. Peggie Price (216) Hospital-Based Child Find Specialists (HBCFS) Diane Kahl, MetroHealth, Matthew Hoffman, Cleveland Clinic Children s Hospital, Kristin Webb, University Hospitals Caren Kirchick, University Hospitals Help Me Grow Hospital-Based Child Find Specialists are an integral part of the Help Me Grow Program. Located at each of the three major hospital systems Cleveland Clinic Children s Hospital, MetroHealth, and University Hospitals the HBCFS are uniquely positioned to identify children who could be eligible for Help Me Grow services. They also provide important linkages and outreach to physicians within the hospital systems. HBCFS establish an ongoing partnership with Help Me Grow service coordinators working directly with children and families receiving Help Me Grow services. They provide access to hospital medical records (with a release from families), help with special requests, consultation with HMG providers and medical professionals and share individualized family service plans (IFSP) and evaluations with medical professionals upon request. The HBCFS meet with Help Me Grow staff and providers to ensure a coordinated process of early identification and referral of children with developmental concerns or at risk children and families. They work with staff on Transition from Hospital to Home procedures (procedures to follow), make referral recommendations for the Parenting Plus at Home Project, help to ensure consistency of eligibility definitions and ensure referrals are made in a timely manner. 23 Guidelines revised 11/02/10

25 Overview of Help Me Grow of Cuyahoga County Partners (continued) 24 Guidelines revised 11/02/10

26 Overview of Help Me Grow of Cuyahoga County Partners (continued) LEA (Local Education Agency) The Local Education Agency (LEA) or school district exercises administrative control or direction over public elementary schools and/or secondary schools. There are 31 LEAs /school districts in Cuyahoga County. For a child receiving HMG Part C services who is suspected of having a disability as defined by Part B of IDEA, an LEA representative shall be invited to the Transition Planning Conference, with parent consent. School District Contacts for Preschool Special Education can be found on the internet at Educational Service Center of Cuyahoga County; Newsletter & Publications; under publications: Transition from Early Intervention to Preschool. For specific updates to this document, contact MMitchell@helpmegrow.org or call Myrtle Mitchell, HMG Transition Coordinator at (216) Medical Community The health care provider has an important role in Help Me Grow. Medical professionals identify children and families who could benefit from all Help Me Grow services. In partnership with the Hospital-Based Child Find Specialists, Help Me Grow of Cuyahoga County ensures health care providers have information about the Help Me Grow program and know how to make referrals to Help Me Grow. Service Coordinators and Home Visitors provide feedback about the child and family to health care providers. MomsFirst (MF) and Ohio Infant Mortality and Reduction Initiative (OIMRI) MF and OIMRI are programs that offer case management and home visiting services to pregnant moms and their young babies. Women who participate in the MomsFirst or OIMRI program will receive education on topics such as prenatal care, breastfeeding and family planning, as well as assistance in connecting with medical and social services. Eligibility for MF is pregnant women in the City of Cleveland, primarily in their 1 st or 2 nd trimester. Eligibility for OIMRI is pregnant African American women in E. Cleveland and Warrensville Heights, primarily in their 1 st or 2 nd trimester. Help Me Grow partners with MF and OIMRI to ensure that all eligible families receive the services that will help families have a good start in life. HMG refers pregnant women who do not meet HMG s eligibility criteria to either MF or OIMRI if eligible. HMG will also try to determine if a pregnant woman is already involved in either MF or OIMRI to avoid duplication of services. If a HMG Home Visitor discerns that a woman they are serving is also involved in either MF or OIMRI, they should work with the family and community health worker to either have one of the programs exit the family from services or they should coordinate services. Due to changes to HMG eligibility criteria for home visiting, the partnership with MomsFirst and OIMRI continues to be developed. This should be done on an individual basis and should be based on preferences and needs of the family. For more information, contact Lisa Matthews, MomsFirst Project Director at or Marie Jones OIMRI Program Manager at x Guidelines revised 11/02/10

27 Overview of Help Me Grow of Cuyahoga County Partners (continued) Starting Point Starting Point is a Resource and Referral agency linked to the Ohio Child Care Resource and Referral Agency (OCCRRA) that connects families to programs and services that meet their children s early care/education and related needs, and strengthens the community s capacity to respond to those needs. Contact Person: Constance Walker (216) State Support Team Region 3 One of the Ohio Department of Education s 16 State Support Teams (SST) that serves school districts, charter/community schools and families in Cuyahoga County regarding children at-risk and children with disabilities (ages 3-21) The mission and goals of the ESC are to provide assistance to contracted school districts and agencies in order to offer a broad range of resources to support their mission to serve all learners. Contact person: Kathy Jillson (216) WIC MetroHealth Center for Community Health Public Health Division 3571 Ridge Road, Cleveland, Ohio Phone: (216) Women, Infants, and Children (WIC) is a federally funded food supplement and nutrition education program. It serves pregnant and breast-feeding women, infants under one year, and children up to the age of five who are at risk due to inadequate nutrition. Administered in Cuyahoga County by The MetroHealth System, the program operates twenty-two nutrition education program sites, and serves over 35,000 participants each month throughout Cuyahoga County. WIC is an important partner with HMG in identifying women who may be eligible for HMG services and providing nutritional support to HMG families. 26 Guidelines revised 11/02/10

28 Help Me Grow of Cuyahoga County Child Find and Public Awareness The purpose of child find and public awareness in Cuyahoga County is to have a coordinated, community based system for early identification of children and families who may be eligible for Help Me Grow services and to expand public, professional, and community awareness of the availability of Help Me Grow services in Cuyahoga County and how to make referrals to Help Me Grow. HMG CHILD FIND AND PUBLIC AWARENESS POLICIES AND HOME VISITING GUIDANCE DOCUMENT CAN BE FOUND AT In Cuyahoga County: Public Awareness in Cuyahoga County includes activities such as: Developing and disseminating culturally sensitive county public awareness brochures and informational material to primary referral sources. All Help Me Grow public awareness material contains the HMG logo, and, as appropriate, the Invest In Children (IIC) logo and the county seal. Participating in community events and presentations to local groups, utilizing appropriate communication tools for presentations, such as displays, PowerPoint, video, handouts, and informational packets. Ongoing contact with the medical community through physician offices, Grand Rounds, residency programs, and partnership with Hospital Based Child Find Specialists. Maintaining a Help Me Grow website ( that shares information about services, family support, professional referrals, and child development. (To be revised July, 2010). Disseminating a Help Me Grow Annual Report. Placing advertisements about Help Me Grow services in local publications. Working with media contacts for feature stories. When appropriate, writing a Letter to the Editor in response to articles. Coordinating with the Cuyahoga County Invest in Children communications strategies. Program staff of Help Me Grow participate in advocacy and awareness efforts to promote Help Me Grow in our local community. This participation includes: Staffing a Help Me Grow display table at a community event (once per fiscal year for HMG Provider agencies). Sharing HMG materials in the community and with families. Educating legislators about the importance of Help Me Grow and early childhood initiatives at the state and national level. Offering feedback on the development of public awareness materials. Local HMG Public Awareness materials can be ordered by submitting the Materials Order Form Contact: Marti Hunter, Communications Coordinator State HMG Resources and Materials can be ordered from: Help Me Grow HELP 27 Guidelines revised 11/02/10

29 EXAMPLE EXAMPLE 28 Guidelines revised 11/02/10

30 Help Me Grow of Cuyahoga County Child Find and Public Awareness Help Me Grow of Cuyahoga County: Procedures to Transition Infants and Toddlers with Suspected or Identified Developmental Delays or Disabilities from the Hospital Setting to Community Services Cuyahoga County is fortunate to have three hospital systems (University Hospital, MetroHealth Medical Center, and the Cleveland Clinic system) with Hospital Based Child Find Specialists (HBCFS) funded by the Ohio Department of Health, Cuyahoga County Invest In Children, and Cuyahoga Help Me Grow. The following reflects the transition procedures between these hospital systems and the Help Me Grow Central Coordinating Site. Infants and toddlers are admitted to the hospital in various settings (i.e. NICU, PICU, general medical, etc). Parents/families often meet with several staff, including physicians, nurses, and social workers who may identify infants and toddlers at risk or with developmental delays and disabilities making them eligible for Help Me Grow services. Help Me Grow of Cuyahoga County can benefit families both in the hospital and as they transition to community services and supports. The Hospital Based Child Find Specialists and Help Me Grow personnel work closely together to ensure continuity of care and timely receipt of early intervention services for children. The Hospital Based Child Find Specialists play a key role in identifying eligible children as early as possible and facilitating the sharing of medical information, while Help Me Grow personnel ensure families receive the supports and services that would be beneficial to their child. Transportation for Children in the Hospital Some families who have infants/toddlers in the hospital may need assistance with transportation. Cuyahoga County Help Me Grow has developed guidelines for accessing transportation services. These guidelines have been shared with the HBCFS. Cuyahoga County is fortunate to have an array of specialized service providers as well as excellent public transportation services. The transportation needs in Cuyahoga County may be different from those needed in other counties without the same options. Staff at the hospitals will work through their own offerings of transportation support, but if Help Me Grow is needed for additional transportation support, the HBCFS can contact Help Me Grow Services Manager for assistance. Children who are preparing for discharge Initiating Help Me Grow services for a child that is preparing for discharge is an excellent opportunity to improve the child s successful transition to community services. If the HBCFS believes a contact from Help Me Grow for a particular child or family still in the hospital would be beneficial and help to expedite the process of accessing early intervention services, the HBCFS will make these referrals to the Central Coordinating Site via the Early Track 3.0 data system. The referral should clearly identify that the child is in the hospital and is preparing for discharge. The referral should include alternative phone numbers to assist the Service Coordinator in reaching the family. The referral will be assigned to a Service Coordinator. The Service Coordinator will offer to meet with the family in the hospital and begin planning for the child s discharge. They will complete the steps typically completed at the first home visit. Medical Information from the hospital can be requested from the HBCFS and may meet requirements for screenings and assessments. An IFSP may begin if the child is eligible for Help Me Grow based on a diagnosed condition even if the assessment for program 29 Guidelines revised 11/02/10

31 Help Me Grow of Cuyahoga County Child Find and Public Awareness (continued) Help Me Grow of Cuyahoga County: Procedures to Transition Infants and Toddlers with Suspected or Identified Developmental Delays or Disabilities from the Hospital Setting to Community Services (continued) planning has not been completed. In this instance, a justification in a delay in timeline for any aspect of the 45 day requirement would be that the child was hospitalized. When a Service Coordinator meets with a family in the hospital, the HBCFS should be informed about that meeting in advance. When appropriate, the HBCFS can assist in making appropriate arrangements within the hospital for the initial Help Me Grow meeting. During the meeting, the Service Coordinator can help to identify activities needed to support the family s transition from hospital to home, coordinate an evaluation or assessment for program planning and, if possible, identify early intervention services to begin postdischarge. During the meeting, the Service Coordinator can help to identify activities needed to support the family s transition from hospital to home, coordinate an evaluation or assessment for program planning and, if possible, identify early intervention services to begin post-discharge. Sharing of Information Upon request, the HBCFS provides medical information to the HMG Service Coordinator (e.g. discharge summaries; well-baby visits) to assist in early intervention evaluations and program planning. HBCFS use their Hospital Consent to comply with HIPAA regulations on sharing medical information. Help Me Grow must comply with The Family Educational Rights and Privacy Act (FERPA), therefore, Help Me Grow must have written permission from the parent in order to release any information from a child s Help Me Grow record to physicians, child care providers, and other agencies and programs. Sharing of information is important for consistency of care and follow-up. The HMG Service Coordinator should: provide the HBCFS or referring physician with a Referral Follow-up Form; obtain release of information from the family and encourage the sharing of the IFSP and the Evaluation Report with the primary care provider and other specialists who are working with the family. The HBCFS can serve as a liaison to physicians within the hospital system. If the IFSP or the Evaluation Report is specifically requested by a physician, the HBCFS will note this in the case notes, so release of information can be obtained from the family and the Service Coordinator, with parental permission, may make contact with the physician to assist in follow-up and consistency of care. 30 Guidelines revised 11/02/10

32 Help Me Grow of Cuyahoga County Intake and Assignment Help Me Grow of Cuyahoga County Intake All referrals are sent to Help Me Grow Intake where they are reviewed to determine appropriate assignments. Referrals are either: assigned to agencies as a Part C, At Risk, Home Visiting, County At Risk, or County Home Visiting referral assigned to MomsFirst or OIMRI determined not eligible for Help Me Grow, MomsFirst or OIMRI Services Part C assignments Intake will assign the following referrals to Part C: Child previously determined eligible for Part C Child with a Part C diagnosis or suspected diagnosis Child with a developmental delay or suspected developmental delay Child referred as CAPTA (see attached clarification on CAPTA referrals) At Risk/Home Visiting assignments Intake will assign the following referrals to At Risk/Home Visiting and mark which one on the Request for Service (RFS) form. (Child will be identified as At Risk if the child was referred prior to 7/19/10 or was previously At Risk eligible.) Please see the Eligibility Chart that clarifies the differences between categories. Prenatal referrals not currently involved with MF or OIMRI that either have a parent in active military or this is their 1 st child and they meet income eligibility or the parent has another child who is At Risk/Home Visiting eligible (see sibling under bullet 4). Child referred up to 46 days prior to 3 rd birthday whose parent is in active military, or who has been identified as CAPTA (see attached clarification on CAPTA referrals) or who is a first child under 6 months of age and family meets income guidelines. See section on Children involved with DCFS for children that are living with foster parents or in kinship care. Child previously determined At Risk eligible. Child previously determined Home Visiting eligible. Note: This is true when this child was the target eligible child (1 st child, CAPTA or parent in active military). Child previously determined eligible because of a sibling should be treated as a sibling. See next bullet. Sibling (who lives in the same house) of a child who is Home Visiting eligible. As of July , any sibling that is made eligible will only be eligible until the 1 st born or CAPTA child turns three. Note: Siblings of a child who is At Risk or Part C eligible are not eligible unless they qualify themselves for Home Visiting or Part C eligibility. 31 Guidelines revised 11/02/10

33 32 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Intake and Assignment (continued)

34 Help Me Grow of Cuyahoga County Intake and Assignment (continued) County At Risk / Home Visiting assignments Intake will assign the following referrals to County At Risk/Home Visiting and mark which one on the Request for Service (RFS) form. (Child will be identified as At Risk if the child was referred prior to 7/19/10 or was previously At Risk eligible.) Please see the Eligibility Chart that clarifies the differences between these categories. Prenatal referrals with 2 risk factors that do not meet either state At Risk/Home Visiting eligibility criteria or MF/OIMRI eligibility criteria. Child referred up to 46 days prior to 3 rd birthday who does not meet state At Risk/Home Visiting eligibility but who has 2 risk factors. See Children involved with DCFS for the list of applicable risk factors for children that are living with foster parents or in kinship care. For all other children, the list of risk factors includes: o adolescent parent o single parent o parent with history of abuse or neglect or domestic violence o lack of stable residence, homelessness or dangerous living conditions o parent with chronic or acute mental illness or developmental disability o maternal prenatal substance abuse o parent with drug or alcohol dependence Child previously determined county At Risk/Home Visiting eligible. Note: This is true when this child was the target eligible child. Child previously determined eligible because of a sibling should be treated as a sibling. See next bullet. Sibling (who lives in the same house) of a child who is County At Risk/Home Visiting eligible. High risk children that do not meet eligibility may be determined eligible on an individual basis. For assistance in determining if a child may be eligible based on an exception, please contact either Karen Mintzer, Services Manager or Lori Mago, QA Team Leader. MomsFirst and OIMRI assignments Intake will assign the following referrals to MomsFirst (MF) or the Ohio Infant Mortality Reduction Initiative (OIMRI). They will send the family a letter and the MF/OIMRI brochure as well as send a Referral Follow Up form to the referral source: Families who do not meet HMG eligibility criteria. Families whose referral identifies that they are already receiving MF/OIMRI and who do not have any additional concerns or other HMG eligible children. Program Eligibility Cuyahoga County intake determines eligibility for County At Risk/Home Visiting services prior to assigning them to the HMG agency. HMG agencies never enter county eligibility into ET 3.0. The Home Visitor must obtain consent for services in order for a child (or adult if prenatal) to be eligible for Home Visiting. The date of eligibility would be the date when both the HV confirms the eligibility and the consent is signed, whichever date is later. The Service Coordinator must have consent and medical confirmation of the diagnosis in order to determine a child eligible for Part C based on a diagnosed condition. The date of eligibility would be the date when both the medical information has been received and the consent has been signed. If a family does not consent to the initial assessment for program planning, they must be exited from Part C services. If medical information is not received, proceed with a two 33 Guidelines revised 11/02/10

35 Help Me Grow of Cuyahoga County Intake and Assignment (continued) person evaluation. If the child is found not eligible based on the evaluation, close and re-open the case if medical information is received confirming the diagnoses that makes them Part C eligible. A child must have consent and a developmental evaluation that identifies (through tool or clinical opinion) that a child is developmentally delayed in order to be determined eligible for Part C based on a developmental delay. The date of eligibility would be the date of the developmental evaluation. If a Part C eligible child does not consent to the Part C evaluation, but does consent to (and is eligible for) Home Visiting services, they can receive HMG Home Visiting Services. In these instances, the SC should complete a Request for Service Form and document the situation. Children involved with the Department of Children and Family Services (DCFS) (or living in alternate placement) Children with a diagnosis, developmental delay, suspected development delay or with a substantiated case of abuse or neglect (CAPTA) are eligible regardless if they are residing with their parents or are in a foster care or kinship care placement. Otherwise, the following applies: Children living with their parents or in the process of reunification are eligible if they meet any of the criteria identified above for a referral to Part C, At Risk/Home Visiting or County At Risk/Home Visiting. Children living with a relative will be eligible if the family income of the relative placement is less than or equal to 200 %, the child is under 6 months of age and the relative is a first time caregiver; or a parent is in active military or the child is considered at high risk because they have experienced 2 of the following risk factors: o parent with history of abuse or neglect or domestic violence o lack of stable residence, homelessness or dangerous living conditions o parent with chronic or acute mental illness or developmental disability o maternal prenatal substance abuse o parent with drug or alcohol dependence If their current caregiver is single, single parent can be the second risk factor. Children living in a licensed foster care home are not typically assigned unless they have a diagnosed medical condition, developmental delay, a suspected developmental delay or are CAPTA. For extenuating circumstances, contact Karen Mintzer, Services Manager or Lori Mago, Quality Assurance Team Leader. Not Eligible or Not Appropriate referrals Referrals may be determined not eligible or not appropriate. The following are reasons and procedures followed: Not appropriate - A referral will be determined not appropriate when it is not able to be entered into Early Track. This is either because the child is too old, the child lives out of county or the referral information is incomplete. Children living in another county will be referred on to the appropriate county. A log is kept of inappropriate referrals and the referral form is kept for at least one year. If the referral information is complete, a referral feedback form will be completed and sent to the referral source. 34 Guidelines revised 11/02/10

36 Help Me Grow of Cuyahoga County Intake and Assignment (continued) Not eligible child is less than 46 days prior to their third birthday - Referrals are assigned to Myrtle Mitchell, Transition Liaison who will work with the family on obtaining services for their child. This referral is entered into Early Track. The Transition Liaison will complete the referral feedback form and send it to the referral source. Not eligible Child does not meet eligibility criteria - A letter is sent to the family along with appropriate resource information. Intake sends a referral feedback to the referral source and the referral is entered into Early Track. Assignment Process 1. Help Me Grow will develop a plan with each contracted agency which will include the expected number of weighted children to be served each month. Agencies that have some of their SC/HV qualified to provide bilingual services and/or who are Registered Nurses will also include their names along with their full-time equivalent (FTE) percentage providing Help Me Grow Services. Agencies with all staff who are bilingual and/or who are Registered Nurses will not need to provide this information. The agency is responsible to let Help Me Grow know about any changes to this staffing plan. 2. Intake Runs the Service Coordinator Caseload Report and the Home Visitor Caseload Report (for both County and State eligibility) on a monthly basis and identifies the following: Total Part C and At Risk Caseload Number Total Home Visiting Caseload Number This number will be multiplied by to obtain the weighted caseload. These 2 numbers will be added together to obtain the total weighted number of children on the agency s caseload. This will be subtracted from the number to be served in the next month. This number will be the total number of children to be assigned within the next month. Intake will also look at the available slots for bilingual staff or staff that are Registered Nurses to identify possible numbers for specialized assignments. Intake will inform agencies of the number of children to be assigned for the month. Intake will scan and assignments to agencies throughout the month based on many factors including incoming referrals, the number designated above, self generated referrals, parent requests and input from provider agencies. What Agencies Receive from Intake Effective 7/19, ODH is requiring that the Child Information and Referral Data Collection form be used and kept in the child record. (See forms tab earlier in this manual) When receiving referrals via phone, fax, Early Track, or U.S. mail (on the current local Request for Service form), Intake will complete any missing required information on the ODH Child Information and Referral Data Collection form and attach it to the entire request for service (RFS) form. Intake will send the appropriate referral form(s) to the agency with any additional paperwork received with the referral. TIP: When receiving referrals always check the history tab in Early Track to see if the child was previously served in HMG. 35 Guidelines revised 11/02/10

37 Help Me Grow of Cuyahoga County Central Coordinating Site Referral Follow Up Forms Effective 7/19/10 ODH is requiring use of their new referral follow up form. (See forms tab earlier in this manual). A referral follow-up form is completed and sent to all referral sources within 45 days of the initial referral with the exception of self-referrals. A self-referral is defined as either the parent/guardian (with the exception of the Department of Children and Family Services) or when the referral is made by a Help Me Grow staff person at the Help Me Grow agency that is assigned the case. Help Me Grow central intake staff is responsible to send the referral follow up form to all referral sources when the child is either not assigned to a Help Me Grow agency (for example because the child is not eligible or the family is not interested) or when they are assigned to MomsFirst or OIMRI. The SC, HV or Transition Liaison is responsible for sending the referral follow up form to all referral sources when the child is assigned to them. Cuyahoga County Data Quality Plan The Child Record policy requires every county HMG to develop and implement a data quality plan to ensure appropriate, timely, accurate and complete collection of HMG data. In Cuyahoga County, the Quality Assurance and Data Departments implement and oversee the data quality plan consisting of onsite visits to agencies for record review, monthly Corrective Action Plan (CAP) log processes, and data entry timeline requirements. CHILD RECORD POLICY CAN BE FOUND AT 1. On-site Visits - The Quality Assurance Specialists visit the agencies each month and review a sample of client records to ensure policies are being followed and give technical assistance. 2. CAP Log Processes a. The Quality Assurance Team Leader runs the compliance reports available in Early Track 3.0 (ET 3.0) monthly to ensure Cuyahoga County is compliant in regards to the 45-day timeline and timely receipt of services. The QAS verify any non-compliance reasons entered into ET 3.0 as presented on the compliance reports. QAS request agencies enter any missing dates into ET 3.0 and/or obtain non-compliance reasons (NCR) to support data that is truly missing. Any change in NCR is documented by the Quality Assurance Specialist and sent to the Lead Data Specialist for the change to be made in ET 3.0. b. The Transition Coordinator runs the Transition Compliance report monthly, requests agencies to enter transition planning conference data (TPC) into ET 3.0 if the TPC was completed and obtains non-compliance reasons if the TPC has not yet occurred. Any change in NCR is documented by the Transition Coordinator and sent to the Lead Data Specialist for the change to be made in ET 3.0. c. These compliance reports are used to monitor Part C services only and are referenced each month in agency monitoring reports. 36 Guidelines revised 11/02/10

38 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) 3. Data Entry Requirements a. HMG of Cuyahoga County began decentralized data entry in Agencies are required to enter all service data into ET 3.0 within 10 calendars days of the service date. This requirement is to ensure timely data entry and payment for services rendered. b. Effective 7/19/10 Help Me Grow of Cuyahoga County is requiring the use of the ODH 45 Day Data Collection Form for home visiting. (See forms tab earlier in this manual). This form ensures all necessary data required in Early Track needed to meet the 45 day timelines for home visiting is collected for entry into Early Track. The form must be kept in the child s record. ET 3.0 Data Collection System Early Track version 3.0 (ET 3.0) is the Ohio Department of Health s statewide web-based application designed to allow decentralized data entry and the collection of information to accomplish comprehensive prenatal to three program oversight of HMG. The ET 3.0 application includes referrals, service coordination assignments, Individualized Family Service Plans (IFSP)/Family Plans (FP), screenings, evaluations, home visits, outcomes, transition, and exit data. The website can be found at 37 Guidelines revised 11/02/10

39 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) ET 3.0 System Administrator Each county has a county system administrator who is responsible for authorizing all of the users in the county. In Cuyahoga County, the County System Administrator is Missy Bixel, Lead Data Specialist and County System Administrator. An individual is designated with an access level within the county. An individual s viewing and maintenance capabilities are implemented based upon that access level. To obtain access to ET 3.0, submit an Early Track System Access Rights and Responsibilities Agreement to Missy Bixel, Lead Data Specialist via at mbixel@helpmegrow.org or fax the form to The system administrator is the only authorized ET 3.0 user to request changes or deletions of information in ET 3.0 for HMG of Cuyahoga County via the contact us link in the data system to ODH. ET 3.0 Guidance Beginning July 2010, revisions to ET will be released in phases over the course of the next 6 months, to accommodate the Home Visiting program and other necessary changes. This section will be periodically revised accordingly. 1. Users will be asked periodically to change passwords by ET 3.0. Passwords require at least 8 letters/numbers/characters. They must include at least one number and one character. 2. When searching for a child s record in ET 3.0, best practice recommends conducting four separate searches: a. First three letters of the child s first and last name b. First three letters of the primary caregiver s first and last name c. Child s date of birth d. Child s due date 3. To access the details of a record, click on the pencil. 4. Use the left navigational column to access a particular service section within a child s record. This column also shows the order in which data must be entered into ET Red fields are required, blue fields are conditionally required and black are not required. 6. A child referred At Risk can only be determined At Risk, County At Risk, or Not Eligible. Evaluations and assessments cannot be added to the child s ET 3.0 record and diagnoses cannot be entered on the eligibility page. 7. A child referred Home Visiting can only be determined Home Visiting, County Home Visiting, or Not Eligible. Evaluations and assessments cannot be added to the child s ET 3.0 record and diagnoses cannot be entered on the eligibility page. 8. A child referred Part C can only be determined Part C or Not Eligible. Evaluations can be added to the child s ET 3.0 record and diagnoses can be entered on the eligibility page. 38 Guidelines revised 11/02/10

40 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) 9. If a child meets At Risk/Home Visiting eligibility and Part C eligibility, ET 3.0 will show the child as Part C eligible. a. Once a child is found Part C eligible in ET 3.0, they cannot be made At Risk or Home Visiting eligible in ET 3.0. b. When a child with a home visiting eligibility status in ET 3.0 is found Part C eligible in ET 3.0, ET 3.0 will recognize the Part C eligibility only and will no longer allow the home visit data to be entered. 10. The Primary Service Coordinator Funding Source field (found in the Service Coordination section under the SC List tab) is initially entered by HMG Central staff at time of referral. This field is determined based on the child s Referred to Category and the funding stream being used to compensate the agency for the child s services each month. HMG Central staff will provide guidance to agencies on the correct funding source to choose when re-assigning service coordinators and entering the funding sources for service coordination, home visiting, parent education, etc. on an IFSP. 11. The Evaluation section is only completed for those suspected Part C eligible children without a medical diagnosis. 12. When a child is referred Part C and found not eligible, the evaluation and eligibility sections are completed in ET 3.0. The assessment section does not get completed for those children found not eligible for Part C services. The Service Coordinator should review the child s risk factors and if applicable make a referral for At Risk/Home Visiting to HMG Central Intake staff. If the child is not eligible for any HMG services, the exit section is then completed in ET Prior to saving an IFSP, all services must be entered. 14. For children referred Part C, if a timeline is not met ET 3.0 will require a non-compliance reason be entered. 15. Agencies are required to enter all service data into ET 3.0 within 10 calendars days of the service date. 16. All data must be entered in the correct order or ET 3.0 may not accept it. Please reference the Early Track Data Entry Process for At Risk Referred Children, Early Track Data Entry Process for Home Visiting Referred Children, Early Track Data Entry Process for Part C Referred Children with a Medical Diagnosis, and Early Track Data Entry Process for Part C Referred Children with a Suspected Delay handouts attached. 17. Agency staff is never to create a child in ET 3.0 or enter a referral electronically. 39 Guidelines revised 11/02/10

41 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) Technical Support ET 3.0 technical support requests are submitted by the clinical supervisors only via at HMG central staff will respond to all Tech Support submissions within 4 business hours. Examples of Tech Support situations are as follows: 1. Child s Name and/or Date of Birth Change(s) a. The Agency staff changes the child s name and/or date of birth in ET 3.0 and notifies the agency s clinical supervisor. b. The clinical supervisor s tech support the ET #, child s old & new name, and/or child s old & new date of birth. c. HMG central staff modifies the HMG central client record. 2. Data Changes (i.e. Wrong date entered for screenings, IFSPs, transitions, or exits) a. The Agency staff provides the ET #, the name of the item needing the date change, the incorrect date previously entered incorrectly, and the correct date to the agency s clinical supervisor. b. The clinical supervisor s tech support all the fields listed above unless the date change is for a screening or transition, then the Clinical Supervisor will make the change in ET 3.0 directly. c. HMG central staff changes the date and notifies the agency s clinical supervisor upon completion. 3. Adding Additional IFSP Services a. The Agency staff provides all data fields required to add a service to an IFSP including ET #, IFSP date, Service Type, Service Provider name, Service Location, Frequency, Intensity, and Payment Source to the agency s clinical supervisor. b. The clinical supervisor s tech support all the fields listed above. c. HMG central staff adds the service to the existing IFSP and notifies the agency s clinical supervisor upon completion. 4. Adding an Exit (only when an error message appears) a. The Agency staff provides all data fields required to add the exit including ET# and error message appearing. b. The Clinical Supervisor s tech support all data fields necessary to add the exit. c. HMG staff troubleshoots the issue and enters the exit or submits a request to ODH to add the exit. 5. Deletions (i.e. wrong screening/evaluation name chosen, exited the wrong child, etc.) a. The Agency staff notifies the agency s clinical supervisor of the item incorrectly entered into ET 3.0 including the ET #. b. The clinical supervisor s tech support all the information necessary. c. HMG central staff submits a request to ODH to delete the error made in ET 3.0 and notifies the agency s clinical supervisor upon completion. 6. Passwords a. When a password is forgotten or needs to be reset, the individual notifies the agency s clinical supervisor. b. The clinical supervisor s tech support the individual s name and address. 40 Guidelines revised 11/02/10

42 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) c. HMG central staff submits a request to ODH to reset the password in ET 3.0 and notifies the agency s clinical supervisor upon completion. An will be sent by ODH to the individual directly with a reset password. 7. All other data issues and questions related to ET 3.0 can be ed to techsupport@helpmegrow.org by the agency s Clinical Supervisor. Transferring Records Reference the HMG of Cuyahoga County Child Records section of this document. 41 Guidelines revised 11/02/10

43 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) Payment Information Management System (PIMS) Cuyahoga County uses the Payment Information Management System (PIMS) for billing. Each month the following steps occur: 1. HMG central site ensures all assignments are entered into ET 3.0 from the prior month (Before the 3 rd of the month following service delivery). 2. Agency checks ET 3.0 using the Service Coordinator Caseload Report to review service performance and data entry accuracy (Before the 12 th of the month following service delivery). 3. Agency data entry ensures all service data is entered into ET 3.0 and ready for billing (Before the 12 th of the month following service delivery). 4. HMG central site extracts all service data from ET 3.0 (On the 12 th of the month following service delivery or the next business day). 5. HMG central site prepares and distributes the encrypted Request for Payment spreadsheets to the agencies via (By the 15 th of the month following service delivery). 6. Agency completes the Request for Payment spreadsheet, encrypts it, and submits it back to HMG central site via (By the 20 th of the month following service delivery). a. Completion of the Request for Payment spreadsheet i. Reference the HMG Reimbursement Guidelines SFY 2011 when requesting payment for each child assigned to your agency. ii. Request payment only for those children that were assigned to your agency during the service month being billed. iii. The Billing Category column now includes 6 options (At Risk Month of Service, County At Risk Month of Service, Home Visiting Month of Service, County Home Visiting Month of Service, Part C Month of Service, and None). This column drives payment. The agency will not receive payment for a child if a Month of Service Billing Category is not selected. iv. Submit the Income Verification form with initial IFSP for At Risk, County At Risk, Home Visiting, and County Home Visiting children. v. Indicate the non-compliance reason in the appropriate NCR column on the Request for Payment spreadsheet if a service was required to occur and did not occur or was delayed. If an IFSP is outdated include a non-compliance reason in order for HMG to consider reimbursement. NCRs should be recorded on the spreadsheet in the associated NCR column and those reasons must match the reason selected in ET 3.0. vi. Indicate the number of visits in the Face-to-Face Visit Qty. column. Please ensure dates are listed in the child's record for audit purposes. vii. Indicate Yes or No if the agency had successful communication, in the Successful Communication column. viii. Indicate Yes or No if the service coordinator/home visitor mailed the Attempts to Engage letter as per the Contact Protocol. ix. If a child needs to be added to the Request for Payment spreadsheet, go the end of the spreadsheet, add the Child's ET # and complete columns AL - AP as applicable. x. Enter the primary caregiver's DOB in column K if data is available. 42 Guidelines revised 11/02/10

44 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) 7. HMG central site calculates payment totals for month s service, prepares and approves final invoices and purchase orders, and submits purchase orders with invoices to ESC for payment (By the first Educational Service Center (ESC) cutoff of second month following service delivery). 8. HMG central site sends encrypted agency copy of invoice approved for payment and submitted to ESC for payment via (By the 5 th of the second month following service delivery). 9. HMG central site sends encrypted Denial Request for Payment Spreadsheet along with the encrypted ET 3.0 Data Alerts report to the agencies via (By the 5 th of the second month following service delivery). 10. ESC sends payment via U.S. mail to agency (By the 15 th day of the second month following service delivery). 11. Agency reviews payment requests that were denied, makes any needed corrections, and submits a request for additional payment using the Denial Request for Payment spreadsheet (By the 30 th day of the second month following service delivery). a. Completion of the Denial Request for Payment spreadsheet. i. Review the Original Denied Reason. ii. Make any changes needed in ET 3.0 or on the spreadsheet (i.e. enter IFSP in ET 3.0 or provide a missing NCR on spreadsheet). iii. Decide if resubmitting a request for payment is applicable. iv. Choose a Billing Category from the drop-down list if requesting payment is applicable. v. Indicate the number of visits in the Face-to-Face Visit Qty. column if applicable. Please ensure dates are listed in the child's record for audit purposes. vi. Indicate Yes or No if successful communications occurred in the Successful Communication column. vii. Indicate Yes or No if the service coordinator/home visitor mailed the Attempts to Engage letter as per the Contact Protocol. Please note: Approximate dates for each step are provided above in parenthesis. HMG Central staff will provide all agencies with an actual schedule for each fiscal year. 43 Guidelines revised 11/02/10

45 Help Me Grow of Cuyahoga County Central Coordinating Site (continued) HELP ME GROW REIMBURSEMENT Help Me Grow Reimbursement First month of service: This is the month that the child is assigned to the agency. The agency can be paid for this month and does not need documentation of successful contacts or contact attempts. * ^ Second month of service: The agency can be paid during the month if there was a successful contact (face to face visit or successful communication this month or the previous month) or the agency sent the family an Attempt to Engage (ATE) letter. * ^ Third month of service: The agency can be paid for this month if the initial IFSP/FP was completed. Exceptions may be made for one month if there are family reasons (This would not include the family reason of unable to engage). * ^ Subsequent months of service: The agency can be paid in subsequent months if the child is eligible for HMG services, has been served under an IFSP/FP and meets the following criteria: The child s IFSP/FP is up to date. Exceptions may be made for the month that the IFSP/FP is due and one additional month if there are family reasons. This may include the family reason of unable to engage. There was a successful contact either that month or the previous month. OR The agency sent the family an ATE letter (following protocol). * If the IFSP/FP was completed during this month, then a completed Income Verification form must be sent to the HMG central coordinating site in order for the agency to receive payment. ^ Each of these months of service will be paid at half the rate UNTIL either 1) the Part C Evaluation/ Assessment is complete or 2) the IFSP or FP is complete. Once either the Part C Evaluation/Assessment or the IFSP/FP is complete, HMG will reimburse the agency the remaining half rate for any applicable month. *Successful contact for billing purposes means (1) face-to-face communication related to HMG between HMG staff/providers and the family; (2) electronic communication related to HMG between HMG staff/providers and the family; (3) written communication related to HMG between HMG staff/providers and the family and/or (4) telephone communication related to HMG between HMG staff/providers and the family. (Note: This would not mean phone tag where people were just leaving messages for each other that they called. It could include a telephone message from the family related to HMG business.) **Contact Attempt means (1) a visit to the child/family s last known address; (2) an electronic communication sent to the family via a previously agreed upon mechanism; (3) a written communication mailed to the child/family s last known address; (4) a telephone message left at a number previously agreed upon. *** Exceptions may be made for ONE month if there are family reasons. For payment purposes, the successful contact must be from the SC or representative at the SC agency. Documentation on the PIMS RFP spreadsheet should be only for services provided by the SC or SC agency. 44 Guidelines revised 11/02/10

46 45 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Central Coordinating Site

47 46 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Central Coordinating Site

48 47 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Central Coordinating Site

49 48 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Central Coordinating Site

50 Help Me Grow of Cuyahoga County Child Records Central Coordinating Site Record HMG Central Site maintains intake documentation on families referred to HMG. This includes the Request for Service Form, medical documentation accompanying the referral, welcome letter and case notes if applicable. A copy of these documents are sent to the HMG Provider Agency upon assignment of the referral where the complete record is maintained for the child. Agency Record There should be one complete record for a child. Please refer to the HMG Child Record Policy for a list of required documentation in a record. CHILD RECORDS POLICY CAN BE FOUND AT Transferring/Re-opening Records 1. If a child transfers within Help Me Grow of Cuyahoga County (from one agency to another) a. The original record is maintained at the current agency and a copy of the entire HMG record is sent to the receiving agency upon notification from HMG central site of the transfer. b. If the family is Part C eligible i. The Parental Prior Notice form (written prior notice section) must be sent by the current Service Coordinator to the family, notifying the family of the change in SC agency. A copy of the notice must be kept in the record. ii. A change in SC agency constitutes an IFSP review for Part C families. iii. The new information must be updated in Early Track. c. If the family is At-Risk or Home Visiting eligible i. The family will be notified in advance in writing of the change. A copy of the letter must be kept in the record. ii. Once the new Home Visitor is assigned, their information on the Family Plan will be updated. iii. The new information must be updated in Early Track. 2. If a child transfers out of county a. The parent must provide written consent via a Release of Information form before the hard copy can be transferred to another county HMG. If the family has already moved, the electronic record will be transferred and the receiving county will obtain the release before the hard copy record transfers. * The release must be in both records. b. The current Service Coordinator must update the Early Track record with all current information, including the new address/contact information for the family in the new county. c. Exit the family from Early Track. d. Cuyahoga County Help Me Grow Tech Support to request the transfer. e. All records (electronic and hard copy) must be transferred within 10 calendar days of the request once the signed Release of Information form is received. *Guidance related to transfer of electronic records per endorsement of HMG Executive Committee ( ) 49 Guidelines revised 11/02/10

51 * Help Me Grow of Cuyahoga County Child Records (continued) 3. If a child transfers to Cuyahoga County from another county a. The receiving agency contacts the former county to request a copy of the record once the Release of Information form has been signed. Contact information for other HMG programs throughout the state can be found at b. The former county will send you the record within 10 calendar days of the request. 4. If a Part C child is exited and re-opened with a different agency a. Agency staff should review child history in Early Track b. If the child was previously served by a current HMG agency, the receiving agency will contact the former agency for a copy of the record. c. If the child was previously served by a former HMG agency, electronic copies of these records are being stored at HMG. The receiving agency will contact techsupport@helpmegrow.org for a copy of the record to be sent. Please include the child s ET 3.0 number, child s name, date of birth, primary caregiver name, new Service Coordinator name, and agency address. The electronic copy will be printed and mailed by the HMG data team to the receiving agency within two (2) business days of receipt. TRANSFERRING RECORDS POLICY CAN BE FOUND AT Confidentiality 1. All Help Me Grow (HMG) child and family records will be stored and maintained in a secure and confidential manner. HMG records maintained on agency premises will be locked when not in use. HMG records leaving agency grounds for the purposes of conducting HMG business must be returned to the agency and locked at the end of the business day or must be stored in the staff s home in a secure and confidential manner. It is not permissible to leave HMG child and family records in a vehicle. If confidentiality of records has been breached (i.e. records are lost or stolen), the agency must notify the HMG Quality Assurance Team Leader immediately for instructions on how to proceed which will include written notification to the families involved. 2. Whenever HMG child/family information needs to be shared outside of HMG of Cuyahoga County, a Release of Information form must be completed by the parent/guardian prior to releasing any information. (HMG of Cuyahoga County may use one of 2 Release of Information forms - see samples at the end of this section.) It is best practice for the SC/HV to have this form completed at the first visit in order to identify any other systems or individuals working with the family that the SC/HV may need to contact to coordinate services. For families referred for Part C eligibility determination, SC's should automatically write in Cuyahoga County Board of Developmental Disabilities for the purposes of coordinating evaluations and assessments. The expiration date on the form can be determined to be at age three or sooner if the parent/guardian chooses. The SC/HV's should review the form prior to sharing information to ensure consent is applicable and current. It is further recommended that the SC/HV review the form with the family prior to IFSP/FP meetings or more frequently to capture new or changing information. 50 Guidelines revised 11/02/10

52 Help Me Grow of Cuyahoga County Child Records (continued) Parent s Rights and Consent All HMG eligible families provide written consent for HMG services and acknowledge the receipt of parent s rights and the complaint process via completion of the required forms. See miscellaneous section for more information. Case Notes and Home Visit Notes Case Notes: Effective 7/19/10, ODH is requiring the use of the HMG Case Notes form for the Home Visiting program. (See forms tab earlier in this manual). HMG of Cuyahoga County is requiring its use for all Help Me Grow children. The case notes form is to be used to document anything that did not occur during a home visit (i.e. correspondence with family or providers, scheduling of visits, phone calls, letters sent, etc.). Documenting non-compliance reasons (NCRs) ET 3.0 will begin collecting non-compliance reasons for Home Visiting timelines that are not met (details to follow pending ET 3.0 phase 1 release). Service Coordinators/Home Visitors are required to support/justify NCRs selected in ET 3.0 for all HMG eligible children in the hard copy record. Case notes should show a clear sequence of events leading up to a missed timeline that supports the NCR chosen. Additional details contributing to a missed timeline can also be added to the ongoing home visit note, if appropriate. Ongoing Home Visit Notes: Effective 7/19/10 HMG of Cuyahoga County is requiring the use of the ODH created Ongoing Home Visiting Data Collection form (See forms tab earlier in this manual) for all Home Visiting eligible families. This form is used to document what occurred on a home visit and to ensure that the appropriate required elements are captured for entry into ET 3.0. For data entry purposes, the form prompts the user to indicate the curriculum topics covered and the method used. Due to the fact that the checklist doesn t incorporate many components of the curricula, the additional details section below must be used to elaborate on what was done with the family (i.e. Reviewed 24 month chapter, discussed immunizations and trips to the doctor and gave handouts. Observed mom and Joshua doing a play dough activity, etc.) Ongoing Part C Notes: Agencies should continue to use their current note form to document events that occur at Part C home visits until further notice. Guidelines for writing good case notes: ODH Home Visiting manual Pg HV-22 The numbered list of required elements does not include a signature though page HV-20 states a signature is required. Signatures on every entry are required. If electronic notes are used and periodically printed and placed in the record, when printed, Service Coordinator/Home Visitor must sign every entry. Initials are not acceptable. It is important to ensure that filing of forms into hard copy records are regularly kept up to date in the event that records are requested for an audit. 51 Guidelines revised 11/02/10

53 Help Me Grow of Cuyahoga County Child Records (continued) Family Plan (FP) versus Individualized Family Service Plan (IFSP) Family Plan: Effective 7/19/10, ODH is requiring the use of the new Family Plan for all Home Visiting eligible children. (See forms tab earlier in this manual) The ODH Home Visiting manual gives guidance that each child should have their own family plan unless the parent prefers to have all Home Visiting eligible children on one plan. This should be offered by the Home Visitor. Current At Risk eligible children are to remain on the IFSP form. Early Track does not support the use of the FP for these children. Individualized Family Service Plan: The IFSP form continues to be required for all Part C eligible children. If a Home Visiting eligible child on a FP becomes Part C eligible, the child is now required to have an IFSP. These children no longer need a FP and appropriate information should be transferred to an IFSP once determined Part C eligible. Home visiting services should be incorporated into the IFSP as appropriate. Both plans can still be used if the family prefers but the FP is no longer required and FP data can no longer be entered into ET 3.0. Accessibility of Records All HMG families have the right to review and inspect all information in their HMG record at anytime. The request must be accommodated within 15 calendar days. a. Families requesting to examine their record or receive a copy of their record should make that request via their current SC. If they are no longer active with HMG, they can make that request via their former SC agency or the HMG Central Site. b. Families that are no longer active and requesting a copy of their HMG record must verify their information before a copy can be sent. At minimum, this includes verifying parent/caregiver name, DOB, address, phone, child name and DOB as it appears in Early Track. Record Retention All child records must be retained, at a minimum, until the child has reached at least six years of age. a. Agencies may use a standard closing letter of their choice for families exiting HMG that informs the family that the record will be retained until the child reaches age six upon which time the record may be destroyed. A sample of this letter can be found in the Expectations for Home Visits and other Contacts with Families section. b. Records for exited families may be stored on site or in off-site storage but must be readily accessible if requested by HMG Central Site, ODH or family. CONFIDENTIALITY AND CONSENT, CHILD RECORDS, AND PARENTS RIGHTS POLICIES CAN BE FOUND AT 52 Guidelines revised 11/02/10

54 EXAMPLE EXAMPLE 53 Guidelines revised 11/02/10

55 EXAMPLE EXAMPLE 54 Guidelines revised 11/02/10

56 EXAMPLE EXAMPLE 55 Guidelines revised 11/02/10

57 Help Me Grow of Cuyahoga County Personnel Changes in Staff 1. Agencies must notify Lori Mago, Quality Assurance Team Leader in writing of changes in HMG staffing (hires, resignations/terminations). The notice can be ed and must be sent as soon as the change is known. The notice must include: a. Name of relevant staff b. Position (Service Coordinator and/or Home Visitor, Clinical Supervisor) c. Date of hire/last day of employment d. Degree or licensure (for new hires) e. FTE status (for new hires) f. address (for new hires) if known. This information can be sent as a follow up once account has been created. 2. Lori Mago, Quality Assurance Team Leader is responsible for notifying ODH whenever a credential-required employee has been hired or leaves HMG. [source: HMG Personnel Standards Policy effective 7/1/10] PERSONNEL STANDARDS POLICY CAN BE FOUND AT 3. HMG Contact Persons/Clinical Supervisor(s) should refer to the HMG Personnel Standards Policy for qualifications before hiring new SCs/HVs. Any questions should be directed to your Quality Assurance Specialist or Lori Mago, Quality Assurance Team Leader. Service Coordinator / Home Visitor Credentialing 1. Effective 7/19/10, ODH has separated credentialing requirements, making them specific to each program. The Service Coordinator credential is required for any personnel providing service coordination to Part C eligible families. A new Home Visitor credential has been added as a requirement for personnel serving any home visiting eligible family. Personnel that will continue to serve both Part C and Home Visiting eligible families will need to obtain both credentials. Please refer to Page PS-7 earlier in this manual for details on the Home Visitor credential. Refer to the HMG Personnel Standards Policy for specific requirements of each credential. 2. All HMG staff must follow HMG Personnel Standards Policy and adhere to timelines and requirements outlined in the policies. 3. Upon receipt of any credentialing certificate (initial or renewal) staff must provide a copy to Toni Walker, Quality Assurance Specialist, via fax, mail or The HMG Quality Assurance department monitors all credentialing timelines for SCs, HVs and Clinical Supervisors based on date of hire provided by the agency and associated timelines outlined in ODH policy. Compliance with credentialing status is part of monthly monitoring and appears on monthly agency reports. 5. Questions should be directed to your Quality Assurance Specialist or to Lori Mago, Quality Assurance Team Leader. 56 Guidelines revised 11/02/10

58 Help Me Grow of Cuyahoga County Personnel (continued) Trainings 1. All HMG staff must adhere to training requirements as outlined in the HMG Personnel Standards Policy and annual Training Bulletin published by ODH. Required trainings outlined here must be taken before staff can apply for their credential. These bulletins are published annually by ODH and ed to you by HMG Central Site upon receipt of each publication. Note, trainings are subject to change and ODH frequently sends a notification of new or changed trainings via to the County Project Directors. These s are forwarded to agencies upon receipt. 2. All HMG staff must maintain their own documentation of professional requirements, licensure, training records, continuing education, etc. Documentation must be provided to HMG Central Site and/or ODH upon request. 3. The Parents As Teachers, Born To Learn training/certification requirement is a part of the initial and renewal credentialing process. Timelines for this requirement are also monitored by the HMG Central Site Quality Assurance department. After 10/1/10, counties are required to pay for their staff to attend this training. Help Me Grow of Cuyahoga County will pay for this training on a limited basis with prior approval. Please see ODH Training memo # for details. 4. Staff receiving Parents As Teachers, Born To Learn certificates directly from the Parents As Teachers, Born To Learn National Center (and not via the central site) are to send a copy of the certificate to Toni Walker, Quality Assurance Specialist via fax, mail or immediately upon receipt. 5. Staff that are certified as PAT Parent Educators are required to complete a follow up training in order to earn their second year certificate. The follow up training should be done after the Parent Educator has been using the curriculum for at least 3 months. This training can be completed online by going to and logging on. Once logged in, click on course listings. Six (6) professional development hours are offered upon completion of the training. Online trainings are offered weekly and are free of charge for certified Parent Educators. Participants must register prior to attending as they have capacity limits. 6. Questions or issues regarding training, registration, etc. should be directed to your Quality Assurance Specialist or the Quality Assurance Team Leader for assistance. Adequate Supervision 1. Clinical supervision must be conducted by Clinical Supervisors according to ODH Clinical Supervision Policy for personnel who provide service coordination and/or home visitation. 2. Help Me Grow of Cuyahoga County contract requirements stipulate that each contracted provider agency have a Clinical Supervisor at a minimum of.50 FTE s. 3. Clinical Supervisors must keep ongoing documentation of appropriate clinical supervision. This documentation must be provided to the HMG Central Site or ODH upon request. Agency Staffing/Back Up Plans All HMG Provider agencies must have a back up staffing plan in place in the event that staff leave unexpectedly or are out for long periods of time (i.e. Family Medical Leave Act). This plan will outline coverage for caseloads and other essential HMG functions to ensure that HMG eligible families have a SC or HV at all times, timelines are not compromised due to staff absences and the agency can continue required HMG business without interruptions. This plan must be provided to the HMG Central Site upon request. 57 Guidelines revised 11/02/10

59 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families Contacting New Referrals Contacting the Family Once a Help Me Grow referral is assigned to the provider agency, the agency assigns each child to a Service Coordinator or Home Visitor and follows these guidelines: New referrals must be contacted within two working days. All phone calls, letters, and visits will be documented in the child s record. For those families who have not been reached within two working days or who are contacted and have indicated they are not sure if they want service, outreach services will be continued in an attempt to engage the family in services. The outreach effort continues as outlined below. Attempting to Contact a New Referral Within 30 calendar days of the date of referral to HMG, the SC/HV will follow this protocol for attempting to contact the family: If the family has a telephone that works and/or an alternate cellular number: A minimum of two (2) calls will be made within the first 10 working days after receipt of the referral. If there is no response to the two calls, the SC/HV will contact the referral source (excluding self/family generated referrals) for updated family information and/or ideas about how to contact the family. The SC/HV will use this information to attempt to contact the family. One (1) follow up letter (ATE letter) will be mailed to the family. The letter will include the SC/HV s name and telephone number, the agency name and a deadline for contacting the SC/HV to accept services (or the family will be exited). The deadline cannot be less than 10 calendar days from the date of the letter, but must be within the 45 day timeline. If the family does not have a telephone that works or alternate cellular number: One (1) letter will be sent to the family. The letter will include the SC/HV s name and telephone number, the agency name and Help Me Grow service related information. If there is no response from the family the SC/HV will contact the referral source (excluding self/family generated referrals) for updated family information and/or ideas about how to contact the family. The SC/HV will use this information to attempt to contact the family. One (1) stop by visit will be attempted and documented. A second letter (ATE letter) will be mailed to the family. This letter will include a deadline for contacting the SC/HV or the family will be exited. The deadline cannot be less than 10 calendar days from the date of the letter, but must be within the 45 day timeline. Closing New Referrals * The agency will close the case whenever: a family refuses services a family that demonstrates no interest in HMG services (i.e., family no shows for all appointments) OR within the 45 day timeline and all attempts have been completed and documented in the client file Note: The provider agency will provide written notification to all referral sources to inform them that the case will be closed due to inability to contact the family with a copy kept in the child s record. *Guidance related to holding cases open for 90 days per endorsement of HMG Executive Committee ( ) 58 Guidelines revised 11/02/10

60 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) Ongoing Contact Help Me Grow pays providers on a capitated basis per month of service. A month of service for payment purposes is a calendar month such as January or February. This is different than the ODH policies which uses a specific number of calendar days. Please refer to the Help Me Grow Reimbursement Requirements for SFY11 to determine the contact requirements needed for payment, found in the Central Coordinating Site section. ODH requirements for ongoing contact can be found in the Home Visitation Policy and the Part C Service Coordination Policy. Both policies have many similar requirements related to ongoing contact with the following exceptions: Successful home visiting contact has to be between the HMG staff and the family. Successful Part C contact can be between the HMG staff/providers OR service providers and the family. If a home visiting family requests less frequent contacts, that request must be documented in the child s record and signed and dated by the parent. If a family of a Part C child requests less frequent contacts, that request must be documented on the IFSP. Written Notification When there has been no successful contact with the family by the Home Visitor, Service Coordinator or Part C Service Provider, then a letter (ATE letter) will be sent to the family following the guidance in the ODH policy. Please see the template letter which can be modified. Closing Children being Served * The agency will close the case whenever: The eligible child reaches the age of three years A family refuses required core HMG services A family requests to terminate HMG services A child s residence changes to a location out of the county A family that demonstrates no interest in HMG services (ie. family no shows for all appointments) For Part C eligible children When the IFSP team (parents, service coordinators and service providers) decides that goals are met, services are no longer needed, and the family is ready to transition out of Help Me Grow. * Guidance related to 90 days after last successful contact endorsed by HMG Executive Committee ( ) and amended per request of HMG Provider Leadership Group ( ) Exit Guidelines Families that have had initial successful contact and have later been determined for exit (as outlined in HMG Exit Policy), the family must be notified in writing of the exit. See the sample template letter which can be modified. The written notification must include: An explanation that their HMG record will be retained until the child reaches age six, upon which time it may be destroyed. The process for requesting to review or receive a copy of the child s record. For Part C children a statement must be included about applicable services listed on the IFSP ending as a result of the exit. Providers listed on the IFSP/FP must be provided a copy of this exit letter and a copy of the letter must be maintained in the child s record. RELATED CUYAHOGA COUNTY POLICIES: CHILD RECORDS AND ACCESSIBILITY OF RECORDS 59 Guidelines revised 11/02/10

61 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) TEMPLATE LETTER TO FAMILIES WHEN THERE HAS BEEN NO SUCCESSFUL CONTACT [Wording and format can be modified but the letter must cover the minimum elements included below.] Date: Dear: [Agency Letterhead] I ve been trying to reach you to discuss services for and have not heard back from you. Please call me at by date if you are still interested in services. If I don t hear from you by the above date, your family will be exited. You may call Help Me Grow back at any time before your child turns 3 if you would like to participate in services. Sincerely, [SC/HV name] [contact information] TEMPLATE EXIT LETTER TO FAMILIES WITH HMG RECORD RETENTION [Wording and format can be modified but the letter must cover the minimum elements included below. Items in italics must remain in the letter as worded below.] Date: Dear: [Agency Letterhead] This letter is to inform you that your family is being exited from the Help Me Grow (HMG) program due to. Please be aware that Help Me Grow policy requires that we retain your records until your child reaches age six. Following that time your records may be destroyed. If you would like to review or request a copy of your Help Me Grow record, please contact us at the number listed below. [Instruction: the following is required for Part C families:] As a result of your exit from HMG, the following Part C services listed on your IFSP dated will also end: [Instruction: List the specific Part C services on the IFSP referenced above.] Sincerely, [SC/HV name] [contact information] 60 Guidelines revised 11/02/10

62 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) EXPECTATIONS FOR HOME VISITORS AND SERVICE COORDINATORS The HMG Service Coordinator (SC) and Home Visitor (HV) have key roles in supporting families to nurture their young children and to assist them to develop to their fullest potential. Help Me Grow expects that SCs and HVs have frequent and ongoing communication with families and that they help build connections for the family within their natural environment. Caseloads: Per the Part C Service Coordination Policy, caseload size is not to exceed 45 children for a full time SC and per the Home Visitation Policy; caseload size may vary between 25 and 45, but may not exceed an average of 45 children for a full time HV. HMG of Cuyahoga County is striving to meet the caseload requirements and to provide quality services to all eligible children in our county. Due to the high volume of new referrals (and many families not engaging at the time of referral), HMG of Cuyahoga County understands that a SC or HV may have more than 45 children assigned to them at a specific point in time yet any active weighted caseload (eligible children receiving full services) will not exceed the average of 45 children. PART C SERVICE COORDINATION POLICY AND HOME VISITATION POLICY CAN BE FOUND AT Weighted Caseload: Due to the added requirements for children enrolled in HMG under the Home Visitation category, HMG is instituting a weighted caseload to determine agency assignments and reimbursement. Children identified as Part C or as At Risk (determined eligible prior to July 1, 2010) will count as 1 child. Children eligible for Home Visiting (referred after July 1, 2010 with first eligibility after July 1, 2010) will count as children. Expectations for Home Visits and Contacts: A full time trained SC/HV is expected to complete a minimum of visits per month. At least 60 % of the active billable children assigned will receive a home visit each month. At least 85 % of the active billable children assigned would receive a home visit and/or have a successful contact with HMG staff each month. 61 Guidelines revised 11/02/10

63 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) Screenings: Tools Help Me Grow of Cuyahoga County uses the screening tools as required by ODH Home Visitation Screening, Assessment and Program Evaluation Policy and the Part C Screening and Assessment Policy with the following clarifications: Cuyahoga County is currently using the ASQ second edition and ASQ-3 Cuyahoga County is currently using the ASQ:SE version 1.1 Cuyahoga County is using the HOME inventory (versus the NCAST) The HMG Safety Checklist will continue to be required for ALL HMG families at the same intervals as required for Home Visiting eligible families described in this manual HOME VISITATION, SCREENING, ASSESSMENT AND PROGRAM EVALUATION POLICY AND PART C SCREENING AND ASSESSMENT POLICY CAN BE FOUND AT Documentation of Screenings Documentation of all screenings must be kept in the record. For children that received the Universal Newborn Hearing Screen the SC/HV must document in the record per parent report that the screening was completed, the date and if any concerns were noted. For children receiving WIC, the SC/HV must document in the record per parent report that the family continues to participate with WIC and the date of the most recent nutrition assessment. If a concern is noted on the Edinburgh Postnatal Depression Scale, please use the attached Maternal Behavioral Health Referral Fax Form to make a referral. A list of providers specializing in maternal depression, along with an order form is attached. Screening Materials Agencies are responsible for ordering screening materials as outlined. Please contact Karen Mintzer, Services Manager or Lori Mago, Quality Assurance Team Leader with questions about ordering materials. Agencies ordering HOME materials should order specifically the Infant/Toddler HOME 0-3 pad of fifty (50) summary sheet and record form. 62 Guidelines revised 11/02/10

64 EXAMPLE EXAMPLE 63 Guidelines revised 11/02/10

65 EXAMPLE EXAMPLE 64 Guidelines revised 11/02/10

66 65 Guidelines revised 11/02/10 EXAMPLE

67 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) Program Evaluation: As of 7/16/10, ODH required the use of three program evaluation tools for families receiving Home Visiting: the Parent Stress Index Short Form (PSI-SF), Adult Adolescent Parenting Inventory (AAPI-s) and the Interpersonal Support Evaluation List (ISEL). Administration of these tools is at specified intervals that can be found in your ODH Home Visiting Manual. The following additional clarifications apply: The tools are required to be first administered 30 days after the eligible child is born for those families enrolled prenatally. For children referred between birth and 6 months of age, the first set of tools would be done at age 6 months and for those referred between 6 12 months, the first set of tools be done at 1 year of age. Home visitors are given 30 days before or after the required interval in which to administer the tools. For example, staff have from 5 to 7 months of age to administer the tools due at the 6 month interval. The three tools are meant to be filled out by the parent, but can be read aloud if the Home Visitor knows that the parent has difficulty reading. The Home Visitor should reassure parents that they may ask for clarification if they do not understand a word, or are unable to read a question. Ask the parent if they have any questions both at the beginning and after administering each instrument. Parent Stress Index Short Form (PSI-SF): Please see the ODH section for specific information including website for ordering materials. Help Me Grow has purchased one Short Form Kit which includes a manual and set of 25 forms for each agency. The agency is responsible to purchase additional forms. These come in packages of 25. The item that you need to order is WW-3095-TB. The attached form can be used when ordering the PSI-SF. Overview and Administration This index indicates the overall level of parenting stress that an individual is experiencing. It has 36 items and asks parents to respond strongly agree, agree, not sure, disagree or strongly disagree. 1. Parents should be asked to fill out the PSI-SF in an environment that is relatively quiet and free from distractions and expect to spend about 10 minutes doing so. 2. Ask parents to first fill out the demographic information at the top of the answer sheet. 3. Review the instructions on the back of the questionnaire with the parent, paying particular attention to the prescribed procedure for changing an answer. 4. Some questions (22, 32, and 33) require a different type of response. Before beginning, make sure that parents are alerted to these differences and that they know how to respond to these questions. 5. Ask them to complete the questionnaire. Encourage them to choose an answer for every question. Their responses will copy onto the right side of the carbon copy attached. Scoring 1. Check the answer sheet to make sure that every question has an answer. 2. Starting at the upper right hand corner (where you see Defensive Responding ) add all the responses for the questions that are shaded (questions 1,2, 3, 7, 8, 9 and 11). Put that number in the square next to Defensive Responding, which is right below the demographic data. 3. Sum the answers to questions 1-12 and put that number in the box next to PD (that box is next to answer 12). 66 Guidelines revised 11/02/10

68 Help Me Grow of Cuyahoga CountyExpectations for Home Visits and Other Contacts with Families (continued) 4. Sum the answers to questions and put that number in the box next to P-CDI (that box is next to answer 24.) 5. Sum the answers to questions and put that number in the box next to DC (that box is next to answer 36). 6. Add the sums in the PD, P-CDI and DC boxes to get the number for the total stress score and put that in the box at the bottom of the page. 7. Take the numbers for Defensive Responding, PD, P-CDI, DC and Total Stress and put them in the correct blanks under the big box labeled Raw Scores. 8. For each number locate the raw score on the column above it and make it with a dark X. After all raw scores have been marked, connect the scores with a line to form the profile. 9. If a parent scores higher than 85%, this indicates that they are experiencing stress in their parenting role. Adult-Adolescent Parenting Inventory (AAPI-2): While there is no manual for this tool, there is information online related to implementation. All forms are free and can be printed from their website. Please see the ODH section for details on forms and online scoring. Additional scoring information is attached. Overview and Administration The AAPI is an inventory that is designed to provide information concerning a person s beliefs about parenting and raising a child. The test consists of 40 questions, asking the respondent to respond Strongly Agree, Agree, Disagree, Strongly Disagree and Uncertain. The scale takes an average of minutes to complete. 1. Have parents fill out, or fill out with them, the demographic information on page For each question, have parents circle if they strongly agree, agree, disagree, strongly disagree or feel uncertain about the statement. 3. Tell parents that they should be as honest as they possibly can and that there is no right or wrong answer since they are being asked to just give their opinions. 4. Scoring is done online. Scoring Higher scores on this inventory indicate that the parent has a realistic understanding of the development capabilities and limitations of children, is sensitive to and values the needs of children over their own needs, is less apt to use corporal punishment to discipline their children and believes that children should be empowered to make choices and become independent thinkers. AAPI-2 Online Account Management Information 1. All Cuyahoga County HMG agencies are set up as satellite agencies under ODH. Each agency has their own username and password specific to their agency. This makes the agency staff satellite agents. Wendy Grove is the principal agent. Agency Clinical Supervisors (one per agency) will receive an from the website to verify their account by logging into the website with their username and password. 67 Guidelines revised 11/02/10

69 Help Me Grow of Cuyahoga CountyExpectations for Home Visits and Other Contacts with Families (continued) 2. Clinical Supervisors should learn the website. Follow the tabs on the top of the page or the blue column to the right and learn about the different features including how to enter the tool for your families. Instructional videos are provided. 3. Each agency staff person will enter their tools using their agency username and password. This means agency staff can view and edit tools (participant profiles) entered by anyone at the agency. They have the same permissions in the site that the supervisor does within the agency. Agencies do not have access to other agency s information. 4. ODH will allocate blank AAPI forms for data entry to each satellite. You can only enter as many tools as you have blank forms in your account. The CS at each agency is responsible for monitoring the balance of blank tools and ing Wendy Grove at ODH when you are running low. Wendy.grove@odh.ohio.gov. The number you have in your account is found in the upper right hand corner of the main screen ( remaining assessments ) Please be aware, it may take one to two days to reload your account. Getting Started It is strongly recommended that the CS at each agency enter the first tool to ensure there are no data entry questions before allowing your staff to enter. 1. Click on the Assessments tab at the top, you can download the AAPI forms you need here. Once a participant is entered, you can click on the Participants tab at the top to search participants by ID number, birthday or social security number. 2. If you are prompted to enter a program to proceed with data entry, simply enter your agency s name. 3. Click on the Dashboard tab at the top to download blank forms and add assessments once they have been completed by the parent. If you get pulled away from entering information before finishing, simply go back in and click on the parents name and it will take you back to the assessment and where your data entry left off. a. Once data is entered from the AAPI-2 Form A completed by the parent, you can enter it here. b. ODH is ONLY using the AAPI-2 Form A, so no form B s should be used or scored. c. The site also lists the Nurturing Skills Inventory. DO NOT USE THIS! If you complete this tool in error, ODH will be charged for the scoring price. Please make sure you are choosing the AAPI-2 Form A. d. There is a link on the right hand side which will take you to a screen which interprets the scores. Remember, Cuyahoga County HMG is using this tool (along with the PSI and ISEL) as program evaluation tools only. The information that is needed from this site are the domain scores to enter into Early Track. 4. Do not create facilitators in this program. Agency staff are to use the central username and password specific to their agencies. QA Team Leader Lori Mago will maintain usernames and passwords for all CCHMG agencies. If you have questions or issues with your account please contact lmago@helpmegrow.org Guidelines revised 11/02/10

70 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) Interpersonal Support Evaluation List (ISEL): This tool is free of charge and is available online. There is differing guidance in the ODH home visiting manual regarding the frequency at which home visitors administer this tool. Please follow the frequency outlined on page SA-16 of the manual. Specifically, it must be collected 30 days after birth (if the child is enrolled in HMG home visiting program at that time), then at 6 months and so forth. Charts found in the intake and referral section (HMG HV flow chart) and the home visiting section (Responsibilities of the Home Visitor) do not include the 30 day requirement. Overview and Administration This inventory is meant to identify levels of social support in a person s life, with social support defined as the people they can count on when they are in need. It consists of 12 statements, which parents respond to by checking definitely true, probably true, probably false or definitely false. Each response is assigned a score value and then the values are summed to receive a total score between 0 and 36. Scoring 1. Assign a value to each response. a. For questions 1,2,7,8, 11, and 12 assign values as follows: Definitely true -0 Probably true-1 Probably false-2 Definitely false-3 b. For questions 3,4,5, 6, 9 and 10 assign values as follows: Definitely true-3 Probably true-2 Probably false-1 Definitely false-0 2. Add up all of the numerical values, to achieve a total sum between 0 and The lower the score, the less perception of social support the parent has. This parent will need assistance in developing reliable forms of social support with which they can discuss and receive help for problems and engage in social activities. 69 Guidelines revised 11/02/10

71 EXAMPLE EXAMPLE 70 Guidelines revised 11/02/10

72 Help Me Grow of Cuyahoga County Expectations for Home Visits and Other Contacts with Families (continued) Parents As Teachers, Born To Learn County Plan HMG Central Site maintains the Parents As Teachers, Born to Learn program plan for the county. This plan is updated annually and a current copy is provided to Clinical Supervisors at each agency for their reference. Lori Mago, Quality Assurance Team Leader serves as the County Program Supervisor for Parents As Teachers, Born to Learn. Please contact her with questions about the program plan or implementation of the curricula. Group Implementation Please see the Parents As Teachers, Born to Learn Group Meetings in the Family Support section. Part C Children 1. Part C children that also meet Home Visiting eligibility criteria should be offered the Parents As Teachers, Born to Learn curriculum. Procedures outlined in the Part C Eligibility Determination Policy, procedure 10 should be followed. These children no longer need a Family Plan and appropriate information should be transferred to an IFSP once determined Part C eligible. Home visiting services should be incorporated into the IFSP as appropriate. Both plans can still be used if the family prefers but the Family Plan is no longer required, and can no longer be entered into ET. 2. The Parents As Teachers, Born to Learn curriculum can be used for families with Part C or At Risk eligibility based on family needs and other services they are currently receiving. Please contact your Quality Assurance Specialist with questions. Certification Certification for Parents As Teachers, Born to Learn is referenced in the Personnel section of these guidelines as well as the HMG Personnel Standards. PART C ELIGIBILITY DETERMINATION POLICY AND PERSONNEL STANDARDS POLICY CAN BE FOUND ATWWW.OHIOHELPMEGROW.ORG 71 Guidelines revised 11/02/10

73 Help Me Grow of Cuyahoga County Part C Part C Services Guidelines Children with a Diagnosis The Ohio Department of Health maintains a list of Diagnosed Medical Conditions that automatically qualify a child (or expectant child) for Part C. The list is updated frequently and can be found in the report section of Early Track 3.0. Cuyahoga County does require medical confirmation of the diagnosed condition which can be obtained from: medical reports referral or other information from a physician, nurse, psychologist or audiologist referral or information from a hospital or medical office including referrals from Hospital Based Child Find Specialists referral or information from the Regional Infant Hearing Program In most cases, children with a confirmed diagnosis will be scheduled with one licensed professional to conduct an assessment for program planning. Informed Written Consent Parents must provide informed written consent before the initial evaluation and assessment using the Consent for Services and Parent s Rights in the Help Me Grow Part C Program. PART C SERVICE DELIVERY POLICY CAN BE FOUND AT Parental Prior Notice and Related Guidance Service Coordinators and Providers in the HMG System are responsible for giving the family written prior notice (WPN) of any initiation or change in evaluation or services that does not occur at an IFSP meeting. The person initiating or changing the service is the one responsible for giving the notice to the family using the Parental Prior Notice (PPN) form and sending a copy of the form to the Service Coordinator on the same day. Providers in the HMG System as referred to below are: Cuyahoga County Board of Developmental Disabilities (CCBDD), Regional Infant Hearing Program, Bureau for Children with Medical Handicaps and providers in the Early Intervention System of Payment. Initial Evaluation/Assessment scheduled SC completes the WPN section of the PPN form and sends it to the family at least 14 days prior to the date of the evaluation/assessment. The parent may choose to waive their right to 14 days notice. This is reflected on the form. Family or evaluator needs to change evaluation date or evaluator No PPN form needed. Document circumstances in notes per guidance from ODH ( Technical Assistance Visit). 72 Guidelines revised 11/02/10

74 Help Me Grow of Cuyahoga County Part C An initial or IFSP review meeting will be held SC completes the IFSP meeting notice section of the PPN form and sends to family and all providers (with parent permission). Providers in the HMG system are identified and a start date is determined If decision to start services is not made at an IFSP meeting, the provider completes the WPN section of the PPN form and sends to family and SC on the same day. If the family waives their right to 14 days WPN, this is reflected on the form. Once received, the SC completes the IFSP meeting notice section of the form and sends to family and all providers (with parent permission) to add the new services at an IFSP review. Provider in the HMG system changes or ends services If decision is not made at an IFSP meeting, the provider completes the WPN section of the PPN form and sends to the family and SC at least 14 days prior to the effective date (unless 14 days notice is waived by the parent, which is reflected on the form). If changes trigger an IFSP update, the SC completes the IFSP update section of the form with the family. If changes trigger a review, or services are ending, the SC completes the IFSP meeting notice section of the form and sends to family and all providers (with parent permission) to notify them of the review. a. A change in location requiring an IFSP review means a change that would require a different location code on the IFSP section VII, such as from home to center based. Changing centers within the same agency, such as Green Road to William Patrick Day is an IFSP update. b. When services are ending, the provider must still provide updated information for section III of the IFSP for that review including new developmental information/changing circumstances, etc. that contributed to the termination of services. SC changes within same agency Current SC completes the WPN section of the PPN form and sends to the family and all providers on the IFSP (with parent permission). New SC completes the IFSP update section of the form with the family to reflect the change in SC on the IFSP. The person providing services changes within the same agency Provider completes the WPN section of the PPN form and sends to the family and SC. SC completes the IFSP update section of the form with the family to reflect the change in provider on the IFSP. SC changes to a different agency Current SC completes the WPN section of the PPN form and sends to family and all providers on the IFSP (with parent permission). New SC completes the IFSP meeting notice section of the form and sends to family and all providers on the IFSP (with parent permission) to hold the IFSP review. If services are initiated and/or changed within a close time frame of the next 180 day review, it may be appropriate to delay adding those services to the IFSP until that review, to avoid back to back reviews. This can be done if the IFSP team is in agreement. 73 Guidelines revised 11/02/10

75 Help Me Grow of Cuyahoga County Part C When families choose to waive their right to 14 days written prior notice, the conversation preceding that decision should be documented in the notes. For example: SC discussed with mom about the evaluation date of and that she has the right to 14 days written prior notice about the evaluation. Mom still preferred to have the evaluation completed on. When a child is receiving CCBDD toddler services that end for the summer months and restart in the fall, the service provider must complete the WPN section of the PPN form and send to the family and SC within 14 days of the effective date: a. If the change is a change in frequency, intensity, duration, staff or center within the same agency you only need an IFSP update and not a full review to reflect those changes anytime they occur(i.e. the child will continue to receive special instruction from CCBDD in a center based setting but at a different frequency, intensity or duration or with a different Developmental Specialist). b. If the change means the child will now receive special instruction in the home rather than the center or special instruction will not occur at all, this is a full IFSP review. 74 Guidelines revised 11/02/10

76 Help Me Grow of Cuyahoga County Part C (continued) Scheduling Initial Developmental Evaluations and Assessments All initial Developmental Evaluations and Assessments should be scheduled through Gale Sawyer, Evaluation Scheduler, in a timely manner prior to the 45 th day. The Evaluation Scheduler can be reached Monday through Friday at between 9:00 am 12:00pm and between 1:00pm 4:00pm 1. The SC will determine the caregiver s availability and will contact the Evaluation Scheduler from the caregiver s home or the office. The SC will provide all demographic information as well as information and observations about the child. They should include any unusual circumstances and/or details about entering the home. When scheduling the evaluation and assessment consider the following: It should be scheduled at a time when the child is awake. A caregiver that knows the child very well should be present. It is important to ask the caregiver for additional medical/therapy documentation which can be used to assist the evaluators in understanding the child s needs. Report all diagnosed conditions, not just the ones that are on the Part C list. This information may also be used to confirm the diagnosed condition. While confirmation of a diagnosed condition does not necessarily have to come directly from the physician s or therapist s office, it must be clear that the information is from the professional confirming that this particular child has the diagnosed condition. The caregiver should be informed that a call will be made on the business day preceding the evaluation and assessment to confirm the appointment. The evaluation and assessment process will take approximately one and one-half hour. All cancellations or changes in demographic information should be called in to the Evaluation Scheduler. If the family cancels a third time the call may be transferred to the Evaluation Team Leader. 2. The SC will complete all appropriate screens and identify the 45 th day at the time of the call. 3. The evaluation and assessment can take place in the home or another location pending the availability of the caregiver. The Evaluation Scheduler will provide a date for the evaluation and assessment and the name of the Evaluators. 4. The SC will also schedule the follow up (IFSP) meeting and document all information on the Evaluation Scheduling Card. The bottom half is given to the family and the top half is maintained in the child record. 5. The SC will be reminded by the Evaluation Scheduler to provide the evaluation and assessment packet either by (evals@helpmegrow.org) or fax ( ). The evaluation and assessment packet should be sent as soon as possible, at least a few days before the appointment. If it is not received by 3:00 p.m. on the day preceding the scheduled evaluation, the evaluation may be cancelled. The packet includes the following: Sections 1,2,4, and 5 of the IFSP. (Blank pages should not be sent) HMG consent for the evaluation and assessment All medical documentation, therapy reports and mental health reports Completed screens or document that the child is on WIC. Additionally, if medical/therapy/mental health documentation is received after the evaluation and assessment packet has been sent, send it immediately to the Evaluation Scheduler. The Evaluation team will incorporate the additional information in the developmental summary report. 75 Guidelines revised 11/02/10

77 Help Me Grow of Cuyahoga County Part C (continued) 6. The SC will receive the completed evaluation and assessment report from the Evaluation team in 8 calendar days by or fax. 7. It is critical that the SC reviews the report prior to meeting with the family. The SC will contact the Evaluator if there are questions about the report before the scheduled IFSP meeting. 8. In situations where the evaluation and assessment is near the 45 th day, the SC may receive a document called the Snapshot. (see attachment) This document will inform the SC about the child s eligibility in order to facilitate completion of the IFSP prior to receiving the actual report. The SC may also opt to attend the evaluation and assessment and complete the IFSP at that time. 9. The SC will review the evaluation report with the family. One copy is given to the family and another placed in the child s record. With parental permission, a copy is sent to the medical provider(s) and others as agreed upon. There are some situations where the SC is providing service coordination for one child and a sibling is identified as having a Part C concern. This child then becomes eligible for an evaluation and assessment. There are specific guidelines available if there is a Developmental Specialist from the Cuyahoga County Board of Developmental Disabilities already in the home. There are situations where the SC may not be certain of a child s need for an evaluation and assessment due to a prior referral, prior evaluation or other circumstances. A decision tree has been developed to help determine the appropriateness of an evaluation or assessment in those special circumstances. Any questions can always be addressed to Kim Broadnax, Evaluation Team Leader at Children who are determined not eligible for Part C services Follow the requirements from the Part C Eligibility Determination policy for children determined not eligible for Part C services. Remember to document the date of parent notification in the case notes. If a child is eligible for Home Visiting services, the SC must send a new Request of Service Form to HMG Intake. 76 Guidelines revised 11/02/10

78 77 Guidelines revised 11/02/10 EXAMPLE

79 EXAMPLE EXAMPLE 78 Guidelines revised 11/02/10

80 Help Me Grow of Cuyahoga County Part C (continued) Scheduling an Evaluation or Assessment when there is a Developmental Specialist (DS) already in the home and another Part C child is identified 1. The new child with Part C concerns can be identified by the DS. The DS will contact the SC, or the child can be identified by the SC who will contact the DS. (This process is in place to keep both providers aware of new situations occurring in the home.) 2. The Request For Service Form should be generated by the SC or the DS (with the legal guardian/caregiver s consent) within 1 business day of the identification of the Part C child. 3. The DS will contact Gale Sawyer, Evaluation Scheduler to schedule the evaluation/assessment on the HMG evaluation calendar. For children with a Part C diagnosed condition, the Evaluation Scheduler will just add the date of the DS assessment to the HMG calendar. For children with a suspected delay, the Evaluation Scheduler will add the DS to another discipline available in a chosen time slot on the HMG calendar. 4. The DS will contact the SC within 1 business day with follow-up information and/or the date and time of the evaluation/assessment. 5. The SC will /send the evaluation packet to the Evaluation Scheduler no less than 3 business days prior to the scheduled evaluation/assessment. 6. The Evaluation Scheduler will ensure that the packet is given to the DS and the second discipline (if appropriate). There may be some situations in which the SC may give the packet directly to the DS for children with Part C diagnosed conditions where there is no second discipline. 7. Upon completion of the evaluation/assessment, the DS will fax the report to the SC to facilitate completion of the IFSP (within 8 calendar days). If 15 days from the 45 th day the DS will complete the Snapshot with the child s concerns and therapy recommendations and fax it within 1 business day of the assessment so that the IFSP can be developed. Revised Guidelines revised 11/02/10

81 80 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Part C (continued)

82 Help Me Grow of Cuyahoga County Part C (continued) Ongoing Part C Assessments It is a new requirement that all children found eligible for Part C have a 180-day and annual assessment for program planning in all five domains (areas of development). Help Me Grow and its partner, the Cuyahoga County Board of Developmental Disabilities, developed a process of providing Ongoing Assessments. This Ongoing Assessment must be completed by a qualified professional using one of five approved developmental assessment tools. A Multi-Factored Evaluation (MFE) from a local school district can also be used. (Per Guidance from the HMG Monthly Conference Call) Children receiving services by a Developmental Specialist (DS) will be assessed by the DS providing the service. Other early intervention service providers might also conduct the Ongoing Assessments if they have the appropriate licensure/certification and can provide documented proof that they are trained on one of the five approved tools. Some general guidelines are the following: The Ongoing Assessments will take place at center-based locations that serve east, west or downtown. Service Coordinators should contact Celeste Bajorek (see attached instructions) if the family is interested and able to attend one of the available Monday, center-based locations. Service Coordinators should contact Gale Sawyer (see attached instructions) if the family is unable to attend one of the available Monday center-based slots, but is interested and able to attend one of two center-based locations at Quincy Place or William Patrick Day, at a time that meets the family s needs. The Service Coordinator must inform Ms. Sawyer that they specifically need an Ongoing Assessment. The Ongoing Assessments should be scheduled days prior to the IFSP review. In order to ensure that this occurs, the SC should call to schedule the appointment days before the IFSP review. The Ongoing Assessment information must be entered into the ET 3.0 data system. If a family is not interested or is unable to participate in any of the Ongoing Assessment slots that are available, the Service Coordinator should send an to Kim Broadnax at kbroadnax@helpmegrow.org along with their clinical supervisor explaining the reasons why the family is unable to participate in the Ongoing Assessments available. This should be documented in the child s record. Cuyahoga County will implement this process for a trial period. During that time, Service Coordinators will not need to exit children because they refuse (or are unable to attend) the available Ongoing Assessment slots. * A Service Coordinator does not have to postpone an IFSP review or exit a child if the child does not have an Ongoing Assessment. The Service Coordinator can use other information such as other assessments, screenings, observations and parent input to assist with completing the IFSP Review during this trial period. * See attached procedures and forms for additional information for scheduling the Ongoing Assessments. * Guidance per endorsement of the HMG Executive Committee ( ) Continuation of Part C Services: While evaluation for eligibility is not required annually, service coordinators should exit children from early intervention when the IFSP team (parents, service coordinator and service providers) decides that goals are met, services are no longer needed, and the family is ready to transition out of Early Intervention. 81 Guidelines revised 11/02/10

83 Help Me Grow of Cuyahoga County Part C (continued) Early Intervention Services on the IFSP 1. Department of Developmental Disabilities, Early Intervention System of Payment Providers, Regional Infant Hearing Program and Bureau for Children with Medical Handicaps are part of the Help Me Grow system and are held to all Part C policies. 2. The IFSP team (referenced throughout this document) is defined as the parent, Service Coordinator and providers listed on the IFSP. 3. When a provider is not able to attend the IFSP meeting they should send the following information to the Service Coordinator ahead of time: a. Explanation of child s current developmental needs. b. Recommendations for strategies to assist family with meeting their outcomes as identified by the evaluation/assessment or ongoing assessment and the family s priorities. Recommendations should be measurable but not in therapy language. The provider should not develop outcomes themselves either with or without the family. This is done at the IFSP meeting. c. Recommendations for frequency, intensity, etc. in order for the SC to assist the IFSP team in writing a meaningful IFSP for the next 180 days. d. The above information should all be sent in the form of a word document or no later than 24 hours prior to the IFSP review. It is not appropriate for providers to complete IFSP pages outside of the team meeting. This is the responsibility of the Service Coordinator. 4. Providers should not change or add outcomes. The outcomes come from the family. A provider may contact the SC to request an IFSP review meeting and be in attendance at the meeting to discuss questions or concerns related to content on the IFSP. The parent has the final decision as to what is included on the IFSP. 5. Developmental Assessment information from providers should be shared prior to each 180 day review as described above. In order to ensure providers can predict when their information will be due, the following guidance applies to: a. Part C children whose initial Part C IFSP is on or after November 1, 2010: The 180 day IFSP review timeline is based on the date of the initial IFSP. For example, if the initial IFSP is held on 1/1/10, the 180 day review would be held no later than 6/30/10, regardless of other reviews that may occur in between. Providers on the IFSP would know to complete their assessments prior to that date with the understanding that they will receive timely written notice of the scheduled date and time of the review as described below. b. Part C children whose initial Part C IFSP is prior to November 1, 2010: The 180 day IFSP review timeline is based on the last IFSP or IFSP Review. c. When a child s developmental situation changes substantially between 180 day reviews such as when a child has been hospitalized or has a new diagnosis, a new assessment and IFSP review is warranted and the 180 day timeline would be adjusted to those dates. 82 Guidelines revised 11/02/10

84 Help Me Grow of Cuyahoga County Part C (continued) d. In any of those situations, if a review is scheduled between those dates (for example, because SLP services are being added), an Early Intervention Service Provider would not need to submit updated developmental information unless they were the person requesting the addition of the SLP. Other exceptions apply: (Consult your Clinical Supervisor and/or QA Specialist for guidance.) 6. Service coordinators should provide at least 14 days written notice of IFSP review meetings to the family and providers (with parent permission). It is not appropriate to hold impromptu IFSP review meetings with families who have not responded to calls and happen to be home when a stop by visit is attempted when other service providers are present on the IFSP. 7. When a provider that is currently on the IFSP is invited to a review meeting and does not attend and does not provide information for the review in time for the meeting the SC will: a. Discuss the current status with the family including what is listed on section VII of the IFSP. b. All current Part C services being provided to the child should be listed on section VII and in Early Track regardless of whether or not they are in attendance at the IFSP meeting. Providers are not liable for services written on section VII unless they sign the IFSP. c. With the team s agreement, the SC should continue the services for the next IFSP period. In some cases, the IFSP team may just be the parent and the SC. d. The SC should use all available information (including parent report) to complete section III of the IFSP. e. Those in attendance, including the parent will sign the IFSP. This is the IFSP date. (The exception is when DCFS has custody. In this case, they are considered the parent and the IFSP date is when they sign.) A copy of the IFSP should be submitted to the service provider not in attendance requesting their signature. f. If the service provider submits additional developmental information after the IFSP meeting (for section III), the SC can attach the information as applicable, ensuring the family has a copy. This is just an attachment, not an IFSP update or review. g. If the service provider submits written prior notice that changes strategy, method, frequency, intensity and/or duration of an existing service, or a change in provider at the same agency, the SC should contact the family to conduct an IFSP update. (See IFSP policy for guidelines on IFSP updates.) h. If the service provider submits written prior notice of items that require an IFSP review shortly after the review was just conducted, the SC should contact their Clinical Supervisor/QA Specialist for additional guidance. Example: The IFSP was reviewed on 10/1/10 and the SLP was not in attendance and did not submit anything prior to the meeting. On 10/12/10 the SC receives information from the SLP showing a change in location of SLP services from home based to center based. i. The following constitutes an IFSP review: additions or deletions of outcomes or services, changes in location of services and/or a change in service provider agency. i. Note: the above bullets are exceptions and should not be occurring on a regular basis. Service Coordinators must give providers adequate notice of all IFSP meetings so 83 Guidelines revised 11/02/10

85 Help Me Grow of Cuyahoga County Part C (continued) attendance can be prioritized or information can be sent ahead of time. Service Coordinators should contact families one month prior to the IFSP review due date to agree upon the meeting date. This will allow SC s enough time to give providers at least 14 days notice to attend and allow for rescheduling if needed. j. For some families, services change on a more frequent basis which may result in a need for increased IFSP reviews. If you have concerns about the frequency of IFSP reviews for a particular family, as described in above or the family is refusing the IFSP review as required by policy, please contact your Clinical Supervisor/QA Specialist for guidance. Note: IFSP reviews are required at least every 180 days per policy. If the IFSP is still current when the child turns 3, another review is not needed before the child ages out. The SC will meet with the family prior to exiting and may refer to the IFSP to provide closure and ensure services are in place beyond transition but it is not necessary to review the IFSP again. 84 Guidelines revised 11/02/10

86 Help Me Grow of Cuyahoga County Part C (continued) Child Outcome Summary Forms A Child Outcome Summary Form (COSF) is completed for Part C eligible children at the following intervals: Upon entry into Ohio Part C services. This means at the time of the first IFSP for a child that is six months of age or older. This might be their initial IFSP (if they are = or > than 6 months at the first IFSP) or it might be the IFSP review (if they were < than 6 months at the first IFSP). Annually At the time of the annual IFSP review. This date is based on the initial Part C IFSP (not necessarily the entry COSF IFSP). According to the Part C Screening and Assessment Policy, children who have had an entry COSF completed must have a COSF. Exit when a child exits Help Me Grow. Please note the following: A child must be in the program for six months in order to enter an annual or exit COSF. COSF information is very important. It provides outcome information needed for state and federal reporting and provides outcome information for children receiving Part C services. COSF information must be entered into Early Track. HMG agencies should monitor the completion of COSF forms through the COSF report in Early Track. HMG Quality Assurance will be monitoring this area more closely in SFY11. Part C Specialized Services Service Coordinators should assist families in obtaining the Part C services that are needed for a particular family. There are 17 identified Part C services which can be found in the Part C Service Delivery Policy. Service Coordinators must help families get connected to those services in a timely manner which is specified in policy. It is important for Service Coordinators to talk to families about what services are available as well as funding options. Cuyahoga County has a variety of service options to meet the individual needs of a child and family. Many children obtain services through the Cuyahoga County Board of Developmental Disabilities. Information on their programs is included at the end of this section. The Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County (ADAMHS) contracts with six agencies to provide Early Childhood Mental Health Services. Specific information about obtaining these services can be found in the Overview of Help Me Grow section of these guidelines. Additionally, there are a variety of other individuals, agencies or hospitals that provide therapy services or other early intervention services. These services can be found by contacting the family s insurance company, by searching the web or by contacting First Call for Help at 211. A copy of the Summer and Beyond Directory 2010 Academic, Social/Emotional, Therapeutic, Recreational Supports and Services for Students with Disabilities can be found on the following website The Bureau for Children with Medical Handicaps (BCMH) assists families in obtaining services to diagnose a potential handicapping condition (the diagnostic program) and assists with ongoing services for children with an eligible medical handicap (The Treatment Program). 85 Guidelines revised 11/02/10

87 86 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Part C (continued)

88 Help Me Grow of Cuyahoga County Part C (continued) Early Intervention System of Payment (EISOP) Guidelines and Other Funding EISOP 1. Service Coordinators will inform Part C eligible families of the EISOP when they do not have resources available to pay for EI specialized services identified on the IFSP as defined in the EISOP Policy. 2. Service Coordinators will assist families in applying for EISOP when they are interested and meet the criteria defined in the policy. a. Service Coordinators will use the guidance and forms accompanying the policy to complete the application. Note, the policy and forms can be found at The 2/2010 revised version of the Ohio Department of Jobs and Family Services Combined Programs Application form should be used. Please contact Lori Mago, Quality Assurance Team Leader if you need a copy. Additional guidance on EISOP can be found at: b. Service Coordinators will document in the record when they have offered EISOP to a family and they have declined an application. 3. The services needing EISOP must be listed on section VII of the IFSP. The section should be completed with as much information as you know (provider name, recommended frequency, intensity, etc.). Information such as start date and payment source that is unknown due to the pending application should be marked as pending EISOP. 4. The Service Not Available Form referenced in the policy must be signed by Melissa Manos, Help Me Grow of Cuyahoga County Project Director. Please submit to Lori Mago, Quality Assurance Team Leader to obtain signature. 5. Lori Mago, Quality Assurance Team Leader should be contacted for questions regarding the EISOP process. Other Funding 1. All forms of other funding listed in this section must be exhausted before applying for EISOP as these are funds of last resort. 2. CCBDD Family Support Program available to CCBDD eligible families and can be used for certain services including respite. Refer to CCBDD s Forms Packet containing details and application information. 3. Tier III/Community Assistance Funds may be available to active HMG eligible families and can be used for tangible goods such as appliances, utilities, furniture, rent, etc. Refer to the Tier III Funding Fact Sheet and the Tier III Request form for details and application process found in the miscellaneous section at the back of this document. Contact Nadia Brahim, Quality Assurance Specialist for questions regarding this process. 87 Guidelines revised 11/02/10

89 Help Me Grow of Cuyahoga County Part C (continued) HMG Service Coordinator/CCBDD Developmental Specialist - Clarification of Roles Service Coordinator (SC): Holds a minimum Associate s degree from an accredited college or university in a major field of study related to early childhood Participates in required trainings and becomes credentialed through the Ohio Department of Health Maintains credentialing renewal through continuing education and training as required by policy Informs parents of their HMG rights Secure appropriate consents and permission to release information in order to communicate with other Providers about the family Serve as the single point of contact to the HMG system for the family Coordinate the evaluation/assessment when delay is suspected or for child with medically diagnosed condition Facilitate and participate in the development, implementation, review and monitoring of the IFSP and its timelines Coordinate completion of ongoing screenings and assessments Identify and establish medical/health home Coordinate with medical and health providers Identify available service providers Inform families of the availability of advocacy services Coordinate, facilitate and monitor the timely receipt of services Monitor family s changing circumstances and adjust service coordination activities according to family preferences Assure ongoing contact with the family and/or Part C providers as required by policy Respond to communications from the DS and other Providers within 2 business days as best practice Assists the family in determining payment options for needed services and coordinates referrals to EI System of Payment, where applicable Deliver home visiting program to appropriate families including provision of curriculum when acting in the dual role of SC/Home Visitor and maintains appropriate ongoing certification from Parents As Teachers, Born to Learn Facilitate transition plans to preschool and/or other services if appropriate 88 Guidelines revised 11/02/10

90 Part C (continued) HMG Service Coordinator/CCBDD Developmental Specialist Clarification of Roles (continued) Developmental Specialist (DS): Holds a Bachelors or Master s Degree in Early Childhood Special Education, Child Development, or a related field Licensure and/or certification as an Early Intervention Specialist from the Ohio Department of Developmental Disabilities, may also need licensure/certification from the Ohio Department of Education Participates in ongoing training in order to renew certificate or licensure Conducts eligibility assessments for HMG using approved tools from ODH Conducts ongoing assessments for program planning for children on their case loads Discusses and explains results of the assessment to parents and caregivers Designs specialized interventions based on area of concerns or medical diagnosis in all areas of development Collaborates with other members of the team serving the child to provide follow up in the home with strategies suggested by other team members Adapts curricula to meet the needs of the parent and child and/or the specific medical diagnosis of the child Provides developmental guidance to the parents/caregivers regarding the needs of the child, works with the family to individualize developmental strategies based on the families needs and child medical diagnosis Coaches the family and other caregivers in parent-child interactions to foster development Provides information on child development, behavior, and parenting related to a child s needs and any adaptations a child may need related to the curriculum, toys or the environment Provides 1-1 instruction/coaching in a the families home or other agreed upon location to foster development of the child May provide coaching and instruction in parent child play groups offered throughout the community, groups are formed based on parent child needs Will participate in inter-disciplinary discussion regarding the appropriateness for toddler class referrals Will coordinate the referral to toddler if appropriate When the parent requests or upon recommendation of the DS, the DS will participate in the transition process to preschool or the next environment Communicates with the SC before initiating any change to frequency, location or type of service Returns phone calls to the SC or family within two business days If DS becomes aware of another child who may be eligible for Part C services in the family, the DS will inform the SC. The DS may facilitate the assessment of that child with another team member and will notify the SC of the outcome of the evaluation. 89 Guidelines revised 11/02/10

91 Part C Cuyahoga County Board of Developmental Disabilities Memo from Cuyahoga County Board of Developmental Disabilities To: Help Me Grow Service Coordinators From: Janet Cimino and Kathy Zielinski Date: Revised March 8, 2010 RE: Cuyahoga Therapy Services and Billing There has been much confusion regarding therapy and billing. Hopefully this will answer your questions. If you have further questions, please contact Kathy Zielinski - SLP (216) Janet Cimino OT and PT (216) Sharon Dwertman Assistive Technology (AT) (216) Initially Insurance (Medicaid or private) will be utilized to cover therapy sessions. The consumer is responsible for the first 10 sessions (of each discipline: OT/PT/SLP) if o The insurance does not cover therapy o The insurance is maxed out o There is no insurance o The person has insurance but does not want to use it When the consumer is responsible for payment of therapy services, the following options are available o Family Supports if the family qualifies o Sliding Fee Scale If the family qualifies o Family Pay if the family does not qualify for Family Resources or Sliding Fee o Family can contact their insurance carrier to ask which agencies are providers for requested service After the above periods are completed, local funding from CCBDD will be utilized. Speaking with Families When making a referral for CCBDD Occupational Therapy, Physical Therapy, or Speech Language Therapy, please inform the family that: A Doctor s prescription must be obtained before services can be initiated. The process can go more quickly if the prescription accompanies the request form but if not, the therapy services support staff will pursue and obtain the prescription. There may be a cost associated with these services depending upon their individual insurance policy. In order to expedite the process, please ensure that the family provides complete information regarding insurance and physician. Upon receipt of referral, if Cuyahoga Therapy Services has further questions the AT Administrator, Sharon Dwertman will contact the family. 90 Guidelines revised 11/02/10

92 Part C Cuyahoga County Board of Developmental Disabilities A Guide to Early Intervention Services Offered Through the Cuyahoga County Board of Mental Retardation /DD 2/2/09 CCBMR/DD provides both home based and center based services for children birth to 3 years of age. When referring for early intervention services, please consider the needs of both the child and the family. Although a child may be eligible for Part C services, CCBMR/DD may not necessarily be the most appropriate agency to serve the needs of the child and family. CCBMR/DD will not duplicate services already being provided by other community providers regardless of the funding source except in certain situations as determined by CCBMR/DD In order to refer a child for early intervention services, please submit the following: CCBMR/DD Early Intervention Referral form. Completed IFSP including the Outcomes/Goals (section VI of the IFSP) that relate to the areas of concern. All available medical information. *The Health and medical information section of the IFSP must be completed and immunizations should be current. (If not current then include a strategy on the IFSP to get immunizations current or have the doctor submit an immunization exemption form.* Birth verification will be necessary within 60 days of enrollment in home based services. If not immediately available a strategy should be written to provide that information within 60 days of enrollment. Additional information is required for the Toddler program or for Family Resources. See attached requirements. Early Intervention Services available include: 1. Assistive technology services- CCBMR/DD therapists can assist in the assessment for, selection of, consultation about or use of assistive technology such as communication devices, computer adaptations, adapted utensils, adapted seating, or other environmental modifications. Since these services are provided by therapists, billing will be submitted to the families insurance, Medicaid or Family Resources. Families may be charged for these services (out-of-pocket). There is a sliding fee scale available. Therapy services cannot begin until a doctor s prescription and insurance information is provided. 2. Health and Nursing Services- limited services to children enrolled in the Toddler program. May include administration of medication or treatments, tracheotomy care or tube feedings or other similar services. 3. Nutrition services- only available to children involved in CCBMR/DD EI services. Children are screened for nutrition concerns. CCBMR/DD contracts with the Cuyahoga County Board of Health to provide nutrition services. 91 Guidelines revised 11/02/10

93 Part C Cuyahoga County Board of Developmental Disabilities 4. Occupational Therapy (OT) - is provided a maximum of two times per month. Services are provided in the home or clinic. If children are over the age of 2, clinic services only are available, unless the child meets the definition of a medically fragile child. Children must be less than 33 months of age at the time of referral. For therapy services, billing will be submitted to the families insurance, Medicaid or Family Resources. Families may be charged for these services (out-of-pocket). There is a sliding fee scale available. Therapy services cannot begin until a doctor s prescription and insurance information is provided. 5. Physical Therapy (PT) - is provided a maximum of two times per month. Services are only available to children who are over 6 months of age. Services may be available in the home or clinic. If children are over the age of 2, clinic services only are available, unless the child meets the definition of a medically fragile child. Children must be less than 33 months of age at the time of referral. For therapy services, billing will be submitted to the families insurance, Medicaid or Family Resources. Families may be charged for these services (out-of-pocket). There is a sliding fee scale available. Therapy services cannot begin until a doctor s prescription and insurance information is provided. 6. Psychological Services- limited services to children already enrolled in a CCBMR/DD program. Referrals may be considered for non-enrolled children on a case by case basis and if it determined that these services might be the best match for the child and family. Services may include psychological testing, consultation and parent education regarding developmental or behavioral concerns. 7. Speech Language Pathology (SLP) - provided a maximum of two times a month and is available to any Part C child. Services may be provided in the home or clinic. Children over the age of 2 will be seen in the clinic unless the child meets the criteria for a medically fragile child. Late afternoon slots available Clinic closes at 6 PM. A short term intensive model of therapy (10 visits) may be available after a period of consultation with the CCBMR/DD SLP. Children must be less than 33 months of age at the time of referral. If a child needs more intensive services, the child should be referred to another community provider. For therapy services, billing will be submitted to the families insurance, Medicaid or Family Resources. Families may be charged for these services (out-of-pocket). There is a sliding fee scale available. Therapy services cannot begin until a doctor s prescription and insurance information is provided. 92 Guidelines revised 11/02/10

94 Part C Cuyahoga County Board of Developmental Disabilities 8. Specialized Instruction (Developmental Specialist) - available for all Part C eligible families with the exception of children with a social emotional delay only. Late afternoon and evening appointments available. There is no Saturday availability. Specialized instruction is provided in a variety of locations including the child s home, relative s home or child care center. Specialized instruction services may include: Developmental assessments and interventions for children who born premature, have vision impairments, autism, multiple disabilities, Down syndrome, other syndromes, drug and alcohol exposure and other conditions. Parent child programs for infant massage, early literacy, parents with special needs or teen parents. Special educational strategies to develop cognitive, play, fine motor, gross motor, communication, self help and social emotional skills. Family support and information regarding disability resources, developmental expectation and family expectations, and assistance with accessing community resources. Parenting support to establish family routines, integrate interventions from a variety of disciplines into family routines, developmentally appropriate toys and baby equipment, and adapting toys and environments to facilitate play and independence. Children should be less than 33 months of age at the time of referral with exception of children with autism. There is no fee for specialized instruction services. Family Resources/Respite-can provides some financial assistance to support specific things related to a child s special needs. Children must meet eligibility criteria for CCBMR/DD services in order to access Family Resources. They do not have be receiving direct services from CCBMR/DD. Respite services may also be available to families of children eligible for CCBMRDD services. These services are not available to foster children. There is a co-pay for Family resource services based on family household income after taxes. Toddler program- available for children 18months to 3 years of age with a delay in cognition or with developmental delays in two domains. Children should be 17 months to 30 months at the time of referral. The toddler program is an intensive early intervention program that meets two days a week. It is not a playgroup or childcare program. The program is staffed by a licensed Developmental specialist and teacher assistants. Related services such as OT, PT, SLP, music and gym are provided based on the needs of the child. The toddler program is available at Cleveland (WPDECC or Green Rd), Parma (St.Bridget), Westside ECC and Sussex. Spaces are limited and there is frequently a waiting list. Transportation to the toddler program is available or parents may transport. P.L.A.Y. program- available for children birth to three years of age with a diagnosis of Autism spectrum disorder or with concerns in that area. It is a home based program and stands for Play and Language for Autistic Youngsters. Families, once enrolled, will have the option of continuing with the PLAY project up to age Guidelines revised 11/02/10

95 Part C Cuyahoga County Board of Developmental Disabilities Questions about CCBMRDD services can be directed to: Assistive technology- Kathy Occupational or physical therapy services- Janet Speech-language pathology services- Kathy Specialized instruction services- Kathy Wojciak@ or Janet Toddler programs at WPCECC- Celeste Bajorek@ Toddler programs at Green Rd.or Sussex- Janet Banks@ Toddler programs at Parma (St.Bridget) or Westside ECC- Kathy or Celeste Autism services (home based)- Kathy or Celeste Autism services (center Celeste Bajorek at or Kathy for Westside Early Childhood Center Family Resources- Tim Note: Different staff work at different locations and may change offices. Please make sure that you check the roster for location changes. CCBDD Toddler Classroom Locations William Patrick Day ECC (WPD) 2421 Community College Ave. Cleveland, OH (216) Fax: (216) Sussex/Shaker Family Center (SXD) Sussex Road Shaker Heights, OH (216) Fax: (216) Green Road ECC (GRD) 4329 Green Road Highland Hills, OH (216) Fax: (216) West Side Center (WSD) Center Ridge Road Westlake, OH (440) Fax: (440) St. Bridget (SBD) 5620 Hauserman Road Parma, OH (440) Fax: (440) Guidelines revised 11/02/10

96 Part C Cuyahoga County Board of Developmental Disabilities Reference only: NOT TO BE DISTRIBUTED TO FAMILIES Frequently asked questions guide to accessing CCBDD early intervention services QUESTION Developmental Specialist Occupational Therapist Physical Therapist Speech/Language Pathologist 1. I want to request a EI referral form EI referral form EI referral form, EI referral form service, what form do I use? for children over 6 months of age 2. Will a doctor s No Yes Yes Yes prescription be needed for home based or clinic services? * 3. Will a doctor s No No No No prescription be needed for toddler classrooms? 4. Will there be a fee for the No Yes, 10 visits Yes, 10 visits Yes, 10 visits service? (insurance, private pay) 5. Can Family Resources be No fee Yes Yes Yes used to pay for therapy services? 6. Will insurance need to be No Yes Yes Yes approved (or other funding agreed upon) before services can be initiated? 7. Is there a fee for the toddler class? No No No No 8. I have already requested a service and now the family needs an additional Service. What form do I use? Referral form for additional services Referral form for additional services Referral form for additional services Referral form for additional services *If the doctor s prescription is not received with original EI referral form, then Rikki Ford from CCBDD will contact the doctor to obtain the prescription. After 4 attempts with no success, a letter will be sent to the family and copied to the SC, asking them to assist with obtaining the prescription if they are still interested in the service. If no response is received to the letter within 10 days, the request will be closed and the service coordinator will be notified. **If other information is missing, such as the evaluation report, then a DD staff person will contact the SC. For questions re home based developmental specialist svc. contact Celeste Bajorek at For questions regarding occupational therapy and physical therapy, contact Janet Cimino at For questions regarding speech and language therapy, contact Kathy Zielinski at For toddler services at WPDECC, contact Celeste Bajorek at For toddler services at Sussex and Green Road, contact Janet Banks For toddlers services on the West side or at St. Bridget, contact Kathy Wojciak For insurance questions, contact Sharon Dwertman at For questions regarding Family Supports, contact Tim Lewicki at /10 95 Guidelines revised 11/02/10

97 EXAMPLE EXAMPLE 96 Guidelines revised 11/02/10

98 EXAMPLE EXAMPLE 97 Guidelines revised 11/02/10

99 Part C Cuyahoga County Board of Developmental Disabilities Family Support Family Support Program ELIGIBILITY: The Family Support Program is offered through the Cuyahoga County Board of Developmental Disabilities. Each individual receiving service from the Family Support Program must be eligible for services from the Cuyahoga County Board of Developmental Disabilities. Eligibility is established upon first request for services and is re-determined at age 3, age 6 and age 16. For further information about eligibility requirements for the Cuyahoga County Board of Developmental Disabilities, please contact our intake department at (216) The Family Support Program is open to individuals who are living at home with their families. Individuals living in their own apartment, on a waiver, in an ICF/MR or in foster care are not eligible for service from the Family Support Program. If you are receiving services from a Support Administrator, they will plan with you and give you similar services. ALLOWANCE: The Family Support Program operates on a fiscal year beginning July 1 st each year. Maximum level of service per family may vary from year to year based on funds available and numbers served. The amount of funding for a family will be based upon their reported taxable income as per state rule. This is not an entitlement program. Requests are filled on a first-come first-served basis as funding permits. Allowances for families joining the program in mid-year will be pro-rated. COMMUNICATION: Your questions are very important to us. In order to serve you better, if it is necessary to leave a message for us, please only leave that message for one of the staff. Please state your name and spell it and the reason for your call. This will allow us to research your question and get back to you in a timely manner. Services Available DIAPERS: Disposable diapers are available for children and adults over the age of 3 who are not eligible for them through Medicaid. A physician s prescription certifying the individual is incontinent is required on an annual basis. We contract with a company to deliver these diapers to your home on or before the 10 th of each month. We are able to get a variety of brands under our contract; however we are not able to purchase all brands. If type, size or quantity of diapers needed changes, please let us know as soon as 98 Guidelines revised 11/02/10

100 Part C Cuyahoga County Board of Developmental Disabilities Family Support possible. The contact for diapers is Sandi Szuch (216) The cost of diapers will be deducted from your total allowance. DIETARY ITEMS: Specialized dietary items are available for children over age 1 and adults. A physician s prescription certifying that the special dietary item s necessity is required. Typical formula for infants will not be covered under this program. The contact for Special Dietary Items is Sandi Szuch (216) The cost of special dietary items will be deducted from your total allowance. SPECIAL EQUIPMENT: Special Equipment is available upon the recommendation of any of the following people: Physician, Occupational Therapist, Physical Therapist or Speech and Language Pathologist. The therapist is required to fill out our therapy request form as well as attach a picture and description of the specialized piece of equipment. This equipment will be ordered and shipped to the location specified by the therapist on the form. The form should be forwarded to the address on the front or faxed to (216) It is not necessary for you to make a phone contact in addition to sending the documentation. You will be contacted if any other information is required. If the piece of equipment is over your allotment you have the option of sending a check to CCBDD for the portion that is above your allotment. Due to the large number of requests received, typical processing time is about 45 days. Please note that orders can not be processed for less than $35. Typical toys will not be purchased under this program. Families may, with prior approval purchase items for reimbursement. For questions related to Special Equipment, please contact Sandi Szuch at (216) The amount of the special equipment will be deducted from your total allowance. THERAPIES, COUNSELING, TRAINING: This program can assist in funding traditional therapies like Occupational Therapy, Physical Therapy and Speech Therapy for Children under 3 years of age. For individuals 3 years old and above, these therapies are the responsibility of the local school district and will not be funded by this program. Recreational therapies, such as music therapy, therapeutic horseback riding, adaptive aquatics, etc can also be funded. Please note that any of these therapies or classes must be adaptive classes. Typical classes are not able to be funded under this program. This program will also fund registration costs for conferences for families on issues related to the eligible individual. Prior approval is required for this program to fund the conference. For questions related to therapies, counseling or training please contact Sandi Szuch at (216) The cost of these programs will be deducted from your total allowance. CAMP ASSISTANCE: Each year funds are set aside for the cost of camp. There is usually a set amount for each camper that is available. Please note that these funds may be used to cover the cost of a specialized camp only. Typical camps are not able to be funded through this program. Campership forms are 99 Guidelines revised 11/02/10

101 Part C Cuyahoga County Board of Developmental Disabilities Family Support available around the beginning of February each year. They will be processed as they are received. For questions related to camp, please contact Mary Ann Pressler at (216) The cost of camp will be deducted from your total allowance. HOME MODIFICATIONS: Substantial home modifications such as ramps, lifts, bathroom alterations, etc, typically require a rather lengthy process of evaluation, competitive bidding and installation. We will work closely with a rehabilitation engineer in order to make sure your modification is completed according to all applicable housing and building codes. Your modification may require us to make a referral to an appropriate therapist for specific recommendations. The work will be completed by one of our contractors. They will be required to obtain any necessary permits in order to complete the modification. Outside work is at the mercy of weather conditions and may need to be started when the conditions are appropriate. Please note that some of these modifications may take some time so as much notice for the request as possible is required. If you live in a rental home and you need modifications, written permission from your landlord is required for us to begin the modification. Please note that typical household repairs are not able to be funded through this program. Each modification must be adaptive in nature. If you have further questions about home modifications, please contact Tim Lewicki at (216) The amount for the Home Modification will be deducted from a separate fund, which is not a part of your annual family support allotment. RESPITE CARE: Respite care is defined as an occasional break for families. This should be used for individuals who require specialized care beyond what might be expected of an untrained provider. Areas of need that are considered include medical, physical and behavioral issues, age of primary caregiver, number of eligible family members and extraordinary family situations. Demand for respite services is very high. Types of Respite Care Providers: Family Chosen Provider: This would be a provider that the family knows and feels is able to care for their family member. This provider cannot live in the same house with the individual and cannot be a parent. Typically this person is an extended family member, neighbor, friend or other person that you may know. It is our expectation that the training for this provider comes from the family. The Family Support Program will pay them for the hours that they are providing respite for your family member. It is the family s responsibility to keep track of the amount of hours they are requesting the caregiver to perform respite. Any amount over the funding allowance cannot be paid through this program. For a Family Requested Caregiver Application or for any further questions regarding this type of provider, please contact Sandi Szuch at (216) Guidelines revised 11/02/10

102 Part C Cuyahoga County Board of Developmental Disabilities Family Support RESPITE CARE (Con t) Diversified Caregivers: These are caregivers that are hired and trained by the Family Support Department. They receive training in various areas related to providing care for individuals with developmental disabilities. They are also required to get certain trainings on an annual basis. The Family Support Department does background checks on all of the caregivers that are sent into family homes. The cost of each respite sit will be deducted from your annual allotment. For an application for your family member to receive respite services using a diversified caregiver, to schedule a caregiver or for any further questions about this type of caregiver, please contact Leah Dalton at (216) Diversified Caregivers that Provide Respite in their home: These caregivers meet the requirements listed above as well as have their homes certified by the Family Support Department. They have a fire inspection and an annual visit to make sure that their house still meets the standards set by our program. For questions about this respite option, please contact Leah Dalton at (216) Family Support Department Staff Name Title Phone Responsibilities Tim Lewicki Manager, Intake, Eligibility (216) Home Modifications and Family Support Sandi Szuch Payroll Coordinator (216) Coordinates Caregiver Payroll Diapers Dietary Items Special Equipment Therapies, Counseling, Training Family Chosen Caregivers Leah Dalton Housing and Placement Coordinator (216) Locating Respite Providers Mary Ann Pressler Administrative Assistant (216) Camp Family Support Department familysupport@cuyahogabdd.org 1275 Lakeside Avenue East Cleveland, Ohio (216) Fax (216) /22/10,3/20/ Guidelines revised 11/02/10

103 Help Me Grow of Cuyahoga County Family Support Family Support provides families with a variety of opportunities to receive information and social support from other Help Me Grow families or other persons with similar life experiences. PART C FAMILY TO FAMILY SUPPORT AND PARTICIPATION POLICY CAN BE FOUND AT Some shared principles of Family Support in Cuyahoga County include: Family Support encourages parent participation and engagement at all levels of the Help Me Grow Program. Family Support is an ongoing activity that meets the diverse needs of families. Family Support is nonjudgmental and builds upon the strengths of families. Family Support encourages meaningful interactions to address specific needs. Family Support activities are designed to be sensitive to the experiences of families and the demands of parenting young children. Family Support: Parent Participation and Engagement in the Help Me Grow Program Help Me Grow families are included as active participants in the creation and review of policies, training models, informational materials and public awareness activities. Help Me Grow Family Council of Cuyahoga County The Help Me Grow Family Council is comprised of family representatives from each Help Me Grow Provider agency. The purpose of the Council is to: Offer the opportunity for parents/caregivers to give input on various components of the Help Me Grow Program. Provide a forum for mutual support and sharing of concerns or needs across the spectrum of Help Me Grow. Encourage leadership development and parent advocacy. Recruitment of Family Council representatives: Help Me Grow agencies will be provided a Family Council brochure and sample letter to communicate the purpose of Help Me Grow Family Council. Family Council representatives can be recruited from any point in their Help Me Grow participation and can represent Part C and/or Home Visiting. Representatives will be asked to serve a 2- year term on the Family Council. Families who transition out of Help Me Grow can continue their participation on the Help Me Grow Family Council until their term ends or they no longer wish to serve. Agencies are asked to recruit one to three representatives to Family Council. If agencies have difficulty recruiting representatives, contact Kayann Zentarski, Lead Family Support Specialist. Family Council Meetings: The Help Me Grow Family Council will meet three (3) times per HMG fiscal year (July-June). October 20, 2010 January 19, 2011 April 20, Guidelines revised 11/02/10

104 Help Me Grow of Cuyahoga County Family Support (continued) Kayann Zentarski, Lead Family Support Specialist will provide ongoing contact with Family Council members through mailings and/or . If additional feedback is desired on a particular topic, conference calls with Family Council members can be arranged. Meeting Format: The meeting will include rapport-building, an educational presentation, and open discussion on HMG topics. Minutes of the meetings will be shared with Family Council members and Agency contacts. Meetings will include lunch. No child care is available at the meeting site. A $20.00 stipend will be offered each Family Council representative who attends a meeting. Early Childhood Coordinating Committee (ECCC) The ECCC assists in the design, coordination, and implementation of a comprehensive, coordinated, interdisciplinary, family-centered Help Me Grow system of services for families with an infant or toddler at risk for or with developmental disabilities/delays. Membership on the ECCC must include at least 20% Parent membership, reflecting the diversity of the county. Parent Membership on the ECCC will be recruited from: o Help Me Grow Family Council membership; o Families who have recently transitioned from Help Me Grow; and/or o Other interested HMG families. A $20.00 stipend will be offered to each ECCC representative who attends a meeting. Part C Families Family Information Network of Ohio (FIN): Through their Steps sessions, The Family Information Network of Ohio provides Help Me Grow families with educational and emotional support opportunities. In addition to eight Steps sessions on a variety of pertinent topics, FIN provides a series of scheduled webinar sessions and a newsletter (FINfacts) for families with young children in Help Me Grow. Each Provider agency is asked to provide one (1) FIN Session per fiscal year for Part C families. This session can be targeted toward specific family needs at various points in the Help Me Grow program. (e.g. Cooking up a Successful Transition for families nearing transition; Your IFSP: Positive Planning for families beginning the IFSP process.) See FIN listing of Sessions. 103 Guidelines revised 11/02/10

105 Help Me Grow of Cuyahoga County Family Support (continued) Some further suggestions for providing a FIN session include: Explore using other community settings where families are naturally frequenting for providing a FIN session. (e.g., library story time) Attendance is enhanced when there is a personal invitation to attend the session. FIN needs 5 participants to provide a session. Match family need to session topic and invite those families to a session. Utilize the webinar offerings and invite families to a shared viewing. Arrangements for FIN sessions can be made by contacting: Janet Strottner, FIN representative ; jstrottner@att.net Parent to Parent Support When a baby is born prematurely, or a child is diagnosed with a disability or chronic illness, nothing quite compares with the knowing, empathetic support that can come from another parent who has been there. Research shows that families tend to cope better with the special needs of a child when they are offered the support of another parent who has experienced a similar situation. With this understanding, Help Me Grow of Cuyahoga County will develop a plan for implementation of a county-wide Parent-to-Parent Program that would match volunteer Parent Partners with families of similar needs. A workgroup will develop the Parent-to-Parent Implementation Plan for Help Me Grow of Cuyahoga County. Home Visiting Families Parents As Teachers, Born to Learn Group Meetings Group Meetings are a component of the Parents As Teachers, Born to Learn program. Group Meetings provide parents the opportunities to learn by observing their own children and other children and helps families form new support networks with other families in the community. The Parents As Teachers, Born to Learn Supervisor s Manual offers an overview of Group Meetings and strategies to help in designing a Group Meeting. Several Group Meeting formats are suggested. They include: Parent-Child Interaction (most popular group meeting format) Presentation-Plus (sharing specific information paired with an activity for parents) Small ongoing groups (focused around a topic or an issue) Community Events (meetings that take place at various locations in the community). Help Me Grow Provider agencies will offer two (2) Group Meetings to families involved in Help Me Grow Home Visiting. Use the information in the Supervisor s manual and the Parents As Teachers, Born to Learn curriculum to plan Group Meetings. There are 13 sample group meeting plans in Module A of the curriculum. 104 Guidelines revised 11/02/10

106 Help Me Grow of Cuyahoga County Family Support (continued) Sharing Information & Resources Cuyahoga County is rich in resources and opportunities for families to support one another. Sharing this information with Help Me Grow families is a part of Family Support. The Help Me Grow website and other social media avenues (e.g. Facebook; Twitter) could assist in sharing family support opportunities that are available in the community. Service Coordinators should be aware of support groups (e.g. Upside of Downs) and share information about these support groups on an ongoing basis with families. For more information about community groups and resources: First Call for Help Community Resources Tools for Today & Tomorrow Provides information and support to people who care for children with chronic illnesses or disabilities For more information about Help Me Grow Family Support in Cuyahoga County, contact Kayann Zentarski, Lead Family Support Specialist at , kzentarski@helpmegrow.org Family Support Timeline Family Support Activity DATE Family Council Brochure & Sample Letter/Talking Points distributed to July 30, 2010 agencies to assist in family recruitment Agencies recruit representatives for Family Council August-Sept 30, 2010 First Family Council Meeting Oct. 20, 2010 Parent to Parent Program Workgroup Develops Implementation Plan. July-January, 2011 Agencies and other stakeholders participate. Dates to be determined. Second Family Council Meeting-Feedback on Parent to Parent January 19, 2011 Implementation Plan Begin implementation of Parent to Parent Program per Spring 2011 Implementation Plan Provider Agencies plan and facilitate 1 FIN Session July, 2010-June, 2011 Provider Agencies plan and facilitate 2 Home Visiting Group Meetings July, 2010-June, 2011 Third Family Council Meeting April 20, Guidelines revised 11/02/10

107 106 Guidelines revised 11/02/10 Help Me Grow of Cuyahoga County Family Support (continued)

108 Help Me Grow of Cuyahoga County Transition Transition The ODH Transition Policy is only relevant for Part C and At Risk families. It is not applicable for Home Visiting families (ODH-HMG Program Track and Policy Crosswalk ). Per ODH Guidance ( Cuyahoga County Technical Assistance Visit), counties do not have to do a Transition Planning Conference, nor do they have to do Transition Outcomes for Home Visiting families. The current IFSP form includes an opt out section for Part C families to decline having their information shared with the Local Education Agency (LEA). Please refer to the Opt Out Guidance for Sharing Information with the LEA and Early Track. Service Coordinators must use the Transition Conference Meeting Notice to inform identified participants of the Transition Planning Conference (TPC). In Cuyahoga County, all children referred 45 days or fewer before his/her 3 rd birthday are referred to the Myrtle Mitchell, Transition Liaison. Please contact her with questions regarding LEA attendance and problem solving transition timelines and requirements. Per ODH Guidance ( Cuyahoga County Technical Assistance Visit), children cannot be served by Part B and Part C at the same time. If a child has been determined eligible for Part B and can begin services prior to age 3 per approval of the school district and the family wishes to pursue Part B services early, they must exit HMG. TRANSITION POLICY CAN BE FOUND AT Guidelines revised 11/02/10

109 EXAMPLE EXAMPLE 108 Guidelines revised 11/02/10

110 Help Me Grow of Cuyahoga County Transition (continued) EXAMPLE 109 Guidelines revised 11/02/10

111 Help Me Grow Miscellaneous Parents Rights/Local Complaint Process Parents rights in HMG are explained and documented for all HMG families in the following ways: 1. The Parents Rights in the Help Me Grow system brochures. (Effective 7/19/10 there are separate brochures for Home Visiting and Part C.) 2. The HMG of Cuyahoga County Local Complaint Process form. 3. Rights and Consent per HMG program a) The Consent for Services and Parent s Rights in the Help Me Grow Part C Program. This form is for Part C eligible families. b) Beginning 7/19/10, the Consent for Services and Parents Rights in the HMG Home Visiting Program form will be used for Home Visiting eligible families. Effective 10/1/10 this form will also be used for all At Risk eligible families. Refer to the forms tab earlier in this manual. Parents Rights in the Help Me Grow System brochures outline rights for families in HMG. These brochures are given to each family at their first home visit by their SC/HV. For Part C families, the IFSP signature page requires that families confirm that they have received their rights and understand them. It is recommended that Service Coordinators travel with this brochure in the event that families have questions about their rights. This brochure is required to be given to Part C families whenever there is a change in HMG services that requires written prior notice as outlined in the Part C Service Delivery policy and documented on the Parental Prior Notice Form. For Home Visiting and At Risk eligible families, documentation of receipt of rights is on the form listed above in 3b. HMG of Cuyahoga County Local Complaint Process Help Me Grow of Cuyahoga County has developed a local complaint process to outline options for families to resolve concerns or complaints regarding their HMG services at a variety of levels. For Home Visiting and At Risk eligible families, this information is found at the bottom of the Parent s Rights leaflet. For Part C families this information is given as an insert in the Parent s Rights in Help Me Grow brochure. The insert is title Local Complaint Process. The Parents Rights Brochure can be found at Rights and Consent per HMG Program In June 2010, ODH created a separate consent form for Home Visiting eligible families (3b). Effective 10/1/10, At Risk eligible families will also use this form. Families must complete the consent form appropriate to the program the family is referred to / eligible for. For example, a family referred to the Home Visiting program would complete the form referenced in 3b. If the child was later referred by their Home Visitor for Part C eligibility determination, the family would then complete the form referenced in 3a at the time of referral. Questions regarding parents rights, consent or the complaint process should be directed to your Quality Assurance Specialist or Lori Mago, Quality Assurance Team Leader. 110 Guidelines revised 11/02/10

112 Help Me Grow Miscellaneous Parents Rights/Local Complaint Process EXAMPLE 111 Guidelines revised 11/02/10

113 Help Me Grow Miscellaneous Parent, Guardian and Custody Issues 1. When not otherwise stated throughout HMG guidelines, policies and forms, the term parent refers to those that have custody over the HMG eligible child. The parent (custody holder) is the authorizing signature needed on all HMG required forms (Rights and Consent, Release of Information, IFSP/FP, etc.). a. The Department of Children and Family Services (DCFS) worker must sign the forms when DCFS has custody of the HMG eligible child. b. Adolescent or teen parents are the authorizing signature for all HMG services regardless of their age, provided custody of the HMG eligible child has not been removed from that individual. i. It is best practice to involve other relatives living in the home in HMG services (such as the HMG eligible child s grandparents) as appropriate and with the parent s permission. This is especially important when working with adolescent or teen parents. ii. It is best practice to have these individuals co-sign all HMG documents, though it is not required. c. When custody is pending with DCFS (i.e., DCFS has filed for custody but a decision has not been granted from the courts), please contact the QA Specialist for assistance in determining the authorizing signature as each situation is different. d. When the parent is not able to be located or is in prison and has left the child in the care of a relative and DCFS is not involved or is not pursuing custody, the relative caregiver can be the authorizing signature. Documentation of these family circumstances must be in the record. 2. When HMG is working with both parents and custody is uncertain, (for example parents who are separated or divorced), and there is disagreement between parents over the provision of HMG services, the SC/HV will: a. Request a copy of legal documentation such as a custody/parenting agreement showing who has decision making authority for services for the child. b. When the legal documentation in (a) above is not available because it is still pending, the SC/HV will continue to work with the parent that referred the HMG eligible child, providing the child is residing with that parent and will contact Lori Mago, Quality Assurance Team Leader for assistance in how to proceed with involving the other parent in HMG services. c. The Quality Assurance Team Leader will consult with the County Prosecutor s Office for legal guidance in these matters and advise the SC/HV accordingly. d. The SC/HV will document conversations, requests for documentation and all matters related to this issue thoroughly in the child s record. 3. Any questions regarding custody and the provision of HMG services should be directed to the Quality Assurance Team Leader. 112 Guidelines revised 11/02/10

114 Help Me Grow Miscellaneous Department of Children and Family Services Protocols Help Me Grow / Department of Children & Family Services (DCFS) Partnership Protocol Guidelines for Help Me Grow Spring 2010 Bolded items are requirements specific to Service Coordinators and Home Visitors. Help Me Grow is committed to the acceptance of DCFS referrals and agrees to; Establish and maintain an intake protocol for Child Abuse and Prevention Treatment Act (CAPTA) eligible children. See Program Eligibility and Assigning Referrals section of these guidelines. Provide all CAPTA mandated Help Me Grow services for CAPTA eligible children. Any child referred by DCFS with substantiated abuse/neglect is automatically eligible for HMG Home Visiting. Provide Help Me Grow services to all eligible children referred by DCFS. Provide Help Me Grow services to all eligible pregnant teens and women referred by DCFS. Offer other appropriate services for other Help Me Grow eligible children involved with DCFS. Siblings of HMG eligible children referred by DCFS may be eligible for HMG Home Visiting and/or Part C services. HMG will provide linkages to appropriate community resources for siblings that are not eligible for HMG services. Provide referral feedback to DCFS. HMG provider agencies are responsible for ensuring all referral sources receive the Referral Follow Up form within 45 days of the receipt of the referral. Where DCFS is the referral source and has custody, HMG Service Coordinator/Home Visitor will contact DCFS by phone within two (2) days of successful phone contact with the family to begin communication process and coordination. When the children are in custody of the family, contact will be made to DCFS following appropriate consent by the family on the Release of Information form. All correspondence will be documented in the record. Invite DCFS to IFSP/FP meetings and prioritize participation in DCFS meetings. DCFS workers will be invited to all HMG Individualized Family Service Plan (IFSP)/Family Plan (FP) meetings when DCFS is the custody holder. When the parent has custody, DCFS will be invited to all IFSP/FP meetings with appropriate parental consent on the Multi System Release of Information form. Include DCFS on the IFSP/FP and ensure DCFS has a current copy. When DCFS is participating in IFSP/FP meetings per the above protocol, their services will be reflected on the IFSP/FP and DCFS will be provided a copy of that IFSP/FP. When DCFS is the custody holder, the IFSP/FP is not considered complete until DCFS signature is obtained. If DCFS is not present at the IFSP/FP meeting, the IFSP/FP will be faxed or ed to them at the conclusion of the meeting for their signature. All attempts to obtain the signature will be documented in the child s record. 113 Guidelines revised 11/02/10

115 Help Me Grow Miscellaneous Department of Children and Family Services Protocols (continued) Help Me Grow / Department of Children & Family Services Partnership Protocol Guidelines for Help Me Grow Spring 2010 (continued) Meet jointly with HMG and family prior to DCFS closing a case to ensure a smooth transition and emphasize continued participation in HMG. HMG SCs/HVs will refer to DCFS plan and follow ongoing communication protocol to aide in the planning of the joint visit prior to DCFS closing a case. When a closing date is unknown, the SC/HV will contact DCFS to obtain this date and assist in the coordination of the final joint visit. Ensure DCFS had current contact information for HMG staff. SC s/hv s are responsible for providing their contact information to DCFS staff that are assigned to their families. HMG Central Site has provided DCFS with a copy of the Service Coordinator/provider agency roster and will ensure DCFS is provided with an updated copy regularly. Provide program reports to DCFS. HMG Central Site will provide these reports to DCFS. Provide monthly status reports of CFS families served by Help Me Grow. SC s/hv s will scan and home visit notes each month to the ongoing DCFS worker and/or the DCFS Liaison (once identified) assigned to their cases. Evidence of this correspondence will be retained in the child s HMG record. Provide training to DCFS staff on HMG services. HMG Central Site will continue to provide training to DCFS staff regarding HMG services and will work with DCFS to identify additional training needs. Source: DCFS Inter-Agency Agreement Guidelines revised 11/02/10

116 Help Me Grow Miscellaneous Procedures for Reporting Suspected Cases of Child Abuse and Neglect According to Ohio Revised Code, section , professionals mandated to report child abuse and neglect include: physicians, social workers, nurses, psychologists, child life workers, other health care professionals, teachers, day care employees, attorneys, spiritual treatment providers, and others. Abuse means the infliction, by other than accidental means, of physical harm upon the body of a child as evidenced by: 1. Injuries, unexplained cuts, burns, bruises, scars. 2. Sexual exploitation and molestation. 3. Severe and harsh punishment. Neglect means the failure to provide necessary food, clothing, shelter, medical care, schooling, supervision, and/or abandonment of the child by parent or guardian. It is the policy of Help Me Grow of Cuyahoga County (HMG) that all HMG central intake and referral site staff and independent contractors who are contracting on behalf of HMG and who are providing direct services to HMG families, who suspect or believes that a child has been, or is likely to be physically harmed, sexually abused or exploited, or needs protection, report this information to the Cuyahoga County Division of Human Services ( KIDS) or 911 if there is imminent danger. It is also the policy of HMG that the employee and/or independent contractor have her/his immediate supervisor or other management staff witness the phone report. This legal obligation to report overrides HMG s professional obligation of confidentiality to the family/caregiver. Help Me Grow contracts with community agencies to deliver home visitation services. These contracted agencies are requested to have their own agency policies for reporting child abuse and neglect that are in accordance with the state of Ohio s policy. Help Me Grow agencies service coordinators and home visitors should follow their agency s policy and procedure for reporting suspected child abuse and neglect to the Cuyahoga County Department of Children and Family Services. Copies of written reports should be maintained in the child s file. Reporting Incidents and Contacting Help Me Grow in an Emergency Types of reportable incidents may include: Employee witnesses or suspects child abuse or neglect. Child injured, not as a result of an abusive situation, during a home visit. Employee witnesses an incident or crime while on the job / other critical incidents. If a Help Me Grow Service Coordinator or Home Visitor has an emergency after standard Help Me Grow business hours for which they feel they need to contact Help Me Grow immediately, they may contact Karen Mintzer, Services Manager or Lori Mago, Quality Assurance Team Leader. During regular business hours, Karen Mintzer and/or Lori Mago can be reached at (216) Agency Supervisors will be given phone numbers to reach them after standard business hours. 115 Guidelines revised 11/02/10

117 Help Me Grow Miscellaneous Child Fatality Review Cuyahoga County Board of Health in partnership with the Cuyahoga County Coroner s Office facilitates the Cuyahoga County Child Fatality Review Board. The Child Fatality Review Board consists of professionals, from educators to health and social service experts that consider the research, data and trends within the context of their own mission to keep children safe and families thriving. Lori Mago, Quality Assurance Team Leader represents HMG on this committee and is contacted by the Department of Children and Family Services (DCFS) whenever a child fatality of an unusual or suspicious manner occurs. The Quality Assurance Team Leader notifies agencies whenever they are active or have recently been active with a child or family where a fatality occurred and requests information in order to return a report to DCFS within 24 hours. The following steps outline the persons and responsibilities involved in completing this process. When the Quality Assurance Team Leader is notified of a child fatality by DCFS 1. The Quality Assurance Team Leader searches for the child in the HMG data systems via Early Track 3.0 and/or the former KIDS data system immediately upon receiving the call. She then responds to DCFS via phone and reports current or historical involvement to DCFS including but not limited to eligibility, date and type of service, referral sources and exit reasons if applicable. 2. The Quality Assurance Team Leader notifies the HMG agency Contact Person if any of the following is true: a. The child or sibling is currently active with the agency or very recently exited; b. The child or sibling was ever active with the agency and the child fatality is a high profile case, has an open investigation with the authorities or there are questions or concerns surrounding the case. 3. The Quality Assurance Team Leader will instruct the agency to complete a Child Fatality Report within a specified timeframe, usually 24 hours if possible. This is done via the Child Fatality Report form. This form has been revised to capture key information needed for the child fatality review process and to show how the agency is supporting the family if they are still active with HMG. 4. The Quality Assurance Team Leader will complete a comprehensive written report to DCFS within 24 hours of the initial notification and include details provided in the report received by the agency, if available or send an addendum as needed. 5. The Quality Assurance Specialist will conduct general review of the file. 6. The Quality Assurance Team Leader will share findings from the report and file review with the Child Fatality Review Board when the case appears on the review agenda. 7. The Quality Assurance Team Leader will contact the agency Contact Person if any specific follow up actions are needed. When a Provider Agency is notified of a child fatality (via the family or other source) 1. The provider agency Contact Person will notify the Quality Assurance Team Leader immediately. 2. Steps 3-7 above will be followed. 116 Guidelines revised 11/02/10

118 Help Me Grow Miscellaneous Child Fatality Review (continued) EXAMPLE 117 Guidelines revised 11/02/10

119 Help Me Grow Miscellaneous Public Transportation Tickets Help Me Grow Policy for Distribution of Public Transportation Passes Help Me Grow has a limited number of Greater Cleveland Regional Transit Authority all day bus passes. As of July 1, 2010, the bus passes are only available for Part C eligible children who need transportation to evaluations, medical, nutritional and/or specialized service appointments. In order to continue to distribute all day bus passes, beginning 7/1/10 all day bus passes will be provided according to the following procedure: 1. Agencies with a Part C caseload of less than 270 children can receive one (1) packet of 25 all day bus passes each month. Agencies with Part C caseloads of 270 children or more can receive two (2) packets of 25 all day bus passes each month. Exceptions to this distribution must be discussed with Karen Mintzer, Services Manager or designee. 2. Acceptable uses of all day bus passes include the following: medical or nutrition appointments for a child enrolled in HMG Part C services; transportation to a developmental evaluation appointment for a child; appointments for a child for specialized services such as speech therapy, occupational therapy or physical therapy. 3. Unacceptable uses include but are not limited to medical appointments for the caregiver or sibling of the HMG eligible child, job interviews or appointments with social service providers, shopping trips or other HMG related services. 4. The Bus Ticket Information Form must be completed by an agency to receive the next month of all day bus passes. (This includes the caregiver s signature(s) and family destination for each bus pass distributed.) If this form is not completed or is lost, Help Me Grow requires a notarized letter from the agency with an acceptable explanation. 5. Each time a completed Bus Ticket Information form is submitted, HMG staff will review the form and note any passes used for unacceptable reasons. Any unacceptable use of bus passes will be calculated and either charged to the agency for collection or deducted from an agency s monthly service reimbursement. In addition, a new Supervisor Sign off Cover Sheet must accompany each completed Bus Ticket Information Form to verify that an agency supervisor has reviewed the use of the bus passes and has approved the submission of the form. 6. Bus passes may be picked up at Help Me Grow Central Office located at 8111 Quincy Avenue, Cleveland, Ohio 44104, from Kelly O Dale, Accounting Assistant. Please call to pre-schedule a pickup with staff. 7. Since Help Me Grow may be audited at any time, a provider agency will be financially responsible if there is any fraudulent use and/or poor documentation of use of bus passes. 8. Help Me Grow management may opt at any time to discontinue distribution of public transportation passes to any contracted service provider agency should there be questions of responsibility or fraud. RTA ParaTransit arrangements for children or caregivers with limited mobility: The HMG ParaTransit Policy is being revised. Information regarding this process will be provided at a later date. HMG Bus Ticket Policy 07/01/ Guidelines revised 11/02/10

120 Help Me Grow Miscellaneous Interpreter Services There are Help Me Grow families that require an interpreter in order to participate in Help Me Grow services. Cuyahoga County Help Me Grow fully supports families receiving services in a culturally appropriate and sensitive way including language used. There are two options for families requiring an interpreter: Ohio Help Me Grow-sponsored Affordable Language Services. In-person interpreter services provided by an area company. Additional information follows about both of these options. Ohio Help Me Grow-sponsored Affordable Language Services The Ohio Department of Health via Help Me Grow has sponsored telephone access to interpreter services: Affordable Language Services. Cuyahoga County Help Me Grow does not pay for this service, making it easy to accommodate all requests. Directions are outlined on the attached document: Instructions on Calling Affordable Language Services. The telephone number and access code are: and The client s Early Track ID number will need to be provided at the time the call is placed. Customer Support Contact Information for Affordable Languages is also listed on the attachment. Note: either a telephone that includes a speaker phone option, or a dual port telephone jack and extra telephone are required to utilize this service during a face to face meeting. Help Me Grow has a limited number of kits for borrowing. In Person Interpreter Services Provided by an Area Company Help Me Grow is able to sponsor in-person interpreter services for a limited number of families in situations where the Affordable Language service does not work. Such situations may include: hearingimpaired/deaf family members; no telephone service/ no telephone jack; complicated social situations and/or work processes that do not lend themselves to a tele-interpreter. Help Me Grow must limit use of this service, as reimbursement for interpreter services typically is equivalent to or greater than the Help Me Grow services. If any HMG provider believes in-person interpreter services are needed, following are the action steps required: 1. Submit, in advance of the needed service date, a response to the questions outlined on the attachment: Questions for Help Me Grow provider agencies requesting interpreter services (updated ). 2. If approval is received, contact a translation company and make needed arrangements. (Cleveland Hearing and Speech: ; International Services Center: ; and International Language Bank: ). 3. Sign the translator s service slips/receipts for all dates of service. 4. The translator service will bill HMG directly, submitting all signed receipts from all dates of service. The company/service will need to submit all invoices on a timely basis to ensure payment, at least within 45 days of service delivery. Questions may be directed to either Angela Lowder, Finance Manager ( ), Karen Mintzer, Services Manager ( ), or if neither party can be reached, Kelly O Dale, Accounting Assistant ( ). 119 Guidelines revised 11/02/10

121 120 Guidelines revised 11/02/10 Help Me Grow Miscellaneous Interpreter Services (continued)

122 EXAMPLE EXAMPLE 121 Guidelines revised 11/02/10

123 EXAMPLE EXAMPLE 122 Guidelines revised 11/02/10

124 Help Me Grow Miscellaneous County Family Emergency Funding Tier III funding Tier III funding refers to funds that are outside a given system s typical funding. [Tier I funds are funds that each system has to provide their core services. Tier II funds are flexible funds that some systems have available to assist families with ancillary needs (example CCBDD Family Resource Dollars.] Tier III funds are available to active HMG eligible families. Contact Nadia Brahim, Quality Assurance Specialist with questions regarding this process. There are 2 types of Tier III funding that can be accessed through HMG for families in need: I. Family and Children First Council (FCFC) Community Wrap Dollars What is it: Funding stream of last resort that may cover non-tangible needs such as therapeutic camps, respite, etc. Cannot be used for out of home placement services, psychiatric hospitalization, detention centers, residential treatment facilities or foster care homes. Who is eligible: HMG families that have a current and complete IFSP who have exhausted other resources for funding the identified need. Child must be: at risk of residential placement, OR in a kinship placement that is about to disrupt, OR at risk of involvement with DCFS. Requests are one-time only for each identified need. II. Community Assistance Dollars What is it: Funding stream of last resort that may cover tangible goods such as appliances, utilities, furniture, rent, etc. Who is eligible: same as above with these additional stipulations: Parent/guardian must be gainfully employed or attending school and should be able to show written proof of employment/schooling. Parent/guardian must be the legal parent/guardian of minor children that resides in the home. Important things to know before applying These are funds of last resort all other community and system resources must be applied for first and must be documented on the request. If other resources are pending such as PRC, the family must wait till PRC is approved or denied before seeking these funds. The family must be able to produce 2 letters of denial from other community resources. The SC does not have to determine what type of funding is being requested these are all Tier III funds. Approved funding is always paid directly to the vendor, never the client. Turnaround time for payment takes approximately 2 weeks from time of approval. Payment is rendered in the form of a check from the County. There is a request cap of $ per family and the family must contribute a minimum of $50.00 for all requests of $ or less, and $75.00 for all requests between $ and $ Guidelines revised 11/02/10

125 Help Me Grow Miscellaneous County Family Emergency Funding (continued) The Service Coordinator and family are responsible for identifying the vendor for services like respite, furniture, appliances, etc. Funds are limited. Therefore, requests must include detailed information as to why the family is requesting these funds. If detailed information is not included on the request, you will be asked to provide it in writing before the request is given consideration. Funds for community assistance items (see above) must be for emergency situations and this must be documented. Typical questions for a rent/utilities request would be: What makes this an emergency request? Why can t the family pay for these goods? What is their employment/income status? Will they be able to make future rent/utilities payments after they receive this funding? The SC is responsible for submitting this request/information on behalf of the family. Please make every effort to ensure the information supplied is accurate. For example, if a family states they were denied Prevention, Retention and Contingency (PRC) funds for this request, ask for a copy of the denial letter. 124 Guidelines revised 11/02/10

126 125 Guidelines revised 11/02/10 EXAMPLE

127 Help Me Grow Miscellaneous Children s Trust Fund PROCEDURES FOR CHILDREN FUNDED THROUGH OHIO CHILDREN S TRUST FUND (OCTF) Beginning July 1, 2010 (Revised 6/25/10) Through funding from the Ohio Children s Trust Fund (OCTF), the Family and Children First Council of Cuyahoga County is launching a three-part initiative to build the protective factors of families and help reduce the probability of child abuse and neglect in our community. One of the three components is Help Me Grow Home Visiting using the Parents as Teachers Born to Learn TM Curriculum. Help Me Grow (HMG) will receive $ 140,000 for SFY 11 which will be used for service reimbursements to provider agencies at the rate of $ 102 per child per month assigned (SFY11 rate for At Risk). Funds will cover 1,238 months of service (equivalent to 114 children for one year). Because some of the families will be difficult to engage, HMG Intake will initially assign 150 new children to the OCTF s funding. Programs funded from Ohio Children s Trust Fund are required to use the Protective Factors Survey to measure their impact. A copy of The Protective Factors Survey User Manual can be found at the following website: OCTF Participant Identification: Family and Children First Council will provide HMG with 150 Protective Factors Survey Packets each with a specific identification number. The packets will include the Informed Consent Statement, Survey Script and three copies of the Protective Factors Survey (with child identification information). Assignments: HMG Intake will designate children referred to HMG that meet the state or county At Risk eligibility for OCTF funding as long as they do not meet any of the following: Referred from the Department of Children and Family Services (DCFS) Prior referral to Help Me Grow from DCFS Parent with history of abuse or neglect or domestic violence checked as a risk factor Intake Process: HMG Central Site will identify the referral as part of the OCTF and will provide agencies with the survey packets that include three copies of the pretest/posttest that include the OCTF number, the Agency ID and Participant ID Number HMG Data Entry will data enter the funding source as OCTF (or designated funding source). HMG Data Entry will also add the OCTF number to the PIMS Data System to track the information. 126 Guidelines revised 11/02/10

128 Help Me Grow Miscellaneous Children s Trust Fund (continued) Help Me Grow Agency: The agency will Missy Bixel the names and Early Track ID number of any child they are unable to enroll in OCTF. (ex. child not open with agency or known DCFS involvement) The Service Coordinator/Home Visitor will obtain consent from the parent and will have the parent complete the first survey (pretest) at the next home visit and/or first home visit after the birth of a baby for those mothers expecting within the next 30 calendar days. The agency will mail the original survey and consent form to Missy Bixel with the August Billing (due September 20, 2010) and will place a copy into the child s record. The Service Coordinator/Home Visitor will complete a follow up Protective Factors Survey (posttest) in January or February 2011 for any child still open and will mail the original survey to Missy Bixel with the February Billing (due in March 2011). (HMG will send a reminder to the agencies in December 2010 along with a list of children open and funded by OCTF). The Service Coordinator/Home Visitor will complete another follow up Protective Factors Survey (posttest) in June, 2011 for any child still open and will mail the original survey to Missy Bixel with the June Billing (due in July 2011). (HMG will send a reminder to the agencies in May, 2011 along with a list of children open and funded by OCTF). Monitoring Procedures: Help Me Grow will send a report by August 15, 2010 to Deborah Volk at the Family and Children First Council that includes the OCTF number, participant ID number and date of birth of all children assigned. Help Me Grow will send a list and all surveys (pretests) by October 15, 2010 to Deborah Volk at the Family and Children First Council. Help Me Grow will send a list and all surveys (posttests) by April 15, 2011 to Deborah Volk at the Family and Children First Council. Help Me Grow will send a list and all final surveys (posttests) by July 31, 2010 to Deborah Volk at the Family and Children First Council. Help Me Grow will send additional reports to Deborah Volk at the Family and Children First Council as requested. The Protective Factors Survey User Manual can be found at Guidelines revised 11/02/10

129 Help Me Grow Miscellaneous Children s Trust Fund (continued) 128 Guidelines revised 11/02/10 Introducing the Survey Reviewing Instructions with Participants10 Introducing the Survey : I am going to ask you to complete a survey. This survey will help us better understand the needs of the families we serve. We want to provide the best services that we can to all of our parents and families, and this is one way to help us keep on track. The survey contains questions about your experiences as a parent and your outlook on life in general. The content of the survey should cause no more discomfort than you would experience in everyday life. All of the information that you share with us will be kept confidential and you do not have to put your name anywhere on the survey. The services you receive will not be affected by any answers that you give us in this survey. Do you have any questions about the survey? (Answer participant questions) On the front page of the survey is an Informed Consent Form. This is a document for our records that will be kept separate from the survey. This document tells us whether or not you have agreed to participate in the survey. You do not need to take this survey if you do not want to and the services you receive will not be taken away or changed if you do not take the survey. Please take a few minutes to read the first page of the survey. When you are finished, please check off the appropriate box and sign the form. (Check to make sure informed consent forms are completed before proceeding) 11 Reviewing Instructions with Participants: This survey contains two different sections that you will need to complete. The first section asks for background information about you and your family. You may have already given us some of this information, and we thank you for giving it to us again today so that our survey information can be as complete as possible. The second section asks about your parenting experiences and your general outlook on life. Please remember that this is not a test, so there are no right or wrong answers. You should choose the best answer for you and your family. You will notice that the answer choices are on a number scale. Please respond by circling the number that best describes your situation. If you do not find an answer that fits perfectly, circle the one that comes closest. There is one section in the survey that asks you to focus on the child that you hope will benefit most from your participation in our services. For these questions, it is important that you answer only with that child in mind. Please remember to fill in the space with the child s age so that we can better understand your responses. When you are finished with the survey you can pass it back to me. If at any time you have questions about the survey, just let me know and I can help you. 12

130 Help Me Grow Children s Trust Fund (continued) Informed Consent for Children s Trust Fund Help Me Grow is conducting an evaluation to make sure that the families we serve are benefiting from our program. It is also a way for us to see what we are doing well and if there are areas in which we can improve. We want to provide the best possible services to our families and this is one way to keep us on track. Part of the evaluation involves asking program participants to complete a survey about how our services affect them and their families. If you choose to participate in this evaluation, your identity will be kept confidential. No identifying information will be shared with anyone outside of this program. Other information about the evaluation Your participation is voluntary. Your services will not be affected by your participation or lack of participation. Your privacy will be protected. Your name will not appear on the survey. When you are given a case ID, only authorized program personnel will know it and it will not be shared with anyone. Once you have completed the survey, the information on it will be transferred to a database and the survey will be destroyed. We hope you will help us by participating in this evaluation. Your participation will help us to improve services to all families who may need it. I agree to participate in the evaluation by responding to the PFS survey. I choose not to participate at this time. Participant s Signature Date Program Staff Signature Date 129 Guidelines revised 11/02/10

131 Help Me Grow Miscellaneous Children s Trust Fund (continued) EXAMPLE 130 Guidelines revised 11/02/10

132 Help Me Grow Miscellaneous Parenting Plus at Home Services Parenting Plus at Home is a stress management program for parents of chronically ill children developed fifteen years ago at Applewood Centers. The purpose of the program is to help parents manage their stress more successfully and increase their capacity to effectively complete daily tasks involved in caring for their children. Parents of chronically ill children shoulder an immense burden in taking primary responsibility for managing care. Ranging from increased medical costs and complex treatment regimens completed in the home, parents of chronically ill children endure increased stress levels and higher rates of mental health problems than parents within the general population. Given the potential impact of the parent's stress on the medical and psychological well being of their child, the Parenting Plus as Home project delivers home visiting designed specially to address caregiver psychological and emotional needs. Referrals for the Parenting Plus at Home Program will come from the Help Me Grow Service Coordinator working with the Part C family. Medical providers, specialized service providers and hospital based child find specialists will help identify families that can benefit from this enhanced service. Families who agree to the program will receive four to five home visits by a registered nurse contracted by Help Me Grow. The Parenting Plus at Home curriculum teaches parents basic stress management skills and how they can be applied to living with their child's medical condition. The stress management skills include goal setting, problem solving, positive thinking, a progressive relaxation technique and building on personal and family strengths. The program consists of four to five one-hour home visits spaced about one week apart so that the parent has time to practice and apply what they have learned. Parents receive written materials each week and use them to practice skills between sessions. 131 Guidelines revised 11/02/10

133 EXAMPLE EXAMPLE 132 Guidelines revised 11/02/10