Delaware State of the State Presentation Act Early Regional Summit March 25th & 26th 2010 Philadelphia

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Delaware State of the State Presentation Act Early Regional Summit March 25th & 26th 2010 Philadelphia

Current Delaware System Department of Education (DOE) Department of Health and Social Services (DHSS) Department of Services for Children, Youth, and their Families (DSCYF)

Interagency Collaboration Medicaid (within DHSS) Department of Children, Youth and their Families Division of Public Health (within DHSS) Department of Education Division of Developmental Disabilities Services (within DHSS)

Current Delaware System: DHSS Public Health Central Intake Kids Care Smart Start Child Development Watch Clinics administered by PH (Birth to 36 months) Birth to Three Early Intervention System/ Part C administered by Management Services Women, Infant, & Children Program (WIC)

Current Delaware System: DHSS Division of Developmental Disabilities Services Child Care Administration Data System: ISIS

Part C Model Flow Chart within Delaware Health Network Hospitals & Community Newborn Screens Routine Exams Growing Together Portfolio Public Awareness Centralized Intake through Maternal and Children s Health Network - Div. of Public Health with tracking through ISIS throughout flow chart P R I M A R Y Perinatal Programs Child Development Watch for Children Birth to 36 months with Disability or Delay Suspected DOE, DVI and/or DSCYF Programs DPH Community Services for at-risk children Other Referrals H E A L T H Level One: SERVICE COORDINATION Interagency Team from DPH, DDDS, DVI, DOE and DSCYF Level Two: MULTIDISCIPLINARY ASSESSMENT Interagency Team : DPH, DDDS, DVI, DOE, DSCYF, CCHS, & AIDI C A R E Part C Eligible Children All Other Children Level Three: IFSP (Individualized Family Service Plan) with Service Coordinator, MDA team and Family Level Four: SERVICE DELIVERY through DPH, DDDS, DVI, DOE, DSCYF and Private Vendors Referred to Appropriate Agencies S T A T E W I D E Transition to DOE & other services at age 3 DPH = Div. of Public Health DSCYF = Dept. of Services for Children, Youth & Families AIDI = dupont Hospital for Children DOE = Dept. of Education DV I = Div. for the Visually Impaired CCHS = Christiana Care Health System DDDS = Div. of Developmental ISIS = Integrated Service Information System MDA = Multidisciplinary Assessment Disabilities Services 6

Part C Services Service Coordination Multidisciplinary Assessment Translation Assistive Technology Audiology Developmental Services Family Training Medical Services -Evals only Nursing Services Nutrition Services Occupational Therapy Parent Training Physical Therapy Psychological Social Work Speech-Language Therapy Vision Services

Infants and Toddlers Receiving Early Intervention Services 1972 2144 2205 2445 2563 2747 2750 2855 3026 2730 Total Children Served Per Year, Delaware 3074 FY1998 FY1999 FY2000 FY2001 FY2002 FY2003 FY2004 FY2005 FY2006 FY2007 FY2008 3.10% 3.40% 3.80% 3.87% 3.86% 4.29% 4.23% 4.27% 4.21% 4.52% Percent of Children Served Per Year, Delaware FY1998 FY1999 FY2000 FY2001 FY2002 FY2003 FY2004 FY2005 FY2006 FY2007

Current Delaware System: DOE Early Development & Learning Resources Work Group: DE First Professional Development Credentialing Verification Set Competencies Early Childhood Assistance Program (ECAP)

Current Delaware System: DOE Parents as Teachers (PAT) Head Start Collaboration Office IDEA 619 Early Childhood Standards Development EC Positive Behavioral Support TA Data: DELSIS/e-School

Current Delaware System: DOE Delaware Autism Program Statewide program housed in the Christina SD serving children from birth to 21 years with ASD Director provides on-site technical assistance and inservice training to DAP programs Some school districts evaluate & serve their own students with ASD with technical assistance from DAP Director

DE Students Identified with Autism 1000 900 800 700 600 500 400 300 200 100 0 310 325 358 425 475 530 599 714 779 868 929 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Autism Identification by County 600 500 400 300 200 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 New Castle Kent Sussex

Current Delaware System: DSCYF K-5 Early Intervention (FC Therapists) Child Care Licensing Delaware s Best (SAMHSA 6 year grant) Pre-School PTSD Treatment Child Care Development Funds Foster Care Data: FACTS

Other Screening and Diagnostic Resources Private Primary Care Physicians Nemours Pediatric Clinics Alfred I. dupont Hospital for Children Kennedy Krieger Institute Easter Seals

Existing Statewide Early Childhood Screening & Autism Initiatives Interagency Coordinating Council (Birth-3) Interagency Resource Management Committee (Birth-5) Gov. Advisory Council for Exceptional Citizens (GACEC) Delaware Early Childhood Advisory Council National Academy of State Health Policy (ABCD)

Existing Statewide Early Childhood Screening & Autism Initiatives BBS of Delaware funds AAP s Delaware Developmental Early Screening Project (DCS) Four Pilot Pediatric Practices use (PEDS) Parent liaisons establish a Parent Resource Center Comprehensive Resource Binder Trainings by Family to Family Health Information March conference: Primary Care Collaboration in the Matrix of Care Nurse educators collect ongoing evaluation data Wrap-up conference: Integrating Developmental Screening Statewide

Institutions of Higher Learning Provide EC Personnel Preparation University of Delaware Wilmington University Delaware State University Delaware Technical Community College Springfield College

Advocacy and Information Groups Family to Family Health Information Center Family Voices (Health Care & Resources) Parent Information Center (Parent Information Resource Center) Autism Delaware Lower Delaware Autism Foundation

Professional Organizations Delaware Association for the Education of Young Children Delaware Association of School Psychologists DE Speech & Hearing Association DE Occupational Therapy Association DE Physical Therapy Association DE School Nurses Association DE American Academy of Pediatrics Medical Society of Delaware

Current Legislative Activities HB 199 passed in August 2009 Requires that private insurance covers developmental screenings Proposed SB 204 Requiring individual health benefit plans to cover diagnosis & treatment for children with autism children ages 21 & under Proposed HB 331 Child Care Quality & the establishment of tiered reimbursement based on quality of care (Delaware Stars for Early Success)

Current Challenges and Gaps Lack of coordinated State policy Implement Statewide Developmental Comprehensive Screening Improve current Screening Legislation Lack of sufficient EC screening & supportive training across child care providers (Traveling Screening Team) Lack of consistency of EC screening instruments

Current Challenges and Gaps Challenges in meeting the needs of the growing Hispanic population Lack of standardized screening & comprehensive evaluation protocol for ASD Need for traveling diagnostic team highly trained in best practice EC Assessment of ASD

Current Challenges and Gaps Need for a consistent data collection system Funding challenges due to the Delaware state budget deficit Substantial increase in the population of children with ASD Need for earlier identification of children with ASD to improve their outcomes

Looking Towards the Future Early and more reliable statewide screenings will yield stronger referrals Evaluation teams will then more efficiently use shrinking state resources Earlier diagnosis will allow children to access early intervention services sooner Better outcomes for kids

Looking Towards the Future