Identifying the Services, Costs, and Reimbursements for Young Children with Disabilities Through Data Collected by Tennessee Part H IDEA Program. Description of the Agency

04/01/1996

After passage of Part H of PI-99-457, the governor of Tennessee appointed the Tennessee State Department of Education as the lead agency to implement a statewide program of early intervention services for infants and toddlers with disabilities, birth to under 36 months of age, and their families in accordance with Part H of PL99-457 now known as PI-1 02-119. After three years of planning TEIS was implemented.

In 1989 the state contracted with nine district offices, and in each district, the state chose to contract with a university or nonprofit agency for the needs assessment and pilot phase. The state developed a separate contract with one additional university for technical assistance. In all but one district the state contracted with an institution of higher learning. This arrangement worked so well that it was continued in the full implementation phase. Pilot implementation occurred in 1990, with partial implementation in 1991 and full implementation in 1992.

The mission of TEIS is to advocate for families of young children (birth to under 36 months) with established disabilities or in circumstances likely to cause developmental delay and empower the families. It also promotes comprehensive, coordinated systems of early intervention including the full spectrum of service delivery options. It accomplishes this by (a) increasing public awareness among Tennessee citizenry regarding early intervention, (b) offering basic services to families by providing resource information and therapeutic referrals, (c) supporting families in the ongoing process of finding and accessing early intervention services (service coordination), (d) fostering coordination and communication among service providers on the behalf of families, (e) assisting families in the process of planning for and accomplishing transitions between service settings, (f) operating a statewide network of nine district level "points of entry" and a statewide toll-free telephone number, and (g) filling gaps in services to meet Individualized Family Service Plan (IFSP) requirements.

Organization and Operation of TEIS

The program is organized into nine district offices. Each district office is staffed with a primary principal investigator or two co-principal investigators. The training of the PI's is varied and represents the disciplines of early childhood education, clinical psychology, occupational therapy, speech/language therapy, pediatrics and early childhood development. The PI's are generally faculty from the contracting institutions of higher learning.

In addition, each office has a staff of service coordinators who also represent various professional disciplines including early childhood education and special education, nursing and social work. Several of the service coordinators are also parents of children with special needs. Each service coordinator makes family visits, helps obtain evaluations, helps families to determine eligibility for various programs, helps identify appropriate services, organizes IFSP meetings, develops IFSP's, and helps monitor services. Most of the regional offices also have a contract coordinator and an individual responsible for screening and "child find".

The regional offices work closely with a Part H technical assistance office and with the lead agency staff. The technical assistance office designs, coordinates the collection of, and analyzes the information gathered and maintained by the district offices. Each district office and the state office collects information related to payment of services provided to the eligible population.

The district offices receive referrals from multiple sources including parents, physicians, therapists or day care workers. Service coordinators contact the families, and if the families are interested, appointments are made to obtain information about the child and family for intake purposes. They clarify what is required to determine if the child is eligible. Some children are eligible because they have a condition such as Down Syndrome which is known to make the child at high risk for developmental impairments. Obtaining a statement from a clinician that the child has the condition automatically makes the child eligible without any further evaluation. This is referred to as "paper eligibility". If such a condition does not exist, they child is still eligible if they are delayed 25% or greater in two developmental domains or 40% in one domain. (The domains are gross motor, fine motor, communication, cognitive, social/emotional and adaptive.) The service coordinator will arrange for an evaluation paid for by TEIS, if needed, to determine if a child is eligible. If a child is not eligible but is felt to be at risk, the service coordinator can choose to continue to monitor that child's progress by periodic screens.

If a child is eligible, the service coordinator will help the families to determine their needs. This will usually include an assessment of the child for programming purposes to determine what interventions are appropriate. From the information available about each of the children including that generated by his or her assessments, a plan is developed with the family and service providers. This is called the IFSP, and it consists of specific outcomes and the services required to achieve those outcomes. The plan is developed at a meeting including the providers who evaluated or are likely to provide service to the children and their families, the service coordinator and the parents. In some cases, this service coordination is provided by someone other than the TEIS service coordinator. For instance, if the child is enrolled in a Department of Mental Health and Mental Retardation program, one of their staff may assume the case coordinating role instead of a TEIS service coordinator. (In these cases, the same information about the IFSP is generated and sent to the TEIS program but the service coordinator from TEIS may not have to attend the IFSP meetings.)

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