Best practice model for the provision of programs

Examples for Application. Joint planning Agreement by coach and parent on actions assumed by coach and subsequent opportunities for the parent to practice between coaching visits. Action Spontaneous or scheduled events, occurring in real-life situations, that allow the family member to practice, refine, or analyze new skills. View Large. Family and Associated Environmental Factors. Child Factors. Area of Interest. Example Questions. I ncome General Do you have fear of running short of money by the end of the month?

Food security Do you or anyone in the family ever skip meals because there is not enough money for food? Do you receive assistance food stamps, etc? H ousing Is housing or payment for housing a problem for you? E ducation and development Do you have concerns about how your infant is developing? Early childhood programs Is your child in a program to assist you in supporting her development? Do you feel the need for such a program?

L iteracy Do you have trouble reading forms given from our office or agencies? Do have difficulty in reading generally? Do you read to your child each day? Have you or your spouse ever been the subject of domestic violence? To best sustain the process of information sharing, the individuals at each program should know who one another are and how to contact directly when needed.

Information from the medical home should be available to the Part C assessment team before its evaluation and information, and recommendations on intervention should be forwarded to the medical home as the individualized family service plan is developed and modified.

When the child is seen by subspecialists, their input to both the medical home and the Part C program is valuable. Timely and ongoing flow of information between the medical home and the Part C program reassures the family of coordinated, family-centered care; it relieves the family of the burden of having to interpret and transport the information. Information about infants born preterm and about early childhood delays in all areas, including language and social skills, is available.

Information is guided for families, medical professionals, and school personnel. National and state sites and organizations are available. Resources and publications for medical homes, families, and agency programs for infants and toddlers are available. Improving child-find and optimizing the referral process.

Efficient evaluation and coordination of services. Advocacy roles for physicians in the medical home. Be aware of potential costs to the family public funding, private insurance, private pay.

Carl D. Tapia, MD. Murphy, MD, Interim Chairperson. Stephanie Mucha, MPH. Early childhood stimulation in the developing and developed world: if not now, when? Search ADS. Young Children Develop in an Environment of Relationships. Accessed January 27, Individuals with Disabilities Education Act Part C: Early intervention program for infants and toddlers with disabilities: final regulations side by side comparison. Infants and toddlers receiving early intervention services in accordance with Part C.

The value of the medical home for children without special health care needs. A review of the evidence for the medical home for children with special health care needs. Associations between quality of primary care and health care use among children with special health care needs.

Improved outcomes associated with medical home implementation in pediatric primary care. The medical home, preventive care screenings, and counseling for children: evidence from the Medical Expenditure Panel Survey. The medical home as a mediator of the relation between mental health symptoms and family burden among children with special health care needs.

The medical home: health care access and impact for children and youth in the United States. Rates of early intervention referral and significant developmental delay, by birthweight and gestational age.

Pub L No. Health care reform and the opportunity to implement a family-centered medical home for children. Enhancing developmentally oriented primary care: an Illinois initiative to increase developmental screening in medical homes. Implementing developmental screening and referrals: lessons learned from a national project. Special needs children with speech and hearing difficulties: prevalence and unmet needs.

Family physicians in the child health care workforce: opportunities for collaboration in improving the health of children. Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force. Development of a concept map to convey understanding of patient and family-centered care.

Evaluating Medical Home constructs for children with special needs: integrating theory and logic models. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.

Publication No. Parent-reported quality of preventive care for children at-risk for developmental delay. Washington, DC. Maternal and Child Health Bureau; July Developmental stages of developmental screening: steps to implementation of a successful program.

A family-centered, community-based system of services for children and youth with special health care needs. Results at age 8 years of early intervention for low-birth-weight premature infants. The Infant Health and Development Program. Early intervention in low birth weight premature infants: results at 18 years of age for the Infant Health and Development Program.

Early childhood stimulation benefits adult competence and reduces violent behavior. Early intervention on a large scale. Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: a year follow-up of low-income children in public schools.

Early education. NCED Focus on function: a cluster, randomized controlled trial comparing child- versus context-focused intervention for young children with cerebral palsy. Context therapy: a new intervention approach for children with cerebral palsy.

Side-by side: transdisciplinary early intervention in natural environments. Section on Pediatrics. Caregiver coaching strategies for early intervention providers: moving toward operational definitions. Development of everyday activities: a model for occupation-centered therapy. Making best practice our practice: reflections on our journey into natural environments. Child Maltreatment Developmental needs and individualized family service plans among infants and toddlers in the child welfare system.

Project Thrive: Issue Brief No. Clinical report: maltreatment of children with disabilities [reaffirmed January ]. Maternal psychopathology and infant development at 18 months: the impact of maternal personality disorder and depression. Sleep problems and early developmental delay: implications for early intervention programs.

Barriers to the identification and management of psychosocial issues in children and maternal depression. Feasibility of expanding services for very young children in the public mental health setting. What is ASQ? Preventing disproportionate representation: culturally and responsive prereferral interventions. Accessed August 23, Risk factors associated with children lost to care in a state early childhood intervention program. The impact of race on participation in Part C early intervention services.

Collaboration with culturally and linguistically diverse families: ideal versus reality. The effect of state early intervention eligibility policy on participation among a cohort of young CSHCN. Updated Food insecurity and the risks of depression and anxiety in mothers and behavior problems in their preschool-aged children. Poverty, food insecurity, and the behavior for childhood internalizing and externalizing disorders.

Guiding principles for managed care arrangements for the health care of newborns, infants, children, adolescents, and young adults. New workforce, practice, and payment reforms essential for improving access to pediatric subspecialty care within the medical home.

Clinical genetic evaluation of the child with mental retardation or developmental delays [reaffirmed May ]. The person decides what life outcomes they want and services are provided to meet those goals; people are not bound to a menu of pre-determined services. There is less reliance on institutions such as nursing homes and people are healthier now.

Case managers have a different role: managing quality, developing care networks, and engaging in more interdisciplinary efforts. Case management is a critical component in the design of support services systems. Efforts to improve the design and provision of case management have the potential to greatly affect the quality of life of individuals with long-term care needs who rely on publicly funded services and supports.

Based on this study, there are at least three factors to consider in the design of case management as states move to increase consumer control, improve quality, and manage resources for the best outcomes possible: providing adequate support structures for self-determination, promoting consumer choice of case manager, and streamlining processes. Many initiatives are underway to increase self-determination and consumer control.

However, simply allocating service dollars to consumers is insufficient without well-designed structures for creative planning in the use of those service dollars. States such as New Jersey, Delaware, and Maryland are addressing the challenge of tighter resources for services by increasing their efforts in self-determination and consumer control over their services allocation.

Key elements of such a design include an assessment process that leads to a determination of an individual allocation and intensive support for individuals with disabilities to design the supports they will buy with their services dollars.

Another element in such programs is maximizing the use of informal support mechanisms before or along with using paid services. Design of a case management system and assuring consumer choice of case managers involves a number of elements:. Providing meaningful choice to consumers entails more than simply providing a list of potential agencies, offering the county versus one other agency, or offering two different agencies. Desirable structures include opportunities for individuals and families to meet potential case managers, and to have clear guidance for the decision-making process.

Complex funding systems, overlapping eligibility determinations, and burdensome requirements for documentation all contribute to systems with redundancy, needless complexity, and inequity. Some states are addressing these issues with efforts to standardize processes between different disability groups, such as a universal assessment process and universal planning processes.

Such systems can also improve efficiency, increase time for individual attention to consumers, and enhance the determination that case management performance measures are being met. The technology is available to make these complex information and billing processes manageable for everyone involved. Some states are also addressing their funding of case management by reevaluating their balances between administrative claiming, service claiming, and use of the targeted case-management funding stream.

Finally, reform efforts should be balanced against the basic principles of improving access and service availability while assuring basic safeguards, improving accountability and performance, honoring individualization, and promoting consumer choice and self-determination.

Amado, A. Redesigning case management services for people with disabilities in Minnesota: A report to the Legislature. Available at www. Cooper, R. Medicaid and case management for people with developmental disabilities: Options, practices, and issues Revised. Taub, S. The National Core Indicators project: Monitoring the performance of state developmental disabilities agencies.

Kimmich Eds. Baltimore: Paul H. Zimmer, J. Individual versus team case management in optimizing community care for chronically ill patients with dementia.

Journal of Aging and Health, 2 3 , Department of Education. Managing Editor is Sheryl A. The opinions expressed here are those of the authors and do not necessarily reflect the position of the Center or its funding sources.

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P : F : People under the age of 65 who have a disability and are using home care services. People with traumatic or acquired brain injury TBI. People with physical disabilities or chronic medical condition s under the age of People in nursing facilities NF who are under the age of Community Alternatives for Disabled Individuals CADI : Funding for children and adults with disabilities who would otherwise require care in a nursing facility.

Previous research had identified the following challenges regarding case management: Increased choices creating a demand on resources. Tensions created by limits on services. Duplication and redundancy. Overlapping eligibility for programs. Variation of rules, standards and reimbursement from program-to-program. Inequities from group to group. Multiple assessment processes. Variation in quality from county to county and case manager to case manager. With these in mind, the RTC researchers conducted a literature review and in-depth reviews of case management models and best practices, using the following strategies: Examination of the professional literature as well as national and State reports describing case management models and practices, including support coordination and service brokerage.

Gathering of information on different case management structures in 20 states by interviewing State representatives and reviewing reports and other materials available on State Web sites. Identification of innovative models, through asking national and international experts to nominate such models, then gathering written reports and interviewing people responsible for developing or implementing those innovative models.

Results and Discussion Current trends, national implications, innovations, and best practices in case management were examined in three areas: a federal influences on case management, b differences between States in human services and case management structures, and c innovations which certain States and local areas are undertaking in case management. It includes the following seven design areas: Participation Access : Access to community supports, information and referral, timely intake and eligibility determination, as well as reasonable promptness.

Provider Capacity : Organizational licensure and certification, sufficient providers agencies and staff , adequate staff training, and provider monitoring. Rights and Responsibilities : Protection of rights and decision-making authority, as well as due process and grievance procedures. Outcomes and Satisfaction : Surveys that show outcomes of and satisfaction with services provided, data used to identify and respond to dissatisfaction and poor performance, generally and for specific subgroups.

System Performance : Systematic gathering and analysis of performance data, community participation in designing and appraising system performance and improvement activities, financial accountability, a system that strives to improve quality. This is to be accomplished through three specified quality management functions: Discovery : Knowing what outcomes are being accomplished, identifying problems, determining opportunities for improvement, and finding sources of effective practice.

Remediation : Responding to problems on an individual, agency and system-wide basis. Improvement : Using information about HCBS programs and those persons enrolled in them, knowledge of effective practices, and information and knowledge dissemination to improve the quality of services and supports; elevation of the expectations of and demand for higher quality by service recipients and their advocates.

State Case Management Structures The study found that the degrees and types of innovation in case management were affected by State governance and system structures. Governance Structure One primary area where States differ is their governance structure for human services administration. Definition of Case Management Case management has two key features: 1 providing an interface or connection between individuals with disabilities and the system of publicly-funded and generic services and supports; and 2 assuring that these services meet reasonable standards of quality and lead to important life outcomes for individuals Cooper, The professional literature about case management models summarized in Amado, points to five possible roles or functions for case management: Administration Crisis management Consumer empowerment Individual advocacy Systems advocacy These roles could be seen as additive, going from the most basic and required functions to roles that are desirable but beyond the required minimum.

Efforts Across Disability Groups At least two States, Maryland and Washington, are working to systematically address equitable policies, procedures, and efforts across all disability groups, and are attempting to bring all services for people with disabilities under age 65 together in a unified system.

Efforts to Deal with Limited or Decreasing Resources Virtually every State is faced with increasing numbers of consumers and limited or diminishing resources for direct services and for case management.

Innovative Models The study identified the following six types of innovation among the 20 states reviewed. Table 1. Coordinated Database Systems A coordinated system requires a well-designed, consumer-friendly management information and support technology system that can simplify, streamline, and make as comprehensive as possible the process of collecting and using information concerning service recipients.

Managing the Challenge of Limited Resource Growth Virtually every state is faced with increasing numbers of consumers and limited or diminishing resources for case management and direct services. Models of Publicly-Administered Managed Care: Minnesota and Wisconsin Minnesota is a State that administers health and social services through county government.

Conclusion Case management is a critical component in the design of support services systems. Population : Technical support for providers and programs specific to forensic health and community advocates.

At the same time, it can increase the likelihood that evidence collected will aid in criminal case investigation, resulting in perpetrators being held accountable and further sexual violence prevented. The examination and the related responsibilities of health care personnel are the focus of this protocol. Recognizing that multidisciplinary coordination is vital to the success of the exam, the protocol also discusses the responses of other professionals, as they relate to the exam process. The use of these standards across all U.

The goal is that every person who reports or discloses sexual assault, or in the case of children where sexual abuse is suspected, will have access to a specially educated and clinically prepared SAFE. Uniformity in SAFE education can improve consistency of service provision and aid in evaluating the effectiveness of examiner response.

Department of Justice — convened several working group meetings representing victims, victim advocates, sexual assault nurse examiners, medical examiners, forensic laboratories, law enforcement agencies, prosecutors, and the judiciary. The NIJ working group was directed to address issues relating to evidence collection; prioritization of evidence and time periods for collection; evidence inventory, tracking, and auditing technology solutions; communication strategies; and victim engagement and notification.

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