MISSOURI’S EARLY INTERVENTION
PROGRAM FOR CHILDREN FROM AGES
BIRTH TO 3.
First Steps
Mission Statement
First Steps is a support and service system designed
to improve family capacity to enhance their child’s...
Missouri First Steps Philosophy
Is Family-Focused - Requires the Families Active
Participation & is a Voluntary Program
...
First Steps Belief Statements
Families are Decision Makers and the Child’s First
Teacher – Family is forever, providers c...
First Steps Belief Statements cont.
Effective Services are Provided in Natural
Environments
Services and Supports are In...
Who is eligible for First Steps?
A child with a diagnosed physical or mental condition
associated with developmental disa...
First Steps Missouri’s Early Intervention Program for Children, ages birth to 3.
Very Low Birth Weight
(less than 1500 gra...
Conditions Diagnosed
Neonatal/Infant/Toddler Conditions
• Down Syndrome
• Cri du Chat Syndrome‐ ‐
• Klinefelter's Syndrome...
 Hypoxic Ischemic Encephalopathy‐
(HIE) and at term (36 weeks
gestation or more)
 Cranio facial anomalies‐
 Epilepsy/Se...
Conditions Diagnosed
Neonatal/Infant/Toddler Conditions
 Other Conditions known to be
associated with developmental
disab...
Who is eligible for First Steps?
Children with a half age (50% or more)
developmental delay in one of the 5 developmental
...
Developmental Domains
Physical – Includes hearing, vision and fine and gross
motor skills for large and small muscles
Co...
Developmental Delay: Eligibility
First Steps uses the Developmental Assessment of
Young Children (DAYC) tool to help dete...
Individualized Family Service Plan (IFSP)
An IFSP is a written “road map” or action plan for
the services that a child an...
Individualized Family Service Plan (IFSP)
The IFSP includes:
 Present Levels –
Strengths & Concerns
 The Families CPR’s ...
First Steps Services
Physical Therapy
Occupational Therapy
Special Instruction/
Developmental Services
Speech and Lang...
Family Cost Participation
Some families participating in First Steps are
required to pay a monthly fee.
The fee is not t...
Who will be required to pay a Cost Participation fee?
Families eligible and enrolled in Medicaid will not be required
to ...
What if a child is found NOT eligible
to receive First Steps services?
The Service Coordinator will inform the Family tha...
First Steps
Missouri’s Early Intervention Program for Children from ages birth to 3.
MEDICAL REFERRALS DEVELOPMENTAL DELAY...
Who may refer a child to First Steps?
Primary Referral Sources include:
 Hospitals including prenatal and
postnatal care ...
How do I refer a family to First Steps?
A person may refer a family to First Steps by calling
or faxing their local regio...
What other resources are available for children
who are NOT eligible for First Steps?
Parents as Teachers
Early Childhoo...
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First Steps Powerpoint

  1. 1. MISSOURI’S EARLY INTERVENTION PROGRAM FOR CHILDREN FROM AGES BIRTH TO 3. First Steps
  2. 2. Mission Statement First Steps is a support and service system designed to improve family capacity to enhance their child’s development and learning as well as to increase the child’s participation in family and community life.
  3. 3. Missouri First Steps Philosophy Is Family-Focused - Requires the Families Active Participation & is a Voluntary Program An educational/coaching model of service delivery (Is Not Medically-Based) Provides supports and services in natural environments (where the infant or toddler lives, plays and grows – home and child care) Service - Provider to suggest strategies and activities to the family to implement which should be wrapped around the way the family and child spend time.
  4. 4. First Steps Belief Statements Families are Decision Makers and the Child’s First Teacher – Family is forever, providers come and go. Effective Services are Designed Around and Promote Family Strengths – Promoting family strengths builds confidence & competence that will further enhance the child’s development. Effective Services are Culturally Competent Effective Services are Provided in the Context of the Child’s and Family’s Natural Routines
  5. 5. First Steps Belief Statements cont. Effective Services are Provided in Natural Environments Services and Supports are Individualized – Services & Supports should fit into a family’s life – not be added on. Competent Providers Focus on Family Competence – Providers should be “Consultants & Coaches” to families & other Primary Caregivers. Early Identification and Family Engagement are Critical to Early Intervention
  6. 6. Who is eligible for First Steps? A child with a diagnosed physical or mental condition associated with developmental disabilities or has a high probability of resulting in a developmental delay or disability. A child with a half age (50% or more) developmental delay in one of the 5 developmental areas: Physical, Cognitive, Adaptive, Communication or Social Emotional
  7. 7. First Steps Missouri’s Early Intervention Program for Children, ages birth to 3. Very Low Birth Weight (less than 1500 grams) with one or more of the following conditions:  Apgar of 6 or less at 5 minutes  Intracranial bleeds (Grade II, III, or IV)  Ventilator dependent for 72 hours or more  Asphyxiation Conditions diagnosed at birth or within 30 days post birth (newborn conditions)
  8. 8. Conditions Diagnosed Neonatal/Infant/Toddler Conditions • Down Syndrome • Cri du Chat Syndrome‐ ‐ • Klinefelter's Syndrome • Trisomy 18 (Edward's Syndrome) • Trisomy 13 (Patau's Syndrome) • Turner's Syndrome • Triple X Syndrome‐ • Fragile X Syndrome • Prader Willi Syndrome‐ • Pierre Robin Genetic Conditions known to be associated with developmental disabilities including but not limited to:
  9. 9.  Hypoxic Ischemic Encephalopathy‐ (HIE) and at term (36 weeks gestation or more)  Cranio facial anomalies‐  Epilepsy/Seizure Disorder  Spina Bifida  Blindness, including visual impairments  Macro/Microcephalus, including Hydrocephalus  Deafness, including hearing impairments  Fetal Alcohol Syndrome  Cyanotic Congenital Heart Disease  PKU (phenylketonuria)  Cerebral Palsy  Viruses/bacteria (Herpes, syphilis,cytomegalovirus, toxoplasmosis, and rubella)  Acquired Immune Deficiency Syndrome (AIDS)  Autism Spectrum Disorders Conditions Diagnosed Neonatal/Infant/Toddler Conditions Additional conditions known to be associated with developmental disabilities including but not limited to:
  10. 10. Conditions Diagnosed Neonatal/Infant/Toddler Conditions  Other Conditions known to be associated with developmental disabilities to be considered for eligibility must be based upon Informed Clinical Opinion (ICO) by a Board Certified: Neonatologists, Pediatrician, Geneticist and/or Pediatric Neurologist  ICO: The Physician must indicate the specific condition & document the potential impact of the condition in any of the five developmental areas SPECIFIC TO THAT INDIVIDUAL CHILD BEING REFERRED
  11. 11. Who is eligible for First Steps? Children with a half age (50% or more) developmental delay in one of the 5 developmental domains: • Physical • Cognitive • Communication • Adaptive • Social/Emotional
  12. 12. Developmental Domains Physical – Includes hearing, vision and fine and gross motor skills for large and small muscles Cognitive – Includes thinking, reasoning & problem solving Communication – Includes expressive language skills (spoken) as well as receptive language skills (understanding of spoken words and/or gestures) Adaptive – Includes life skills such as eating, drinking, dressing or self independence Social/Emotional – Includes play skills & interactions with others.
  13. 13. Developmental Delay: Eligibility First Steps uses the Developmental Assessment of Young Children (DAYC) tool to help determine if a child is eligible to receive services. The DAYC evaluates the child’s developmental skills in all 5 developmental domains. In addition to the DAYC; service coordinator interview, feedback from parents and primary caregivers, physician reports, etc., will be used to help determine if a child is eligible for the program.
  14. 14. Individualized Family Service Plan (IFSP) An IFSP is a written “road map” or action plan for the services that a child and family will receive. When will the IFSP meeting take place? Part C federal and state regulations require that the IFSP meeting for eligible children be held no more than 45 days after the referral to First Steps. Who makes up the IFSP Team? The IFSP team includes: The Parents of the Child, Service Coordinator, Early Intervention Providers, Health Care Provider and anyone that the family would like to invite to the IFSP.
  15. 15. Individualized Family Service Plan (IFSP) The IFSP includes:  Present Levels – Strengths & Concerns  The Families CPR’s – Concerns, Priorities & Resources  Outcomes – Strategies & Activities  Services – Frequency & Intensity  Transitions – into, within, & out of First Steps The IFSP for each eligible child must be written within 45 days from the date of the referral and reviewed at least every six months as well as annually.
  16. 16. First Steps Services Physical Therapy Occupational Therapy Special Instruction/ Developmental Services Speech and Language Services Assistive Technology Audiology Family Training Health Services Medical Services (for evaluation purposes only) Nursing Services Nutrition Services Psychological Services Service Coordination Social Work/Counseling Transportation Vision Services
  17. 17. Family Cost Participation Some families participating in First Steps are required to pay a monthly fee. The fee is not tied to a particular service or amount of services. A family will pay a single fee regardless of the number of children actually receiving services. The fee amount varies from $5 per month to $100 per month based on a family’s adjusted income and the number of family members in the household.
  18. 18. Who will be required to pay a Cost Participation fee? Families eligible and enrolled in Medicaid will not be required to pay the monthly fee. A family must have an annual adjusted gross income at or above 200% of the federally established poverty level before their obligation to pay a monthly fee is triggered. If a family encounters “financial hardship”, the monthly fee may be affected. Financial hardship in First Steps is defined as: • Loss of home • Loss of job (one or more income earners) • Extensive medical costs incurred/documented in the current year and determined to be applicable by the SPOE
  19. 19. What if a child is found NOT eligible to receive First Steps services? The Service Coordinator will inform the Family that their child has been found ineligible (go over all assessments & medical records received with the family thoroughly) and provide them with community resources. The Service Coordinator will also provide the family with a copy of their parental rights, evaluations that First Steps conducted & a notice of action for their records. If a child is found ineligible and concerns persist, he or she may be re-referred at any time before the age of 3.
  20. 20. First Steps Missouri’s Early Intervention Program for Children from ages birth to 3. MEDICAL REFERRALS DEVELOPMENTAL DELAY REFERRALS ELIGIBILITY DETERMINATION Medical Records or DAYC CHILD & FAMILY ASSESSMENTS (Assessments, CPRs, RBI) DELAY SUSPECTED ELIGIBLE NOT ELIGIBLE NO DELAY SUSPECTED Parent Withdraw or SPOE Refusal SCREENING Existing Information and/or Phone Interview IFSP DEVELOPMENT INTERVENTION REFERRAL TO COMMUNITY PROGRAMS NOTICE & CONSENT Initial Evaluation NOTICE & CONSENT Initial Evaluation RELEASE OF INFORMATION NOTICE & CONSENT Initiation of Service
  21. 21. Who may refer a child to First Steps? Primary Referral Sources include:  Hospitals including prenatal and postnatal care facilities  Physicians  Parents or Guardians  Child-Care Programs  Local Educational Agencies (including special education, Parents As Teachers (SB658) and Early Head Start)  Public Health Facilities  Other Social Service Agencies, including DSS and DMH  Other Health Care Providers
  22. 22. How do I refer a family to First Steps? A person may refer a family to First Steps by calling or faxing their local regional System Point of Entry office (SPOE). St. Louis Area SPOE: (P) 314-453-9203; (F) 314-453-0802 A person may also refer by calling Missouri First Steps (Toll Free) at: 1-866-583-2392 Online at www.mofirststeps.com
  23. 23. What other resources are available for children who are NOT eligible for First Steps? Parents as Teachers Early Childhood Special Education 2 year old programs Mother’s Day Out Program Hearing Centers Medical Services/Outpatient Therapy Services Early Head Start/ Head Start Child Daycare Association - CDCA

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