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What is the best way to find open positions within Wisconsin's Birth to 3 Program?

By the middle of 2024, the EI in WI website will have a section in which counties can post open positions. In the meantime, we would encourage people to use this DHS webpage to access the Administrative Contact or Program Coordinator in the counties that they may be interested in. These people would be a good source of information about job postings at the county level. In addition, each discipline can contact the Wisconsin chapters of their professional organizations (WOTA, APTA Wisconsin, and WSHLA).

The RESource Team agreed that sharing this RBI training video from Nebraska would be a reasonable next step until we put forth recommendations and materials around family assessment in a more formal manner (state-wide). This is a priority area for us but know you need to support your team with your existing practices in the meantime.

Orientation is available on EI in WI. We hope that our asynchronous Orientation Bundle is helpful and meets your needs.

You bet! RESource developed a learning bundle to meet this need. The OSEP Child Outcomes 101 Bundle is available here at EI in WI.

There are only a couple places that the use of 8s are mentioned in formal Birth to 3 Program documents. The Program Participation System (PPS) User Guide mentions the use of 8s on pages 22 and 31. In both places, it mentions 8s being used when ratings are not applicable but it doesn’t specify situations that are not applicable. Additionally, the Wisconsin Birth to 3 Program County Determination Results and Compliance Matrix Instructions (see page 2) talks about use of 8s similarly in the data quality section. Here it mentions there being a data error when using 8s for a child that has been enrolled for more than six months and 8s were used. In addition to those resources, the state has been generally discouraging the use of 8s since it tends to lead to data quality errors. This was communicated in the most recent round of Child Outcomes training. 8s were originally intended to serve as a placeholder in PPS to be able to move through the system prior to determining a rating. It was also allowable to use 8s when a child was enrolled in the Wisconsin Birth to 3 Program for less than six months (181 days), therefore eliminating their data from being used for federal reporting for indicator 3. Programs are strongly encouraged to provide a rating of 1-7 for each child at entry and exit (regardless of the amount of service or engagement of the family). The only allowable use of 8 is when a child has been enrolled in the Wisconsin Birth to 3 Program for less than 6 months. Again, the use of 8s is discouraged since this practice tends to lead to data errors.

We are excited to hear that counties want to hold book studies with their teams. RESource is happy to help! We have developed Book Study Bundles in response to requests like this. These bundles are available on EI in WI. The links below will take you to the bundle of your choice:

Coaching Book Study

Teaming Book Study 

Pause and Reflect Book Study 

What Happened to You Book Study

As we continue to develop materials for our professional development system, reflective supervision is on our radar. In the meantime, Wisconsin Alliance for Infant Mental Health has an option that might be helpful to explore. To access their resource, follow this link.

With regard to eligibility for the Birth to 3 Program, each evaluation tool will indicate if you are to adjust for prematurity. With the DAYC2, for example, it indicates in the manual that premature children were included in their norm group and that you do not adjust for prematurity for scoring purposes, etc. Other tools will also indicate if you are to adjust for prematurity. Having said that, I am sure you are aware of the diagnosed conditions list and becoming eligible through one of the categories in ‘chart 1.’ Please see page 3 of the Diagnosed Conditions and Atypical Development Guidance for Wisconsin’s Birth to 3 Program document. This shows the level of prematurity needed to qualify for the Birth to 3 Program in Wisconsin.

An electronic signature is acceptable to the Birth to 3 Program to conduct our activities. This is referenced in the WI Birth to 3 Program Operations Guide, in section 12.1.2 Consent.

Yes! In 2022 RESource began holding discipline-specific Communities of Practice, and we would love to have you join us! Through conversations with our workforce, we heard over and over again that people wanted to speak with and collaborate with others in their same position within Wisconsin’s Birth to 3 Program. We hope that our CoPs have helped to satisfy that need. Please visit the CoP Corner on EI in WI for more information and to get signed up. There is a CoP for everyone!

The LEA notification process provides LEAs with an estimated number of children to expect. Please reference The Birth to 3 Program Operations Guide; particularly Chapter 11 on Transition (11.2.1 and 11.2.2 on page 85).

In the past, RESource team members did sometimes support programs more directly by helping with facilitation of interagency agreement meetings – particularly in difficult situations. We are now working to support programs differently by developing tools to support you in your collaboration with your partners. The RESource team is currently collaborating with our Part B partners at DPI to create resources that will help with planning for these types of meetings and the transition process more generally. Stay tuned!

By the middle of 2024, the EI in WI website will have a section in which counties can post open positions. We wish that feature was ready to launch today, but it is in development. In the meantime, RESource is intentionally working to connect higher education programs to the Wisconsin  Birth to 3 Program. We hope this makes new grads more aware of career opportunities within early intervention. That doesn’t help you today, but we want you to know that we recognize that staffing is an ongoing issue that needs to be addressed. It may be helpful to contact the state professional organizations – WOTA, WPTA, and WSHA. You may also have luck using websites such as Indeed and Linked In.

This can be tricky. We know that we provide services in a way that is best for infants and toddlers, but how do we explain that to others? To help, RESource has compliled 3 resources to build a repertoire of responses to common questions.

UPDATED RESPONSE: Whenever consent is required by law from the legal guardian, written consent is required.  Verbal consent was only allowable during the pandemic; that flexibility ended as of June 2023

RESource’s new Assessment Practice Tip Sheets were developed to establish a common language and understanding around assessment. You can conveniently find the Assessment Practice Tip Sheets here on EI in WI. We are continuing to think creatively about options for supporting family assessment tools. Please stay plugged into updates from our RESource team and the EI in WI PD system.

Yes, we can! Wisconsin law (DHS 90) tells us that programs can use either a norm-referenced or criterion-referenced evaluation tool to determine a child’s eligibility for the Birth to 3 Program based on developmental delay. It also says that eligibility based on developmental delay can be established in 2 ways – either a 25% delay or 1.3 standard deviations below the mean. When interpreting evaluation results, percentage of delay is determined by using an age equivalent score and standard deviation is determined by using a standard score. Our Research to Practice team has determined that best practice in evaluation would be use of a standard score to establish eligibility for services. For instance, the tools such as the DAYC-2, the REEL and the Battelle-2 are norm-referenced tools from which a standard score can be determined. Guidance from the developers of each of these tools recommend that, even though the tool provides age equivalent scores, that the standard score is the most valid. Even common criterion-referenced tools that yield age equivalent scores such as the Early Learning Accomplishment Profile (ELAP) suggest use of a norm-referenced tool and standard scores for eligibility purposes. We would suggest reviewing the Birth to 3 Program Operations Guide (Chapter 6, pg 51) for specifics regarding eligibility requirements.

Wisconsin law (DHS 90) says that eligibility based on developmental delay can be established in 2 ways – either a 25% delay or 1.3 standard deviations below the mean. When interpreting evaluation results, percentage of delay is determined by using an age equivalent score and standard deviation is determined by using a standard score. Our team has determined through review of research and in examination of the evaluation tool guidance of both of the eligibility evaluation tools on our Approved Tool List (the DAYC-2 and the DP-4), that we would guide programs using those tools to use standard scores when determining the level of developmental delay.

In addition, as noted on page 1, we recently released the new “Standard Score Tip Sheet” within our Assessment Practice Tip Sheet Series. We think that you will find it helpful and full of information to share with everyone on your team. Check it out!

If the meeting includes both the TPC AND the IFSP, the primary coach needs to be in attendance. But, if it is ONLY a TPC, and the IFSP will happen at a separate time, then the primary coach does NOT need to be in attendance at the TPC. Often the TPC and the IFSP are combined to consolidate efforts, so in that scenario the primary coach would be in attendance. However, there are situations where these two meetings occur separately thus the primary coach would be at the IFSP, but not at the TPC unless the program has made an internal decision to have the primary coach attend the TPC.

Many eligibility tools will have guidance included within the manual regarding re-evaluation, so it would be important to check for this. If there is no specific guidance, the general rule is that it is best to wait at least six months to retest or until the child is in the next chronological age group – especially if using norm-referenced charts to obtain standard scores. It is also not advised to re-evaluate a child before the initial scores achieved on the test would represent a 25% or greater delay. If the child has not regressed in skills, you might want to anticipate whether current skills would reach the threshold of delay before proceeding with a re-evaluation. As always, decisions about evaluation should be discussed within your team – which includes the parent services.

The “Child Enrollment status regarding Birth to 3 Program” form (F-00316) is no longer in use. This form was used previously as a way to document the fact and reason that a child will NOT be receiving one or more services from the Birth to 3 Program. The November 2021 ForwardHealth Update (2021-39), titled “Policy Changes and Clarifications for Occupational Therapy, Physical Therapy, and Speech and Language Pathology” indicat​es that​ providers are no longer required to provide the Individualized Family Service Plan or the Child Enrollment Status Regarding Birth to 3 Program form, F-00316 (03/2017), on the ​prior authorization ​request for children age​s​ 0–3 years​. ​​But ​an outside program may decide to use the form as a method of confirmation that the child has been referred to the Birth to 3 Program​.

In practice, that 45 day timeline is a challenge. However, combining all of these tasks in one visit wouldn’t be considered best practice. They are best done when split into 2+ visits.

A few things to consider:

  1. All of these tasks have specific requirements and procedural safeguards to uphold child and family rights (to review these requirements, visit the Birth to 3 Program Operations Guide). It would be extremely difficult to honor each of these, as intended with everything happening at once.
  2. Each of these tasks can be mentally difficult for families. If they are combined, that is magnified. We would like the first experiences with our program to be as positive as we can.
  3. Before the IFSP can be completed, the child and family assessments plus the record review need to be completed.

If possible, we would suggest attending a PD Community of Practice to ask your peers for ideas regarding how different programs successfully schedule these tasks.

There is not a current state document that outlines separate core values of the WI Birth to 3 Program. However, The Wisconsin Birth to 3 Program Guiding Principles outlines what we believe to be important as we make decisions and serve the families in our program.

  • Children’s optimal development depends on their being viewed first as children and second as children with a problem or disability.
  • Children’s greatest resource is their family.
    Parents are partners in any activity that serves their children.
  • Just as children are best supported within the context of family, the family is best supported within the context of the community.
  • Professionals are most effective when they can work as a team member with parents and others.
  • Collaboration is the best way to provide comprehensive services.
  • Early intervention enhances the development of children.

County Birth to 3 Programs are able to modify parental cost share for families. If the county has determined that a family does have a parental cost share, the parental cost share system does allow for a modification per Wis. Admin. Code § DHS 90.06(2)(i)(4), which states that counties are responsible for informing parents of their right to request a waiver of the parental cost share in part or in whole if the request is based on unique circumstances of the child or family. A family may request a modification to their parental cost share if their “ability to pay” is different.

The process of modifying or waiving a family’s parental cost share is a county process. It usually involves a form and input from or sign-off by fiscal staff or leadership in the county. Each county’s Birth to 3 Program should have a policy and procedure in place for how a family can request a modification and the equitable process of approval/denial of requests.

An initial evaluation is completed with the child and family to determine eligibility for the Wisconsin Birth to 3 Program (based on either a 25% delay or atypical development). This means that a child/family is eligible for the Birth to 3 Program and NOT an individual service/ discipline within the program. So, an additional discipline-specific evaluation is not needed to add a service to the IFSP. Please note, insurance companies may require specific documentation in order to reimburse that service.

UPDATED RESPONSE: Based on the regulations for service coordination services, a family should not only participate in service coordination. According to IDEA Part C federal regulation 303.34(b), service coordinators are responsible for assisting families in obtaining access to needed early intervention services identified on the IFSP and coordinating, facilitating, and monitoring the delivery of services.

It would be highly unlikely that any child’s IFSP would list only service coordination. One example would be a child referred to the Birth to 3 Program within 45 days of turning three and the family only wants support with transitioning to the LEA. Services on the IFSP are a team decision. In all instances the full team would be offered to the family (even if the SC is helping with transition for a child referred within 90 days of turning three).

Even if the “primary coach” is the service coordinator, the child would still be offered the full team (for team meetings) to support the service coordinator when only service coordination might be appropriate. The team may also recommend other team members (not the SC) to do ongoing assessment with the child and family and how often. The team would be used to rate the child at entry and at exit for the child outcomes rating process.

In these cases, the Birth to 3 Program does not choose sides, programs typically inform the parents that they (the parents) need to determine how to proceed and then let the Birth to 3 Program know. That may mean the parents go back to mediation or to a court for judgment to determine who can legally make the determination for services. However, only one parent’s signature is required for consent. Services would be provided with the signing parent. Please see the Part C Regulations § 303.7  for more information.

When a child transfers to another county the exit ratings from the previous county get pulled over and become the entry ratings for the new county. This occurs once the new program has added a file for the child by using the “Search” function in PPS  (by searching for the child using the first and last initials and date of birth) and clicking the “Add” button.

According to the Approved Tool List, the top recommended comprehensive tools for ongoing assessment are the Portage Guide -3 (PG3), Assessment, Evaluation and Programming System (AEPS3) and the Hawaii Early Learning Profile (HELP). It is recommended that one of these be used for overall tracking of skills and age anchoring. That said, a team may decide that supplemental tools could add to this information gathering. Your team might want to consider whether or not administering and scoring supplemental tools is useful (and honestly – worth the extra time). Please reference The Child Assessment Tip Sheet – we think it will be the basis of a good team conversation and might give you some things to think about together.

RESource shared the IDEA 303.13 section that discusses the responsibilities of Early Interventionists in regard to assistive technology. We discussed issues that providers should consider prior to bringing in adaptive equipment such as whether the family already has something that might work to support the child, and if the equipment can effectively be incorporated into family routines. We referenced Key Principle 1 and the ECTA document that outlines what services in natural environments look like and does not look like in practice. There is also a tip sheet in development to further support this topic in the future.

More Resources

EIWI Quick Selections

Transition

Supporting smooth, seamless transitions for children and families in the Birth to 3 Program.
EIWI Quick Selections

Service Coordination

Helpful resources for Service Coordinators as they support children and families in the Birth to 3 Program.
EIWI Quick Selections

OSEP Child Outcomes

Understanding the three global child outcomes adopted by the Office of Special Education Programs (OSEP)

Can the Birth to 3 Program provide the LEA with an estimate of the number of kids that will transition to the school district?

Summer 2022 Update

OUR FIRST AVAILABLE PD OPPORTUNITIES

This summer has been filled with so much planning and organizing. Here are the first offerings to look forward to:

– PD Leadership Forums will be held on October 11th and October 17th. Leaders should have received a save the date email recently. We look forward to infusing our new PD system with our leaders’ voices.

– 3 asynchronous PD offerings are now available on our RESource website – Orientation, the Coaching Book Study and the Teaming Book Study. We hope that you find them helpful!

Mother kissing baby
Mother kissing baby

Winter 2022-2023

The following recap is devoted to sharing the answers that people received in response to their requests for PD/support. While some questions are very specific and not of interest to everyone, we believe that the questions/answers shared here are important for everyone to know. As always, we want to be sure that everyone has access to the same information.