Setting the Stage for Change Drafting Maines State Plan for - PowerPoint PPT Presentation

Setting the Stage for Change Drafting Maine’s State Plan for Individuals with ASD Nancy Cronin, MA ASD Systems Change Initiative Coordinator

ASD Interagency Systems Change Initiative Public and private collaboration since 2006, involving: • DHHS Division of Early Childhood • Parents • Child Developmental Services • Department of Education • • Psychologists Speech and Occupational • Therapists Developmental Evaluation Clinics • • Center for Community Inclusion Medical Professionals and Disabilities Studies • Early Childhood Educators • Developmental Disabilities • Child Care Providers Council • Office of MaineCare Services • State Office of Information • Children with Special Health Technology Needs • Over 200 individuals with PDD, • Autism Society of Maine family members, and • DHHS Children’s Behavioral Health professionals as commenter's Services • Disability Rights Center Maine Developmental Disabilities Council

ASD Systems Change Initiative Process for Change • Value Stream Mapping • Report Drafted and Approved by Stakeholder Group • Request and Compile Public Comments • Advisory Committee Recommendation on Action Steps • Administration Approval of Action Steps/Plan Maine Developmental Disabilities Council

Value Stream Mapping 4 Full Days • Family Group – Current State • Stakeholder Group (includes a smaller group of families) – Current State – Future State – Implementation Plan • Report drafted, vetted, and finally approved by stakeholder group and all families Maine Developmental Disabilities Council

How do people with ASD utilize the multiple systems of care? Maine Developmental Disabilities Council

Maine Developmental Disabilities Council

Overview of the service systems involved in a early intervention for children with PDD Department of Education Child Developmental Services (CDS) DEC Parent Clinic 4 Pediatrician 2 3 1 Children's Behavioral Health Children's Behavioral Services/ Early Childhood Division Health Services Parent Referral Represents Problem Areas identified by PDD System of Care Group Maine Developmental Disabilities Council

Overview of the service systems involved in Transition a Services for Youth with PDD Continuing Individual / Self Education Referral No Long Term Supports Vocational Rehabilitation Mental Long Health Term Substance Abuse Transition Supports Correction Department of Education Planning < >2SD Homelessness Eligible T 2SD Crisis DHHS/D S > 2SD Adult Protection Developmental Services Waiver Eligible but Slot Limited > 2SD Children's Behavioral Health Services T < 2SD Mental Parent Referral Health Substance Abuse Represents Problem Areas identified by PDD System of Care Group Correction Homelessness Crisis Maine Developmental Disabilities Council

DRILL DOWN • Early Identification Value Stream Mapping PDD/Autism Current Experience of the Process Develop Parent Developmental / Developmental Speech Occupational mental Diagnostician Birth Behavioral We Worry We Beg Domain Report Therapist Therapist Therapy Observation Report Concerns Wait and See – Eligibility Report Report Report Meetings Meetings Meetings Meetings Meeting s 1m 1m Physician 1 Year Doctor Doctor 3 Months 1 Month 1 Month 1 Month 3 Months Diagnostician 1 Year 1 Year Referral to Diagnostician 3 Months Some Developmental Delay CDS Eligibility Multi-Disciplinary Referral to CDS IFSP/IEP Assessment Evaluation 3w Speech Therapy 3w Speech Therapy 3w Physical Therapy 3w Speech Therapy Therapies 3w Medical Specialist Occupational 3w Therapy 3w Audiologist Developmental 3w Therapy Slow Weight Gain Tubes Slow Weight Gain Food Issues Food Issues Food Issues Medical Issues GI Problems GI Problems GI Problems MULTIPLE MULTIPLE SPECIALIST SPECIALIST VISITS VISITS Seizures Seizures Seizures Medications Medications Medications Diagnosis/Rule Birth = Wait Time = Decision Point = Wait Time = Decision Point Out Maine Developmental Disabilities Council

Family Experience • Their Doctor saying “Wait and See” • Delays • Some children have medical symptoms such as GI Issues, Seizures, Dietary Issues • CDS System The family stories document that obtaining a diagnosis takes an average of 31 months. Maine Developmental Disabilities Council

Stakeholder Experience of Current System Entity/ Current State Function Bookend Bookend Behavior concrn Diagnosis or Rule out Gathering Family, Data caregivers, etc 1d 1,826 CT B W A 240m 600 420 ST Professional Formal Evaluation(s) PCP Referral PCP Parental Screening Consultation Screening Processing with PCP 120 30d 240d 540d 1d 365d d 15d 15d 15d 480m 960 720 20 20m 20 60m 60m 60m CDS CDS Screening 7d 21d 9.5d 60m 180 120 0-3 Eligibility 0-3 years determination 16d 16d 16d 60 60 60 3-5 Domain 3-5 years Specific Eligibility determination 21d 38.5d 56d 240m 240 240 Maine Developmental Disabilities Council

Workgroup Future System Entity/ Future State Function Bookend Bookend Diagnosis or Rule out Behavior concrn Family, caregivers, etc 1 2 Universal 3 Screening at PCP Referral Evaluation(s) PCP Well Child Visit 0-3yr 2 wks – 3 Months CDS CDS / Services Maine Developmental Disabilities Council

Putting Plans into Action Early Identification Achievements (as of 2010) In Progress Developed Universal Writing policy to ensure clear Screening Protocol and consistent evaluation and diagnosis Tested protocol - Six Field Pilots, with over 3,500 Training physicians not to children screened “wait -and- see” Included screening tools in Streamlining the Referral MaineCare well-child check Process forms Maine Developmental Disabilities Council

Rinse and Repeat • Value Stream Mapping – Early Intervention – Transition • Recommendation Formalized • Agency leads approve various action tasks (Formal Approval of State Plan) • Implement what you can and apply for grants to continue the work Maine Developmental Disabilities Council

For more information Contact: Nancy Cronin Maine Developmental Disabilities Council 1-800-244-3990 nancy.e.cronin@maine.gov