EarlySteps

Early Intervention provides supports and services to families with infants and toddlers from birth to three years who have a medical condition likely to result in a developmental delay or who have developmental delays. The name of the Louisiana early intervention system is EarlySteps.  EarlySteps is a federal program called the Individuals with Disabilities Education Improvement Act (IDEA) Part C. EarlySteps is managed under the Office for Citizens with Developmental Disabilities in the Department of Health.

The intent of early intervention is to build upon the natural routines and supports of families and children within their communities and to support families in meeting the health and developmental needs of their child by integrating services into the naturally occurring activities and routines of the family which promote the generalization of skills for the purpose of Early Intervention is to:

• Enhance the development of infants and toddlers with disabilities
• Minimize a child’s potential for developmental delay
• Minimize a child’s need for special education after they reach school age
• Enhance the capacity of families to meet the special needs of their infants and toddlers with disabilities.

The program is designed to recognize that significant brain development occurs during a child’s first 3 years of life. EarlySteps strives to support families in their knowledge of their child’s developmental needs.

The EarlySteps system is designed to support families regarding their child’s development through:

• Assisting families in helping their child develop and learn
• Assisting families in understanding their rights in EarlySteps
• Assisting families in communicating their child’s specific needs
• Determining a family’s concerns, priorities, and resources regarding their child’s special needs

The following services are provided by EarlySteps: Audiology, Speech-Language (including sign language and cued language services), Occupational Therapy, Physical Therapy, Special Instruction, Assistive Technology, Support Coordination, Medical Services, Health Services, Nursing Services, Vision services, Social Work Services, Psychological Services, Family Training, Nutrition Services, and Transportation.

The process simply starts with a referral to EarlySteps. Once your child is referred, we will conduct developmental screening with you to see if further evaluation is necessary. If so, then health and developmental information will be collected about your child and an evaluation will be conducted with you and your child. The results of all the information collected and the evaluation are reviewed by the team, including you. Eligibility determination is a team decision based on all the information collected and the assessment(s) reviewed by the team.

If your child is eligible for services, the intake coordinator will complete the Concerns, Priorities, and Resources (CPR) assessment and you will select a Family Services Coordinator from the service matrix. Then, an Individualized Family Service Plan will be developed by the IFSP team, including you, based on the multidisciplinary evaluation and the assessment of your child and your CPR. Based on the outcomes identified on the IFSP, you will select providers from the service matrix. The IFSP will be developed within 45 days of the referral to EarlySteps and services will start within 30 days of the development of the IFSP. The FSC working with you is responsible for making sure that the IFSP is implemented as written. She is your first contact for questions and issues once the plan is developed.

The CPR is your opportunity to identify your strengths and needs regarding your child so that EarlySteps can assist you regarding your child’s development. Using this process, your team can assist you in identifying outcomes that will best meet your needs within the routines important for your child and family.

If a child is determined ineligible for EarlySteps, but is enrolled in Medicaid or has private insurance, the intake coordinator or Family Support Coordinator will give you information regarding services that your child may be eligible to receive. You should discuss these options with your child’s doctor as well since referrals may be required. The intake coordinator will make other appropriate community referrals, provide additional developmental screening information, and give you your rights regarding the eligibility decision. If you do not agree with the eligibility team’s decision, you should discuss options with the SPOE intake coordinator or file a complaint.

Through IDEA, families are given guarantees and rights to protect their interests and those of your child. These rights include:

• Written, prior notice in your native language or preferred mode of communication
• Your written consent for evaluation and services
• Confidentiality of information
• Your right to examine records
• A process to resolve disputes
• Your child also has the right to have a surrogate parent assigned in the event he is not represented by a parent or guardian

There are also additional safeguards in place for your child and family that can be found in Chapter 2 of the EarlySteps practice manual.  In addition, you receive the Family Rights Handbook each time an IFSP is reviewed, updated or changed.

You can always start with your EarlySteps Intake Coordinator or FSC. They can assist you in resolving problems with services or with a violation of your rights. If you wish to pursue the issue you can call your regional coordinator and file a complaint. The regional coordinator will review information about your problem, investigate the problem and offer a solution. You will receive a written decision regarding your complaint. You can also file an appeal of this decision. The Family Rights Handbook explains these processes in more detail.

In order for you to receive the maximum benefits from early intervention, it is important for you to fully participate. You are the person who best knows the needs of your child and family. You are your child’s best advocate throughout his life. We ask that you communicate with early intervention staff about your concerns and priorities and let them know honestly what is working for you (and what may not be). By participating as a team member, you can maximize your child’s development and meet your family’s needs regarding your child. We ask that you please notify your FSC and providers when there is a change in address or phone number; accept phone calls from your FSC, and return calls to providers as soon as possible; work as a team member and follow through with activities, strategies and techniques; notify providers if you are unable to keep scheduled appointments and allow for time to reschedule appointments.

Your Intake Service Coordinator or Family Service Coordinator is the single point of contact responsible for helping you obtain the services and supports that you need. They can also provide other contact information based on your specific request.

Beginning in October 2013, EarlySteps has a cost participation component for families to help support the program. This means that families may be charged a portion of the cost for some services based on their income. Families will be asked to provide income information to determine their payment amount if any. Each month you will receive an Explanation of Benefits which details the services provided and any charges to your family. You will mail in the attached invoice to pay your portion of the service costs. Please contact the intake coordinator or FSC for more information about cost participation. All of the funds collected from families go back to EarlySteps to support program costs.

An EOB is a detailed description of the services that were billed by and paid to your EarlySteps providers; EarlySteps providers have up to 60 days to bill from the date a service is rendered. Therefore, the date of service and the actual day the provider billed for the service could reflect a difference of up to 60 days resulting in a delay between the service dates and the EOB charges that are shown in each monthly statement. The EOB will also show the eligibility evaluation and other services that were billed for your child, even if he was not found eligible for EarlySteps. Some services shown on the EOB will have no costs to you: evaluations, FSC services, IFSP team meetings, etc. Families are responsible for paying their portion of the costs even after exiting EarlySteps until the full balance is paid.

The EOB lists key information such as the name of the provider, the actual date you received the service, the amount paid to your provider and any charges you may be responsible for. You will use the statement to submit your payments to the central finance office. This information is also important because you can verify whether or not these services are occurring for your child as determined on the IFSP. You should save the EOBs as verification of your charges and many families use the EOB as verification of payments for reimbursement from their Health Savings Accounts at the end of the year.

In early intervention, we know as you do, that each child develops at his own pace, but we also know that there are certain developmental milestones that most children reach which are measures of social and emotional progress. Screening is used to help to identify children who are at risk for autism. Screening does not provide a diagnosis, but rather determines if there is a need for the further diagnostic evaluation of the child. If a child is diagnosed as having autism, the Family Service Coordinator and the other team members will assist you in finding the necessary supports and services.

The Family Survey is used to ask each family about their participation in the early intervention system. The survey will capture information in areas such as the system’s efforts to create meaningful partnerships with you, the services which were provided, and the ways in which you were involved in the early intervention process. The ultimate goal of the survey is to improve services to families regarding their child’s development, to assist you in understanding your rights in the system, and to effectively communicate your child’s needs.

Transition discussions with you begin at the initial IFSP and are addressed throughout your child’s time in EarlySteps. Between your child’s ages of 2 years, 3 months and 2 years 9 months of age, your EarlySteps Family Support Coordinator will convene an IFSP meeting to discuss the transition process with you and other team members in order to develop a “transition plan.” This meeting is called the Transition Conference. The transition plan will identify options for your child and family after your child’s third birthday including preschool, private preschool, child care, Head Start, Early Head Start Developmental Disabilities services, and Local Education Agency special education services, or other community early childhood programs. The Transition Plan will include the steps and services your child and family will need to obtain information, review options, and visit programs and make decisions about the appropriate program for your child.

If your child is already three years old and appears to be at risk in overall development in one or more of the following areas: cognitive skills, communication, motor, sensory (vision, hearing) or social-emotional skills, contact your Local School Board or your local Child Search Coordinator to be screened and possibly evaluated to see if your child is eligible for special education and related services. You may also contact your regional Human Services Authority or District office to apply for developmental disabilities services. This office will conduct an eligibility assessment to determine eligibility for system entry. If your child is found eligible, a broad range of services and supports may be offered to you and your family. The SPOE intake coordinator can give your contact information for each regional office or you can find it at: http://new.dhh.louisiana.gov/index.cfm/page/134/n/137.