Transcript Supporting Young Homeless Children with Developmental

Supporting Young Homeless
Children with Developmental
Delays: A Successful CrossSystem Model
July 10, 2007
The Partners
Philadelphia
Office of
Supportive Housing
(OSH)
Traveler’s Aid
Kirkbride Family
Shelter
Philadelphia Department
of Behavioral Health/
Mental Retardation Services
Infant/Toddler Early Intervention
Philadelphia Health
Management Corporation
(PHMC)
Homeless Programs
Philadelphia
Infant/Toddler
Early Intervention
Providers
RHD Woodstock
Family Shelter
Infant/Toddler Early Intervention
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Federal Program
Entitlement for Eligible Children
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Family Centered Approach to Service Delivery
Services Delivered in the Natural Environment
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Eligibility guidelines may vary from state to state
Services embedded in family’s typical routines and
activities and delivered in the home and community
‘Child Find’ activities are federally mandated
Preschool Early Intervention
Homelessness in Philadelphia
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City’s Office of Supportive Housing (OSH) is
central point of entry for shelter system
Over 10,000 homeless children birth – 18
years of age
50+ shelters/transitional housing facilities with
women and children (40% of the population)
10% of those in shelters were aged 0 – 5 in FY
2005.
Planning Process
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Meetings with OSH
Meetings with EI service providers
Meetings with shelter directors
Meetings with shelter case managers
All partner meeting at each shelter
Resident community meetings
Regular review meetings
The Foundation of Good Collaboration is Great
Communication (start-up and ongoing)
Meetings, Meetings, Meetings, Meetings, Meetings!
Program Overview
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Shelter/EI Children’s Specialist administers the ASQ
(Ages and Stages Questionnaire)
Findings are shared with the families and all families
are offered a multi-disciplinary evaluation for their child
Those who give approval for an evaluation are
scheduled for a MDE
Those who prefer not to be referred are added to the
‘at-risk’ tracking and monitoring program
Program Overview (cont’d)
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The shelter service coordinator arranges a MDE
appointment to occur in the shelter’s bright space.
MDE slots are set aside for the shelter program
IF the child is eligible, the Individual Family Service
Plan (IFSP) is written at the MDE
Family is offered a choice of service providers, if no
preference, Child services are picked up by the
agency serving the families in that shelter.
Services are delivered in the shelter and are
continued if the family leaves the shelter.
‘Child Find’:
Children at Risk for Delay
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State identifies vulnerable and underserved
populations at risk for developmental delay
Children who are Homeless
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These children are vulnerable and underserved because:
Limited resources
 Poorly educated parents
 Changing caregivers and changing homes and environments
 Developmental concerns low priority until child is school age
Other vulnerable (‘at-risk’) populations for Early Intervention are
children who were premature or had a stay in the NICU, children with
prenatal drug exposure, low birth weight babies and children with high
lead levels.
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Risk Factors Identified
Of 62 children assessed, these are the risk
factors identified
 Exposure to Violence
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Prenatal D/A Exposure
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4 children
No Prenatal Care
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4 children
2 children
Loss of Caregiver
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2 children
Role of EI Service Coordinator
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Every Family referred to early intervention is assigned
a service coordinator
Schedules an initial visit with family within 48 hours of
receiving referral completes a child and family
assessment questionnaire
Completes intake and registration, obtains information
and schedules Multidisciplinary Evaluation (MDE)
Obtains necessary consents
Arranges services for children who are eligible
Supports EI providers to connect/re-connect with
families who miss services
Role of the EI Providers
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Accept Referrals of children in Shelter and assign staff
to provide services to children found eligible
Work with families to learn interventions to support
their child’s development
Interface with shelter staff to establish a presence and
familiarity with shelter staff and families
Develop and conduct other developmentally
appropriate activities in the shelter to help families
learn more about EI and child development
Re-establish contact with family of eligible child if they
leave the shelter while the child is receiving early
intervention.
Role of Shelter Staff
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To identify all children birth – 2.10 months entering the
shelter
To ensure that all children birth to 2.10 months sees
PHMC’s Children’s Specialist no later than 30 days after
entering shelter
To provide copies of daily census to PHMC’s Children’s
Specialist
To develop and update service plan to include early
intervention services
To monitor,support and reinforce family’s participation in the
early intervention process
To coordinate discharge and transition of early intervention
services
Role of Shelter/EI Children’s
Specialist
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Attend Shelter Community Meetings and Shelter Case
management meetings
Check in with shelter staff to determine any changes in
census (new families or families that have left the
shelter)
Assess Talk with each family and complete a ‘Child
Find’ demographic form
Conduct a developmental assessment using the Ages
and Stages Questionnaire for each child 0 – 2.10
months of age entering the shelter
Role of Shelter/EI Children’s
Specialist (continued)
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Share findings of ASQ with family, identifying children
with concerns
Offer all parents the option of having their child
evaluated. (MDE:Multidisciplinary Evaluation)
Interface with shelter staff to establish a presence and
familiarity with shelter staff and families
Develop and conduct other developmentally
appropriate activities in the shelter to help families
learn more about EI and child development
Issues Identified During Assessment
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Behavior
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Communication/Speech
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2 children
Learning Disability
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9 children
Gross Motor
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4 children
2 children
Parent’s concern
(child above ASQ cut-off)
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12 children
12
10
8
6
4
2
0
Behavior
Gross
Motor
MDE reasons
Parent
Duration of Homelessness
2
2
13
18
14
13
< 1 month
1-3 months
3-6 months
6-9 months
9-12 months
12-24 months
Dedicated Staff Needed
Barriers
Shelter crisis driven,
population in transition
One phone for resident’s use
Adult focused system
Solutions
CS receives daily census
CS meets with each parent in
person to complete ASQ and
demographic form
EI family centered system
Difficulty making, rescheduling
appointments
CS schedules apps. for parents
Space is limited
CS schedules Bright Spaces for
Med's and ongoing EI
services
Benefits to the model
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Vulnerable children are identified and served
Cross systems collaborations closes the gaps in
service delivery
Provides an opportunity to teach parents about
importance of child development ( thru the MDE, the
provision of early intervention services and EI
sponsored parenting groups)
Relationships/Services with early intervention
established while in the shelter (designated service
coordinator, designated service providers-challenges)
Services established in the shelter more likely to
follow the child
Funding
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Foundation Grants aimed at homeless families
with young children
Local Office of Shelter Services
Early Intervention Child Find Money
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Screening vs. Evaluation