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Service Coordination

First Steps is Indiana's early intervention system, serving children ages birth through two years of age experiencing developmental delays or disabilities and their families.

Service Coordination is the only service in IDEA, Part C that is required for every eligible child.  In general terms, service coordination refers to those activities carried out by the service coordinator to assist and enable an eligible child and the child’s family to receive the procedural safeguards, evaluation and assessment and services that are authorized to be provided under Indiana’s First Steps Early Intervention System.

There are two types of service coordination available to children and families in the First Steps System: intake coordination and ongoing service coordination.  

The intake coordinator is responsible for all service coordination activities from the point of referral through the development of an initial Individualized Family Service Plan (IFSP).  For children referred at 34 months of age or older, the intake coordinator is responsible for supporting transition for that child by contacting the local education agency and facilitating the family’s awareness of resources that are available after the child turns three.

The ongoing service coordinator is responsible for coordinating the implementation of the IFSP and subsequent reevaluations and assessments. The ongoing service coordinator is responsible for coordinating all services listed on the IFSP and is the single point of contact for obtaining services and resources that may be needed by the eligible child and family. System Points of Entry (SPOEs) have the discretion to adapt the service coordination roles and responsibilities to meet the needs of their cluster. SPOEs may maintain separate intake and ongoing service coordination or utilize one person in a combined role.

SPOEs may not allow the service coordinator to provide any direct early intervention services since that would be a conflict of interest given that one of the roles of the service coordinator is to monitor the provision of early intervention services. SPOEs must do everything possible to provide families with choices regarding their service coordinator and to accommodate requests for service coordination changes when they are made.

High quality service coordination is vital to the health of the First Steps system. Research has shown that if service coordination is high quality, families are more likely to experience outcomes such as being able to: communicate their child’s needs, make informed decisions about services, participate in services that are coordinated and individualized, and experience enhanced health and development for their child (Bruder, 2010).

One of the most important things service coordinators do is facilitate the development of a meaningful IFSP document. The Individualized Family Service Plan (IFSP) is a standardized document for Indiana that reflects the families' concerns, priorities and resources with regard to the development of their infant or toddler.  All children enrolled in the First Steps System have an IFSP that reflects the outcomes and services to be addressed within the system.  Families are full partners in the planning, development, implementation and review of their IFSP.  An initial IFSP is written with the family, service coordinator and input from the Assessment Team (AT).  The IFSP is reviewed at a minimum every six months. Annually the service coordinator works with the family and team to develop a new IFSP.

The IFSP represents a commitment to each eligible child and family that:

  • their unique, individual needs will be considered and addressed;
  • an individualized plan of action will be developed to meet these needs;
  • the family will be a full partner in the initial development and ongoing evolution of the IFSP;
  • appropriate levels of early intervention services will be provided;
  • families will have choices about who will provide these services;
  • early intervention services will be provided in natural environments in which young children without delays/disabilities are participating;
  • the family’s rights and procedural safeguards will always be protected.

STATE REQUIREMENTS BEST PRACTICE RECOMMENDATIONS
  • The service coordinator provides accurate information about First Steps services, state and federal laws, and procedures.
  • The service coordinator shares information about the First Steps philosophy, including topics such as family focus, natural environment, and team approaches to therapy.
  • The service coordinator shares accurate information about community resources and information related to family support.
  • The service coordinator shares the IFSP document with families prior to the IFSP meeting to allow them a chance to become familiar with the content and prepare any questions/contributions.
  • If the child is not eligible, the service coordinator provides the family with alternative resources identified as potentially useful by the family.

  • The service coordinator uses a coaching model to engage families regarding their concerns and provides them with the knowledge and skills to find information on their own in the future; and never simply hands parents a list of resources. For example, families should be given the opportunity to speak first at IFSP meetings in a non-threatening way (e.g., “What has been happening with ___ since the last time we met?” “How are things going?” “What new priorities/concerns do you have?”)
  • If a child is eligible for services but the family does not consent to the provision of services, the service coordinator informs the families of rights, information about following up at a later time, and possible consequences of their decision.
  • The service coordinator should accept and support all family decisions without conveying any judgment.
Research has shown that families have better outcomes when the service coordinator engages in more family help-giving behaviors. These include relational behaviors (e.g., listening, empathy) and also participatory behaviors such as involving family members in decision-making and helping them develop new capabilities (Bruder & Dunst, 2008).

Division for Early Childhood (DEC) Recommended Practices (2014):
  • F1: Practitioners build trusting and respectful partnerships with the family through interactions that are sensitive and responsive to cultural, linguistic, and socioeconomic diversity.
  • F2: Practitioners provide the family with up-to-date, comprehensive, and unbiased information in a way that the family can understand and use to make informed choices and decisions.
  • F3: Practitioners are responsive to the family’s concerns, priorities, and changing life circumstances.
  • F5: Practitioners support family functioning, promote family confidence and competence, and strengthen family-child relationships by acting in ways that recognize and build on family strengths and capacities.
  • F10: Practitioners inform families about leadership and advocacy skill-building opportunities and encourage those who are interested to participate.
  • TC4: Team members assist each other to discover and access community-based services and other informal and formal resources to meet family-identified child and family needs.
STATE REQUIREMENTS BEST PRACTICE RECOMMENDATIONS
  • The service coordinator must facilitate the development of an initial IFSP within 45 days of a child’s referral.
  • The service coordinator should collaborate with the Assessment Team scheduler to ensure that assessment activities occur in a timely manner and that all meetings are conducted at a convenient time and in a place that is familiar to the child.
  • The service coordinator must facilitate the start of new services within 30 days of parent signature on the IFSP. The Service coordinator will provide IFSP information to the SPOE within two working days so that authorizations for services can be processed.
  • The service coordinator should plan to check in with the family and the provider prior to the 30 day start date to confirm that services have begun. Similarly, the service coordinator should follow-up with the physician as needed prior to services beginning.
  • The service coordinator is required to make contact with parents at least once per quarter to ensure that the child and family are receiving the specified services by the specified providers and that the family is satisfied with the services it is receiving.
  • The service coordinator should ask open-ended questions to solicit information about the quality of services such as the progress of the child, any new concerns and priorities the family may have, and what the therapist has taught them in working with their child during daily routines.

Research suggests that service coordinators who have more frequent contact with families (weekly/monthly) engage in more of the desirable service coordination outcomes than service coordinators who see families less frequently (2-6 months) (Dunst & Bruder, 2006)

STATE REQUIREMENTS BEST PRACTICE RECOMMENDATIONS
  • The service coordinator is responsible for arranging appropriate evaluation and assessment activities annually and as needed to meet the changing developmental needs of the child.
  • In order to arrange the most appropriate evaluation and assessment activities, the service coordinator should maintain a high level of high quality communication with both the family and other team members.
  • The service coordinator in conjunction with the Assessment Team, must complete a family-directed assessment based partly on an interview with participating family members which includes a description of resources, priorities and concerns related to the child's development.
  • The service coordinator should build a rapport that allows the family to honestly share concerns and priorities. To this end, the service coordinator should complete an in-depth family assessment (e.g., routines-based interview) that covers family routines, daily activities, things the family enjoys and things that are challenging due to the child’s delay(s).
  •  The service coordinator must inform families of all relevant procedural safeguards and obtain written parental consent and releases to conduct and determine eligibility.
  •  The service coordinator should confirm that families understand by asking, “Is there anything I could explain better?” rather than asking, “Do you understand?” The service coordinator should confirm that families know what they are signing and how the information will be used.
  •  The service coordinator will work with the Assessment Team scheduler in scheduling the assessment with the family.
  •  The service coordinator should determine with the family what is needed to support parental participation in assessment and planning. The service coordinator will share with the scheduler information about the family to ensure meetings are held at times and locations that are convenient and comfortable for the family.
Research and Resources:
  • The service coordinator must ensure that a collaborative team process occurs before (planning), during (process), and after (reporting) an assessment.” (Bruder, 2010, pg 98)
  • To gather the needed information, service coordinators must use help-giving practices such as: “treating the family with respect, being culturally and socioeconomically sensitive to family diversity, to provide choices to families in relation to their priorities and concerns, to disclose information to families so they can make decisions, and to employ communication strategies to empower and enhance confidence” Bruder (2010)
Division of Early Childhood (DEC) Recommended Practices (2014):
  • A2. Practitioners work as a team with the family and other professionals to gather assessment information.
  • A7. Practitioners obtain information about the child’s skills in daily activities, routines, and environments such as home, center, and community.
STATE REQUIREMENTS
BEST PRACTICE RECOMMENDATIONS
  • The IFSP must be reviewed at a minimum every six months and must be re-written annually once eligibility has been re-established.

  • The service coordinator will begin this process at least 45-60 days prior to the termination date of the current IFSP so that there is no gap in service.
  • The service coordinator must work with the IFSP team, which includes the family, to create outcomes that reflect the family’s concerns and priorities.
  • Part of developing an IFSP is writing high quality outcomes. These outcomes should be functional, relevant to the child’s real world, jargon-free, and discipline-free.
  • The service coordinator will read the assessment team report (and provider reports if available) and seek clarification if needed.

  • The service coordinator should combine the information gathered from the assessment report (and provider reports if available) with information about the family’s routines and priorities to create outcomes that are developmentally sound and important to the family (i.e., high quality outcomes).
  • The service coordinator must ensure that the IFSP meeting has representation from a parent, an Assessment Team member, and any appropriate on-going providers.
  • The service coordinator arranges for ongoing providers and Assessment Team members to participate in the IFSP meeting via conference call and/or web-based meeting technology.
Division of Early Childhood (DEC) Recommended Practices (2014):
  • F4: Practitioners and the family work together to create outcomes or goals, develop individualized plans, and implement practices that address the family’s priorities and concerns and the child’s strengths and needs.
  • INS2: Practitioners, with the family, identify skills to target for instruction that help a child become adaptive, competent, socially connected, and engaged and that promote learning in natural and inclusive environments.
  • INS3: Practitioners gather and use data to inform decisions about individualized instruction.

STATE REQUIREMENTS BEST PRACTICE RECOMMENDATIONS
  • The service coordinator is required to make contact with parents at least once per quarter to ensure that the child and family are receiving the specified services by the specified providers and that the family is satisfied with the services it is receiving. Regular contact allows the Service Coordinator to obtain updated information and be aware of any changes to the IFSP that may need to occur.
  • The service coordinator should ask open-ended question to solicit information about the quality of service such as the progress of the child, any new concerns or priorities families may have, and what the therapist has taught them in working with their child during daily routines.
  • The service coordinator is responsible for collecting and sharing the quarterly provider report with families.
  • The service coordinator should follow-up with families after sharing a quarterly provider report to ensure that the family received the report, to ask if the family has talked with the provider(s) about the report, and to encourage the family to ask questions or express concerns to the provider(s).
  • The service coordinator must communicate with the IFSP team any time an IFSP review is needed to modify or change a strategy/activity/service.

  • The service coordinator should have on-going communication with providers, families, and the physician so that they are aware when changes are needed and can make modifications to the IFSP in a timely manner.
  • The service coordinator must assist the family with coordinating all early intervention services, including services outside of First Steps to ensure seamless intervention without needless duplication.   
  • The service coordinator should take into account other services outside of First Steps (DCS, Healthy Families, Early Head Start, childcare, physicians) that the child/family may be receiving and work to integrate all services and facilitate open communication (with consent) between First Steps providers and other agencies.

Research suggests that, in order to work effectively with the entire IFSP team, the service coordinator needs to be positive and proactive in his/her interactions with families. S/he also needs to work collaboratively across disciplines and have good communication/problem-solving/conflict resolution/negotiation skills. (Park & Turnbull, 2003; Bruder & Dunst, 2008).

Research also emphasizes “family-centeredness” such as respecting cultural and socioeconomic differences, identifying and building on family strengths, seeking family input repeatedly throughout the process, and ensuring that the full range of family needs and priorities are being addressed. The service coordinator should be thinking about how s/he can help the family to strengthen their own interpersonal skills so that they can advocate for their child more directly and effectively (Park & Turnbull, 2003).

One of the most important skills the service coordinator can have is the willingness to be collaborative and open. Bruder (2010) suggests that the service coordinator should prepare the team for IFSP meetings by providing questions or issues to consider beforehand; this can facilitate team discussions. Changes should never be made in isolation without the input of the IFSP team, which includes the family.

Division for Early Childhood (DEC) Recommended Practices (2014):
TC2: Practitioners and families work together as a team to systematically and regularly exchange expertise, knowledge, and information to build team capacity and jointly solve problems, plan, and implement interventions.

First Steps State Administration:
Bureau of Child Development Services
402 W. Washington Street W453, MS-51
Indianapolis, IN 46204-2739
FirstStepsWeb@fssa.in.gov
   
1-800-545-7763
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