EIC July 2016 Meeting Minutes

Council Meeting Minutes Meeting Wyoming Early Date July 14 & 15 , 2016 Intervention Council Chair/Facilitator Danielle Marks Time 1:00 PM – 5:00 & 8:30 - noon Location Casper, WY Scribe Nick Whynott Members Last First From Represents In Attendance Big Horn Bullinger Christine Parent Rep. County

Wyoming Child & Kugler Mary Head Start Agency Family

Danielle WY Department of Marks Women and Infant Health Health Pepper Art Tribal Pepper Tonya Therapy Representative

Paul Birgitt Laramie County Parent Rep.

Campbell Rising Holly Service Provider County

WY Department Escobedo Kathy Early Intervention of Health Services Teton and Hough Davey Service Provider Sublette County

Lausche Julia UW WIND Personal Prep Program

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes WY Department Special Education Hermanutz Kirsten of Ed. Preschool Services

WY Insurance Staniforth Jonathan Laramie County Department

WY Department of Pena Shawna Children’s Mental Health

Larson Lloyd Fremont County Legislative Members Absent Hayes Kenya Wyoming Department of Homeless Children Ed

Gamble Wendy Converse County Service Provider

Bush James WY Department of Medicaid Health

Bock Kim Weston/Crook County Service Provider

Ward Dana Foster Care

Guests DeMers Christine WY Department of Early Intervention and Health Education Program (EIEP) Whynott Nick WY Department of Early Intervention and Health Education Program (EIEP) Discussion Items

July 14, 2016

The meeting was called to order at 1:03 p.m. by Danielle Marks, WY EIC Chair. Members present and on the phone introduce themselves. Danielle reads the expected activities in the charter. Danielle reads the expected results and measures of success.

Christine Bullinger makes the point that the charter specifically addresses advising 3-5. Danielle asks if there is a

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes separate council that specifically addresses the 3-5 year old populations. Danielle reminds the council that we used to have a shared meeting with the WAPSD group. Is this something that we would like to continue? Members in the room agree this is something that the council would like to do again.

Danielle asks Kathy Escobedo to bring this possibility up with WAPSD. Christine D. mentions that the charter specifies meeting in person quarterly. Holly and Jonathan agree that they like the ZOOM meeting. Julia agrees that it might be possible but that the logistics of the setup might be more difficult but not impossible.

The group agrees that consistent attendance is important so this is something the Council would like to pursue. Christine B. motions to strike “in person” from the charter. Kathy seconds. The council votes yes.

Approval of the Charter 1:18

Introductions of Guests and EIC Members

Kirsten Hermanutz- WDE is working on their last push for WAVE. August 1st-4th. Three days of national presenters. Discount for CDC staff and child care providers.

Mary Kugler- Some of our H.S. programs has received a partnership grant. Some H.S. has successfully received the TANF grant approval. The H.S. association is pursuing a home visit program in conjunction with UW. The program utilizes live video for coaching and safety. H.S. across the state is looking into that. Currently, Jackson has used it for a year as a pilot site. The program is called Improve Class. Also, looking at the cuts that some of our partner have received. We have lost our dental program. Mary again brings up Christine D.’s idea from the previous meeting about EIC members supporting each other,

Julia Lausche- The ECHO project has grown very quickly. It is a tele-based model using a case study to support providers through continuing education opportunities. There have been quite a few other topics that have been introduced in the Education realm. Currently there are talks of other potential ECHO opportunities in early education. Tomorrow Julia will give training on the Wyoming Vision collaborative. Recently they have been accepted into a national program to help improve based on the newest evidence based practices. Learn the Signs early identification program is a new initiative that is available through the Center for Disease Control out of Atlanta Georgia. Continuing the family mentor ship program for families of children with autism.

Christine Bullinger- Has some questions based on the state cuts in Deaf and Hard of Hearing. Half of the cuts came from the Deaf and Hard of hearing Outreach. Concerns for how that affects the CDC. Are the CDCs at a

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes point where they no longer need the Outreach. Kathy and Davey explain that the CDCs utilize the support of Hearing Outreach and the school district. Disappointed in how the Department of Education presented their responsibilities for Birth to 5.

Danielle asks how EHDI relates. Kathy explains that they collaborate but are different programs. Kirsten explains that while money was cut from the programs the individual consultants are still employed and may have the opportunity to continue that work. Danielle suggests that we make an effort to determine the impacts of the cuts. Representative Larson explains that as an advisory council has the ability to write a letter to the governor. Danielle asks Christine to research how the proposed cuts affect service to children ages birth through 5.

Davey Hough- The cuts are also affecting the CDC. Some to a great degree and some to a lesser degree. Davey is not sure what the recommendations if any of this council should be. Currently planning for the future is a very difficult thing. There are legal responsibilities that may be influenced as a result of the cuts. Christine B. asks where the cuts will affect. Davey explains that they are not sure right now.

Holly Rising- Explains that the budget cuts are affecting them from the State funds and their county funds.

Jonathan Staniforth- No updates.

Shawna Pena- Rural and Frontier Health Unit. Community services block grant supports a few CDCs and some of the Head Start programs.

Danielle Marks- The MCH unit is working on their strategic planning. Working on their Title V block grant that supports women and infants, adolescent programs, and child health programs. There is a development of a new Wyoming Home visiting program. Supported by the MICHV program. The home visiting network will hopefully include all home visiting programs across the state. Working to include the tribal home visiting programs.

Rep. Larson- Budget Cuts: No one has been immune from cuts this year. At the May meeting Director Forslund was notified that he would need to make extensive cuts. The Department of Health was receptive to the challenge. The impact on the Child Development Centers is important for us to realize that it might force a compromise in responsibilities. The liability associated with that responsibility is the largest concern as a result of the compromises being made. This group needs to be realistic to work within the revenue stream that is available. Representatives from LSO have attended the EIC meetings and meet with CDC providers. Their report is almost complete and will be made public in September. Is there a more efficient way to provides services and government oversight.

Danielle asks if the potential new system that might incorporate a broad range of early learning, if this would extend back to pregnancy. Larson- No, but that isn’t to say that it couldn’t include those areas of services.

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes Christine B. Is this birth forward to 3 forward? Larson- Birth forward. Christine B. asks for an Educational Topic on the at the October meeting on the LSO report. Representative Larson suggests that the report should go out to this group prior to the next meeting and suggest that even Michael Swank might be able to present.

Kathy- The EIEP will see a draft of the report as early as the end of the month. There is an open meeting on September 12th. The results of the document will be shared at that time. This is the end of Phase 1; Phase 2 will look more closely at data. After that is completed there will be a final paper on recommendations for improvements. Budget reductions: the original proposal was 6.7 million. And we were able to find almost 1 million dollars to alleviate some of the impact of the cut. We have reached out to OSEP for support in finding alternative funds. We are not receiving any federal cuts and we are accepting federal funds. Mary- could that change in the future? Kathy- Part C is voluntary so potentially that is something that could be discussed. Based on the budget cuts we will not make MOE requirements. We are working with WDE to see if they may be able to support MOE. Davey- there is a persistent rumor that Part C would be cut. No services. Representative Larson clarifies that at no time has there been any intent to not provide services at all to birth through 3.

Danielle asks for additions to the agenda. 2:30- No additions

Any amendments to the previous minutes? Mary motions to approve the minutes, Christine B. seconds. The minutes are passed 2:30

The meeting breaks at 2:32 and we will convene at 2:42. 2:42 Danielle calls the meeting back to order.

Mothers and Babies training update 2:43 Christine provides an update on the Mothers and Babies curriculum. The curriculum is a home visiting based program that is designed to improve the child’s social emotional development. Dr. Tandon is coaching the provider's through the implementation process. Our SSIP stakeholder group worked together to develop this plan to implement the curriculum. Christine B. - asks if other regions chose to participate. Christine D. - one other region did participate and Parents as Teachers also participated. The volunteer region has been very successful. Sweetwater has had a more difficult time in implementing the process. Dr. Tandon has done a great job in coaching the provider's. In October we will have results as to how the CDC has performed in implementing the program. Julia- Who developed the curriculum? Christine D. - Darius Tandon from Northwestern University developed the curriculum. This curriculum and the improvements in the Child Outcome Summary process will provide more consistency in measuring how good social emotional skill acquisition is in Cheyenne. Rep. Larson- will the program metrics be able to be used for other programs. Christine D. - The characteristics and skill metrics will remain the same. Rep. Larson- wants to make sure that the process doesn’t continually change from year to year. We need to be able to compare regions to regions reliable. Christine D. agreed that we need a standard

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes system.

COS Christine D. - Currently there is 1-7 range that is susceptible to variance due to professional judgement. The new system will be based of standard deviation in domains associated with the current three COS areas. Rep. Larsen- will this eventually be implemented across the state? Christine D.-yes. Rep. Larsen-How long will this take? Christine D. - A year of a pilot and then full scale implementation.

Danielle asks for a standing update on Mothers and Babies curriculum implementation and on the COS process.

Membership updates Looking at our missing council members. Mary reminds us that we had talked about reaching out to Brenda Little to fill the position. Rep. Larsen suggests reaching out to Director Corsi to fill the position. We have had two applications submitted to the Governor’s office for the parent of a child with disabilities. The Governor had not yet made an appointment for those positions. Julia reminds the council that we had discussed creating a preparation packet for what to expect in the process and participation of the committee. Rep. Larsen volunteers to follow-up the status on the applicants. Christine D. will provide that information. Christine D. has been working with Leslie Arnett. Christine B. suggests that we find out what they Governor’s office is looking for. Christine D. explains that they mentioned they are looking for a letter of recommendation.

Rep. Larson suggests looking at the Medicaid Agency representative because of the importance in understanding measuring Medicaid services for Part C MOE specifically.

Mary- Is Tricia not a member of the council? Christine D. - She has resigned.

Danielle suggests that how we outreach should be the responsibility of the membership committee.

Local Providers Performance Report Card Christine explains that she provides Performance Report Cards to the local regions similarly to how Part B/619 is evaluated by WDE. Julia- Are these only CDCs? Christine D. - Yes, only CDC providers. Christine explains and goes through the Determinations. This information was located in her presentation materials. Christine walked the Council through the State level report card. Rep. Larsen asks where our identification ranks as a state compared to the nation. Christine explained that the national average is around 2.5 percent. Christine B. explains that while her child was quickly provided services, the knowledge base was not robust

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes enough to provide appropriate services. Rep. Larsen- So, what is supposed to happen if the services provided are not good enough? It is possible that the provider may have to purchase the service. Danielle suggests that targets are included in the table. Julia asks if there was an option to not report some of the indicators which would it be? Christine and Davey explain to the group that the Federal standards are the same standards that we should use because it is also a professional standard. Rep. Larsen Motions that the WYEIC recommend to the WDH to develop State Rules to outline a process for state funding accountability for State Part C funds and to report in October. Christine B. seconds the motion. Davey clarifies this is only State Part C money and not Part B/619. The WYEIC votes and the motion carry.

Adjournment Reservations at Fire Rock at 6:00 pm. Rep. Larson motions to adjourn, Mary Seconds we adjourn at 4:35. Meeting was adjourned at 4:25 PM, to reconvene tomorrow morning at 8:15 AM.

January 15, 2016 The meeting was called to order at 8:20 a.m. by Danielle Marks, WY EIC Chair.

Danielle Marks tells the people on the phone that Rep. Larson is not in the room today but that Brigit Paul is with us. Tanya Pepper has also joined the call.

Committee Updates

Membership Committee- Will write an advertisement in the PIC Newsletter. Would like to find a private provider from the Evanston Area. Would like to invite a private provider to have a different perspective. We may need a change in the Medicaid Representative. We would hope that Kathy Escobedo could reach out for both the new Medicaid rep. And the DFS Rep. We plan to give Rep. Larson a month and then the committee will be reaching out to him for his assistance in pushing applicants through the process. We will also reach out to the Governor's office for some more feedback as to how to make applicants more successful. Christine D. suggests that the Council used to look at applications prior to sending into the Governor’s office. Christine B. suggests that the Committee would still like to have the new Vice Chair assign partners to the new members.

Early Referral- The committee is drafting letters to help anyone who would be referring a family for a referral. The letters would be specific to the individual who is referring the family. The committee believes it is important

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes for the FSC to hand out the referral information to the community to help make the personal connection. WIC has received some of the documents, public health nursing will, Medicaid waiver providers and day care providers can also be contacted. Hospitals and OB-GYNs should also be targeted to provide a referral.

SSIP Committee- We conducted the April training of Mothers and Babies Curriculum. Both CDCs that attended the training have begun to implement. Dr. Tandon is working closely with them to provide coaching as they work through the program.

Child Care Committee- Our group could begin to investigate how to share responsibilities in home visiting programs. Maybe this group could help define expectations for collaboration. Christine D. agrees that there might be able to be an alignment between CDC providers and any other home visiting program to ensure that a global goal might be more easily achieved. Christine believes this might be something that has potential. There might need to be an MOU in place between agencies. Mary requests for Davey to join this committee in order to provide his perspective. Davey agrees to join the committee. Christine will research other state models.

FFY 2014 State Performance Determination Christine presents the information from the PowerPoint previously distributed to the Council.

Council Topic Discussion Julia presents on two topics and brings educational material for distribution. The first presentation is Improving Children’s Vision System, Stakeholders, and Support Collaborative. Davey had a question around a reported fact in the presentation. Julia reported that 45% of the Birth to 5 Population is screened. Davey asked if that came from CDCs. The EIEP unit will find out the percentage of the population that is screened by the CDC. After some quick internet searches by the council it appears that the CDCs screen approximately 25% of the population. A program called Infancy will provide a free eye exam from any participating Optometrist. Davey clarifies that the materials will be in Spanish also. Julia confirms.

The second presentation is on: Learn the Signs. Act Early. Mary asks how follow-up is tracked in the CDCs. EHDI data system tracks Hearing and Vision follow-up but it is limited to those two areas.

The council breaks at 9:54. The council reconvened at 10:10. Danielle explains that looking at the training subject votes for the next visit, it looks like a round table discussion might be interesting to hear how collaboration have worked in Jackson. Danielle suggests that a parent who has benefited from the great collaboration might be a good addition to that round table discussion.

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes Survey is collected at 10:12.

Confirm the schedule October 4th and 5th. Do we want to make it a full day meeting instead? It worked well the previous year. Kathy and Christine D. confirm that the Council could have a full lunch. Tonya proposes a full day on Wednesday the 5th. Holly motions for Wednesday October 5th for an all-day meeting. Mary seconds. The motion carries.

January 12th and 13th. Mary reminds the council that we had discussed meeting with WAPSD. Kirsten informs us that meeting is probably in Casper. The council decides to keep January 12 and 13th in Cheyenne.

April 19th will be a Zoom meeting.

Vice Chair election This is a one year term with the expectation of becoming the Chair. Christine B. suggests that maybe the Chair should be a two year term. Kathy asks if it is in the By-Laws. Danielle confirms that it is in the By-Laws. Danielle explains that the Chair could potentially be re-elected. The Council decides that this should be considered at a future date. Christine B. Nominates Mary and Julia. Shawna seconds both nominations to vote on. The motion carries. Christine changes her nomination to only Mary. Julia seconds. The motion carries. Mary Kugler is the Vice Chair.

Adjournment Before the meeting is adjourned, Danielle provides handouts on the Home Visiting network. MICHV grant is funding this network to bring together all home visiting programs in the state to identify ways to collaborate and connect services in the pregnancy to age 3 year continuum. The vision of the network is, “All Wyoming families are supported in nurturing children to be healthy and successful in life.” At a future meeting the Chair could be invited to present at this Council. Kathy asks if the PHN only visits in the home. Danielle says the majority is in the home, but it isn’t a requirement. Plus/Delta Plus- Zoom, Legislative Impacts, Rep. Larson’s presence was much appreciated. Delta-No suggestions. Davey motions to adjourn, Julia seconds, the motion carries. Meeting was adjourned at 10:39 a.m.

Next Meeting October 5th in Jackson Wyoming.

WDH – Behavioral Health Division Early Intervention Council Meeting Minutes