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

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

Apr 26, 2023 434 likes •598 views

Setting the Stage for Change Drafting Maines 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:

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SLIDE 1

Setting the Stage for Change

Drafting Maine’s State Plan for Individuals with ASD

Nancy Cronin, MA ASD Systems Change Initiative Coordinator

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SLIDE 2

ASD Interagency Systems Change Initiative

Public and private collaboration since 2006, involving:

  • DHHS Division of Early Childhood
  • Child Developmental Services
  • Psychologists
  • Developmental Evaluation Clinics
  • Medical Professionals
  • Early Childhood Educators
  • Child Care Providers
  • Office of MaineCare Services
  • Children with Special Health

Needs

  • Autism Society of Maine
  • DHHS Children’s Behavioral Health

Services

  • Disability Rights Center
  • Parents
  • Department of Education
  • Speech and Occupational

Therapists

  • Center for Community Inclusion

and Disabilities Studies

  • Developmental Disabilities

Council

  • State Office of Information

Technology

  • Over 200 individuals with PDD,

family members, and professionals as commenter's

Maine Developmental Disabilities Council

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SLIDE 3

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

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SLIDE 4

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

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SLIDE 5

How do people with ASD utilize the multiple systems of care?

Maine Developmental Disabilities Council

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SLIDE 6

Maine Developmental Disabilities Council

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SLIDE 7

Parent Pediatrician Child Developmental Services (CDS) DEC Clinic Children's Behavioral Health Services/ Early Childhood Division Parent Referral 1 2 3 4 Children's Behavioral Health Services Department of Education

Overview of the service systems involved in early intervention for children with PDD

a

Represents Problem Areas identified by PDD System of Care Group

Maine Developmental Disabilities Council

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SLIDE 8

Children's Behavioral Health Services T T < 2SD > 2SD > 2SD < 2SD Mental Health

Substance Abuse Correction Homelessness Crisis

Vocational Rehabilitation

No Long Term Supports Long Term Supports >2SD Eligible DHHS/D S

Continuing Education Individual / Self Referral Adult Protection Developmental Services Waiver Eligible but Slot Limited Mental Health

Substance Abuse Correction Homelessness Crisis

Transition Planning Department of Education

Overview of the service systems involved in Transition Services for Youth with PDD

a

Parent Referral

Represents Problem Areas identified by PDD System of Care Group Maine Developmental Disabilities Council

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SLIDE 9

DRILL DOWN

  • Early Identification Value Stream Mapping

PDD/Autism Current Experience of the Process

CDS Diagnostician Physician Therapies Medical Issues Parent

Birth Slow Weight Gain Food Issues GI Problems Seizures Medications GI Problems Slow Weight Gain Seizures Food Issues Medications Physical Therapy Developmental / Behavioral Concerns Doctor We Worry Wait and See Speech Therapy Referral to CDS Some Developmental Delay Referral to Diagnostician Doctor Speech Therapy Medical Specialist Audiologist Tubes Medications Seizures Food Issues GI Problems We Beg Occupational Therapist Report Meetings Speech Therapist Report Meetings Diagnostician Report Meetings Develop mental Therapy Report Meeting s Developmental Domain Report – Eligibility Meetings Eligibility Assessment Observation Multi-Disciplinary Evaluation IFSP/IEP Speech Therapy Occupational Therapy Developmental Therapy MULTIPLE SPECIALIST VISITS MULTIPLE SPECIALIST VISITS Birth Diagnosis/Rule Out = Wait Time = Wait Time = Decision Point = Decision Point 1m 3w 3w 1 Year 1 Year 1m 3w 3w 3w 1 Year 3 Months 3 Months 1 Month 1 Month 1 Month 3 Months 3w 3w 3w

Maine Developmental Disabilities Council

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SLIDE 10

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

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SLIDE 11

Stakeholder Experience of Current System

Entity/ Function

Current State

Gathering Data Professional Consultation Formal Screening with PCP 0-3 Eligibility determination CDS Screening

Bookend Behavior concrn Bookend Diagnosis or Rule out

Family, caregivers, etc PCP CDS 0-3 years 3-5 years

1d 120 d 365d 15d 15d 15d 7d 9.5d 21d

16d 16d 16d 1d

1,826

B A W

PCP Referral Screening

3-5 Domain Specific Eligibility determination

21d 56d 38.5d

Evaluation(s)

30d 540d 240d 240m 420 600 20 20 20m 60m 60m 60m 60m 120 180 60 60 60 240m 240 240 480m 720 960

CT ST

Parental Processing

Maine Developmental Disabilities Council

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SLIDE 12

Workgroup Future System

Entity/ Function

Future State

Universal Screening at Well Child Visit

Bookend Behavior concrn Bookend Diagnosis or Rule out

Family, caregivers, etc PCP CDS

PCP Referral

Evaluation(s)

0-3yr 2 wks – 3 Months

CDS / Services

1 2 3

Maine Developmental Disabilities Council

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SLIDE 13

Putting Plans into Action Early Identification

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

Maine Developmental Disabilities Council

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SLIDE 14

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

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SLIDE 15

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