Research & Training Center in Service CoordinationCFDA # 84.324L Service Coordination: Are We There Yet? Gloria Harbin, Ph.D. Kathleen Whitbread, Ph.D. University of Connecticut A.J. Pappanikou Center For Developmental Disabilities 263 Farmington Avenue, MC6222Farmington, CT 06030USA Phone: (860) 679-1500Fax: (860) email@example.com Website: www.uconnucedd.org
This is a Collaborative Project Four primary sites: • Mary Beth Bruder, Ph.D., University of Connecticut • Gloria Harbin, Ph.D., University of North Carolina-Chapel Hill • Michael Conn-Powers, Indiana University • Sara Miranda, Federation for Children with Special Needs, Massachusetts Additional research being conducted by: • Richard Roberts, Ph.D., Utah State University • Carl Dunst, Ph.D., Orelena Hawks Puckett Institute
Principles • Collaborativemodel of integrated activities. • Families are an integral component of our project. • Stakeholderscontribute to all phases of the center activities. • Use of a Participatory Research Model.
Center Framework Family Service Provision System Administration I. Status II. Outcomes III. Recommended Practices IV. Measurement V. Training Model VI. Dissemination Surveys Focus Groups Delphi Technique OutcomeMeasurement Validation Studies
Objective 1 HOW WE DID IT: WHAT WE DID: Described current models of service coordination Series of Surveys
System Infrastructure: WHAT IS NEEDED TO SUPPORT EFFECTIVE SERVICE COORDINATION
Case Study States • Dedicated and Independent • Blended with Intervention – LA • Blended with Intervention – IA
What Approaches are Used? • Dedicated - and Independent • Dedicated - NOT Independent • Blended with Intervention • Lead Agency (LA) • Blended with Intervention • Interagency (IA) • Variable (Harbin, Bruder, Reynolds, Mazzarella, Gabbard, & Staff, 2002.)
Which Model is Best? FINDINGS: • Differences in nature of some system components SERVICE COORDINATION PRACTICES SYSTEM INFRASTRUCTURE CHILD AND FAMILY OUTCOMES
Which Model is Best? • Not a useful question • Multiple factors – not just the model were associated with positive outcomes
Approaches and their Assumptions ANALYSIS REVEALED • Assumptions not always realized • Multiple factors could influence whether the original assumptions were realized
Dedicated Approach ASSUMPTIONS • Can spend more time on S.C. • Specialist Needed • Offer Broader Array • More Choice for Families
Dedicated Approach WHAT CAN GO WRONG? • Case load Too large • S.C. not knowledgeable about services and resources • Parents uninformed • S.C. not knowledgeable about disabilities
Blended Approach ASSUMPTIONS • Most knowledgeable about child and family needs • More effectively communicate with other providers • Family more likely to reveal needs
Blended Approach WHAT CAN GO WRONG? • Knowledge of needs related to own expertise • Communication doesn’t occur (no time, no mechanism) • Service provider doesn’t elicit needs
Variable Approach ASSUMPTIONS • No model is best • Locals know best • Individualization of approach is more likely to meet needs
Variable Approach WHAT CAN GO WRONG? • Pragmatic decision, not data-based • What locals “think is best” may not be • Lack of consistency confuses parents
Influential Factors • Empowering Relationship • Case Load • Use of Family Support Approach • Parent Choice • Array of Resources • Breadth of Service System • Interagency Linkages
Influential Factors • Integration of Services • Transdisciplinary • Routines-Based • Integrated Therapies • IFSPs With All Needs and Services • Interagency Training • Mechanisms to link needs to resources
Influential Factors • Learning Opportunities in Natural Settings • Identification of New Needs • Frequency of Contact • Case Load • Interagency Linkages
Influential Factors • Knowledgeable Personnel • Diverse disabilities and conditions • Resources • Capacity building
Objective 2 WHAT WE DID: We determined outcomes attributed to effective service coordination across stakeholders HOW WE DID IT: Focus Groups, Delphi Surveys, National Surveys, (Family and Service Coordinator Interviews and IFSP Review)
Delphi Sampling Total of 395 surveys were distributed
Delphi Outcomes • Children and families receive appropriate supports and services that meet their individual needs • Children are healthy • Children’s development is enhanced • Children have successful transitions • Families are involved in decision making • Families are informed about resources and services • People work together as a team
Objective 3 WHAT WE DID: We determined practices that lead to high quality Service Coordination HOW WE DID IT: Focus Groups, Delphi Surveys, National Surveys, (Family and Service Coordinator Interviews and IFSP Review)
Delphi Practice Sampling 112 PTIs distributed to 12 families each 2688 surveys distributed to families Total of 4730 surveys were distributed nationally
Delphi Practice Themes • Providing information • Ensuring family understanding • Being responsive to families • Developing IFSPs • Monitoring progress • Ensuring family satisfaction • Promoting child development • Addressing healthcare and safety issues • Completing administrative responsibilities • Planning for transitions • Collaborating with community organizations • Engaging in professional development activities
Objective 4 HOW WE DID IT: WHAT WE DID: Measured outcomes and practicesof effective Service Coordination Interviews with families, families’service coordinators and IFSP review
Family Demographics (N=98)
Interview Findings • Identified outcomes important to families. • Identified who assisted the family in achieving the outcomes. • Learned how service coordination helped achieve the outcomes. • Identified how long it took to achieve the outcome.
Outcome Methodology • Independent sort of family and SC outcomes into themed categories. • Collapsed similar themes resulting in 14 family and 13 SC outcome themes. Frequencies and percentages were calculated for each. • Second sort of outcomes into themed categories. Frequencies and percentages were calculated for each. • Comparison of interview, Delphi, and survey outcomes yielding final 8 outcomes.
Interview Outcomes • Children will have successful transitions. • Children and Families receive early intervention services that are • individualized, coordinated and effective. • Families make informed decisions about services and opportunities in the • community for their children with a disability. • Families acquire and/or maintain a quality of life that enhances their well-being. • Families are self-sufficient. • Families are knowledgeable of their child’s disability. • Families are satisfied. • Children’s development is enhanced. • Children are safe and healthy.