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                                                 Agenda  
                                                  

    State Implementation Grants for Improving Services for Children and Youth with Autism Spectrum 
                         Disorder (ASD) and other Developmental Disabilities  

                                     Program Meeting Breakout Session  

                                      December 7, 2009, 1:30‐3:30pm  

Moderator/Facilitator: Deidre Washington  

1:30‐1:45 Introductions/Ice Breaker Activity  

1:45‐2:30 States and Congressional Initiative 1) Successes and Strengths, 2) Share what is happening in 
programs  

     ‐   Illinois‐ 1) network existing related to medical home.  Strong bonds with other organizations.  
         State implementation grant, LEND grant.  2) Started out by recruiting families with the help of 
         ARC of Illinois to help parents be good care providers to their children, trained 90 families with 
         this curriculum.  Next phase early detection with the screening programs.  Final step is to choose 
         6 practices statewide to kick this off.   

     ‐   Utah‐ 1) good collaboration to start out with between many agencies.  2) In the first year they 
         trained 8 medical homes; they all implemented MCHAT and figured out how to do follow‐up.  In 
         the third year going to look at distance learning.  Looked at what dental practices need to 
         develop a dental home.  Enhanced website, medical home portal has enhanced info about 
         autism.  Filmed a video about parents of newly diagnosed children to use around the state in 
         English and Spanish.  Enhanced Child Find project in northern Utah.  Working with early 
         childhood education to train educators in the preschool setting.  Identified and trained 4 family 
         navigators to be a resource to families across the state.  Training with all foster care nurses to do 
         ASQ on all kids that come in.     

     ‐   Rhode Island‐ 1) Small state, ability for collaborators to get together.  Concept of learning 
         collaboratively.  2) Issues with private practitioners making diagnosis of autism and schools not 
         accepting.  Problems getting an assessment of function.  Now started a program to assess 
         thoroughly.  Plan for next year is to look at provider competencies, help them understand best 
         practices in intervention and treatment.        

     ‐   Alaska‐ 1) Already had a state autism plan.  Increased ability to push initiatives forward.  Great 
         providers.  2)  Initial efforts were awareness‐related.  Distributed CDC materials to get the word 
         out.  Trying to get a better idea of baseline knowledge of providers in the state.  Working to 
         figure out the best way to distribute info.  Working in collaboration with the infant learning 
         program.  No road system, which becomes complicated to even get in to see a mid‐level 
         practitioner.  Training people who can create access to screening.  There is a relatively new 
         telehealth system.            

     ‐   Wisconsin‐ 1) Already had a state implementation grant, allowed to build a strong foundation.  
         This grant has allowed them to pull everyone together.  2) Have tried to integrate their work 
         with title V grant activities. There is a community of practice around ASD and developmental 
disabilities.  Set up electronic repository/portal with resources, including a place to put the 
        webcast series that they are in the process of developing.  Working with U. Wisconsin to help 
        train FP residents through distance learning.  Targeting the Milwaukee area to do more in‐depth 
        medical home stuff.  Targeting an urban autism group.  Partnered with great lakes and tribal 
        council to reach out to tribal people.       

    ‐   Missouri‐ 1) governor very supportive of autism initiatives.  There are existing grants to 
        collaborate with.  Legislature set groundwork for projects they are working on.  There is a MO 
        family initiative partnership.  2) Awareness building‐ disseminating an autism module that was 
        developed by a regional team, available at no cost to people across the state to educate people 
        about the signs and symptoms of autism.  Learn the signs, act early program.  There are three 
        tertiary sites in MO with family resource specialists to help access.  Providing emotional support 
        for families.  Linked by age, geographic location, and whatever is important to the family.  
        Grappling with issue of how to triage patients with suspected autism.       

    ‐   Washington‐ 1) Momentum from a state taskforce and state recommendations.  LEND program 
        got a grant at the same time they did.  The partnership between LEND and title V is really strong 
        now.  Lots of collaboration.  2) There are problems with diagnoses from certain groups not being 
        recognized by other groups, etc.  Lots of referrals from community to get an autism diagnosis.  
        Plan to go to communities and help them figure out where all these referrals are coming from 
        and what each individual community can do to get them into the right services.  Trying to save 
        DBPs from getting totally backed up, save them for the kids that really require that level of 
        expertise.      

    ‐   New York‐ 1) Large state, resource rich.  Large service delivery system.  Governor established 
        taskforces.  Regional autism summit in NYC last spring.  Systems implementation grant.  2) 
        Working on training of physicians on universal screening.  Trying to find a technology approach 
        to train physicians.  Difficult to recruit providers into their service system.  Working on public 
        awareness for April, which is Autism Awareness Month.  Planning to do some work with families 
        to help empower more families.      

    ‐   New Mexico‐ 1) UCEDD and LEND program.  Spent many years planning and organizing training.  
        2) Still getting started.  Trying to get people on staff.  This allows them to implement other 
        projects started with different sources of funding.  They will be doing a day‐long session 
        involving the LEND program.  Cultural/linguistic competence is integral, statewide project.  
        Particular interest in the native population, which is an interesting area that presents some 
        challenges.  Addressing whether they can continue to serve the at‐risk population for part C.       

    ‐   Congressional Earmark‐ 1) Wanting to do something to help other families.  Developing tools to 
        help provide services at a distance.  Recruiting children/families for home assessments (3hr), 
        followed by parent workshop.  Goal to help children develop in the natural home environment. 

2:30‐3:20 Moderated Discussion  

    I. Models/Interventions/Strategies  

 
        What are your experiences with models, interventions, and tools regarding diagnosis? What has 
        worked? What are your lessons learned? 
‐   Trying to find out all the ways that families are getting the diagnosis.  Lots of people out there 
        making diagnoses, but not all of them competent to do that. 

    ‐   In WI, community‐based waiver has criteria aligned with the Medicaid waiver.  Trying to 
        promote evidence‐based practices.   

    ‐   In RI, there are specific criteria around who can do what.  Certain professionals can do certain 
        components of the diagnosis.   

    ‐   Would be interesting to look at the trends across the states.   

    ‐   In NY, governed by practice law as to who can diagnose what.    

    ‐   ADAM (Autism and Developmental Disability Monitoring Network, which is a state surveillance 
        effort) site‐ look at where the diagnosis came from.         

 

        What are your experiences recruiting family practice physicians into training?  

    ‐   Difficulty with FPs not routinely screening for ASDs.   

    ‐   Once able to incentivize, able to get FPs in to train.  Time of day, bring lunch.   

    ‐   In Washington, working with the chapter president was successful to get the message out.   

    ‐   Use families to get the message out 

    ‐   Give AAP toolkit for autism and the first signs toolkit.   

    ‐   Utilize physician champions to help in this work.  Use these folks to help train FP residents.  
        Continually looking for opportunities to educate.  Do this with pediatricians too.   

         

         

            II. Collaborations A. How have you collaborated with other agencies within your state and in 
                 other states to improve your state’s system of care for children and families affected by 
                 autism spectrum disorder and other developmental disabilities?  

            B. Identify opportunities and areas for cross collaboration between states 

            ‐ Learn the Signs Act Early‐ lessons learned  

            ‐ Right now strong collaboration between part C and others.  Part C recs not updated since 
                 1994.  Head Start already ok to do screening.   

            ‐ Utah‐ part C incorporated in the bureau.  Program manager had a student do an evaluation 
                on the perception and the need. 

            ‐ Illinois‐ kids coming to EI way too late, at point of aging out of EI.   
‐ EI moving toward being more inclusionary.   

           ‐ In NY, kids come in around 20 months of age.  Don’t get diagnosed until around 24 months 
                of age.   

           ‐ Struggling with how to get the word out.  There are troubles working with different 
                communities such as Somali.  In AK, they are beginning to do this with the tribal health 
                organizations.           

           ‐ In IL, waiver system has small number of people on it.  IL developmental disabilities waiver 
                allows parents to use waiver for respite care (only 1000 kids can be funded with this 
                waiver).  It’s like winning the lottery if you get selected for the waiver. 

            ‐ Some providers reluctant to diagnose with autism if they are unable to provide services.    

             

 
    III. Communications  

 
        How can the states better communicate with each other and take advantage of lessons‐learned 
        from other states? What does that process look like? What opportunities do we currently have 
        and what types of opportunities need to be created?  

3:20‐3:30 Wrap Up, Prepare for Report to Larger Group 

    ‐   Wondering about having a states meeting in the spring 
    ‐   Wondering about having quarterly regional meetings 
    ‐   Community asset teaching‐ each state host a brown bag event every month or every other 
        month. 
    ‐   Lots of great topic ideas for conference calls. 
    ‐   Big initiative this spring‐ Peer‐to‐Peer mentoring, would like to bring in all states. 
    ‐   There is a list serve that has been underutilized for this group.  Nice way to communicate long 
        distance on an ongoing basis. 
    ‐   Asset mapping‐ what are community resources?  Who is good with autistic kids of a certain age, 
        etc?  Ethnic or cultural specific organizations?   

     

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State Implementation Grants for Improving Autism Services

  • 1.   Agenda     State Implementation Grants for Improving Services for Children and Youth with Autism Spectrum  Disorder (ASD) and other Developmental Disabilities   Program Meeting Breakout Session   December 7, 2009, 1:30‐3:30pm   Moderator/Facilitator: Deidre Washington   1:30‐1:45 Introductions/Ice Breaker Activity   1:45‐2:30 States and Congressional Initiative 1) Successes and Strengths, 2) Share what is happening in  programs   ‐ Illinois‐ 1) network existing related to medical home.  Strong bonds with other organizations.   State implementation grant, LEND grant.  2) Started out by recruiting families with the help of  ARC of Illinois to help parents be good care providers to their children, trained 90 families with  this curriculum.  Next phase early detection with the screening programs.  Final step is to choose  6 practices statewide to kick this off.    ‐ Utah‐ 1) good collaboration to start out with between many agencies.  2) In the first year they  trained 8 medical homes; they all implemented MCHAT and figured out how to do follow‐up.  In  the third year going to look at distance learning.  Looked at what dental practices need to  develop a dental home.  Enhanced website, medical home portal has enhanced info about  autism.  Filmed a video about parents of newly diagnosed children to use around the state in  English and Spanish.  Enhanced Child Find project in northern Utah.  Working with early  childhood education to train educators in the preschool setting.  Identified and trained 4 family  navigators to be a resource to families across the state.  Training with all foster care nurses to do  ASQ on all kids that come in.      ‐ Rhode Island‐ 1) Small state, ability for collaborators to get together.  Concept of learning  collaboratively.  2) Issues with private practitioners making diagnosis of autism and schools not  accepting.  Problems getting an assessment of function.  Now started a program to assess  thoroughly.  Plan for next year is to look at provider competencies, help them understand best  practices in intervention and treatment.         ‐ Alaska‐ 1) Already had a state autism plan.  Increased ability to push initiatives forward.  Great  providers.  2)  Initial efforts were awareness‐related.  Distributed CDC materials to get the word  out.  Trying to get a better idea of baseline knowledge of providers in the state.  Working to  figure out the best way to distribute info.  Working in collaboration with the infant learning  program.  No road system, which becomes complicated to even get in to see a mid‐level  practitioner.  Training people who can create access to screening.  There is a relatively new  telehealth system.             ‐ Wisconsin‐ 1) Already had a state implementation grant, allowed to build a strong foundation.   This grant has allowed them to pull everyone together.  2) Have tried to integrate their work  with title V grant activities. There is a community of practice around ASD and developmental 
  • 2. disabilities.  Set up electronic repository/portal with resources, including a place to put the  webcast series that they are in the process of developing.  Working with U. Wisconsin to help  train FP residents through distance learning.  Targeting the Milwaukee area to do more in‐depth  medical home stuff.  Targeting an urban autism group.  Partnered with great lakes and tribal  council to reach out to tribal people.        ‐ Missouri‐ 1) governor very supportive of autism initiatives.  There are existing grants to  collaborate with.  Legislature set groundwork for projects they are working on.  There is a MO  family initiative partnership.  2) Awareness building‐ disseminating an autism module that was  developed by a regional team, available at no cost to people across the state to educate people  about the signs and symptoms of autism.  Learn the signs, act early program.  There are three  tertiary sites in MO with family resource specialists to help access.  Providing emotional support  for families.  Linked by age, geographic location, and whatever is important to the family.   Grappling with issue of how to triage patients with suspected autism.        ‐ Washington‐ 1) Momentum from a state taskforce and state recommendations.  LEND program  got a grant at the same time they did.  The partnership between LEND and title V is really strong  now.  Lots of collaboration.  2) There are problems with diagnoses from certain groups not being  recognized by other groups, etc.  Lots of referrals from community to get an autism diagnosis.   Plan to go to communities and help them figure out where all these referrals are coming from  and what each individual community can do to get them into the right services.  Trying to save  DBPs from getting totally backed up, save them for the kids that really require that level of  expertise.       ‐ New York‐ 1) Large state, resource rich.  Large service delivery system.  Governor established  taskforces.  Regional autism summit in NYC last spring.  Systems implementation grant.  2)  Working on training of physicians on universal screening.  Trying to find a technology approach  to train physicians.  Difficult to recruit providers into their service system.  Working on public  awareness for April, which is Autism Awareness Month.  Planning to do some work with families  to help empower more families.       ‐ New Mexico‐ 1) UCEDD and LEND program.  Spent many years planning and organizing training.   2) Still getting started.  Trying to get people on staff.  This allows them to implement other  projects started with different sources of funding.  They will be doing a day‐long session  involving the LEND program.  Cultural/linguistic competence is integral, statewide project.   Particular interest in the native population, which is an interesting area that presents some  challenges.  Addressing whether they can continue to serve the at‐risk population for part C.        ‐ Congressional Earmark‐ 1) Wanting to do something to help other families.  Developing tools to  help provide services at a distance.  Recruiting children/families for home assessments (3hr),  followed by parent workshop.  Goal to help children develop in the natural home environment.  2:30‐3:20 Moderated Discussion   I. Models/Interventions/Strategies     What are your experiences with models, interventions, and tools regarding diagnosis? What has  worked? What are your lessons learned? 
  • 3. Trying to find out all the ways that families are getting the diagnosis.  Lots of people out there  making diagnoses, but not all of them competent to do that.  ‐ In WI, community‐based waiver has criteria aligned with the Medicaid waiver.  Trying to  promote evidence‐based practices.    ‐ In RI, there are specific criteria around who can do what.  Certain professionals can do certain  components of the diagnosis.    ‐ Would be interesting to look at the trends across the states.    ‐ In NY, governed by practice law as to who can diagnose what.     ‐ ADAM (Autism and Developmental Disability Monitoring Network, which is a state surveillance  effort) site‐ look at where the diagnosis came from.            What are your experiences recruiting family practice physicians into training?   ‐ Difficulty with FPs not routinely screening for ASDs.    ‐ Once able to incentivize, able to get FPs in to train.  Time of day, bring lunch.    ‐ In Washington, working with the chapter president was successful to get the message out.    ‐ Use families to get the message out  ‐ Give AAP toolkit for autism and the first signs toolkit.    ‐ Utilize physician champions to help in this work.  Use these folks to help train FP residents.   Continually looking for opportunities to educate.  Do this with pediatricians too.        II. Collaborations A. How have you collaborated with other agencies within your state and in  other states to improve your state’s system of care for children and families affected by  autism spectrum disorder and other developmental disabilities?   B. Identify opportunities and areas for cross collaboration between states  ‐ Learn the Signs Act Early‐ lessons learned   ‐ Right now strong collaboration between part C and others.  Part C recs not updated since  1994.  Head Start already ok to do screening.    ‐ Utah‐ part C incorporated in the bureau.  Program manager had a student do an evaluation  on the perception and the need.  ‐ Illinois‐ kids coming to EI way too late, at point of aging out of EI.   
  • 4. ‐ EI moving toward being more inclusionary.    ‐ In NY, kids come in around 20 months of age.  Don’t get diagnosed until around 24 months  of age.    ‐ Struggling with how to get the word out.  There are troubles working with different  communities such as Somali.  In AK, they are beginning to do this with the tribal health  organizations.            ‐ In IL, waiver system has small number of people on it.  IL developmental disabilities waiver  allows parents to use waiver for respite care (only 1000 kids can be funded with this  waiver).  It’s like winning the lottery if you get selected for the waiver.  ‐ Some providers reluctant to diagnose with autism if they are unable to provide services.         III. Communications     How can the states better communicate with each other and take advantage of lessons‐learned  from other states? What does that process look like? What opportunities do we currently have  and what types of opportunities need to be created?   3:20‐3:30 Wrap Up, Prepare for Report to Larger Group  ‐ Wondering about having a states meeting in the spring  ‐ Wondering about having quarterly regional meetings  ‐ Community asset teaching‐ each state host a brown bag event every month or every other  month.  ‐ Lots of great topic ideas for conference calls.  ‐ Big initiative this spring‐ Peer‐to‐Peer mentoring, would like to bring in all states.  ‐ There is a list serve that has been underutilized for this group.  Nice way to communicate long  distance on an ongoing basis.  ‐ Asset mapping‐ what are community resources?  Who is good with autistic kids of a certain age,  etc?  Ethnic or cultural specific organizations?