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ODRC - Communities - Missouri

Jefferson County, Missouri

Animated Picture of the state of MissouriJefferson County, Missouri, located about 60 miles south of St. Louis, is a large, rural community with rolling hills, woodlands, and limestone. The county was identified as the community catchment area by geography and its politics; the county is the jurisdiction for the majority of the public service agencies, and families travel throughout the county to obtain services as well as conduct their daily routines. Most importantly, coordination of services for young children with special needs occurs via the county-wide collaborative, the Jefferson County Early Childhood Council (JCECC). This council was recognized by the state First Steps Part C program as one of the strongest, most successful collaboratives in Missouri. For this reason, the JCECC was asked to participate as a community in the Opening Doors into Rural Communities Project.
Jefferson County History

The JCECC has a history of going beyond what is required. As an example, Missouri requires local interagency coordinating councils (LICC’s) to be formed to address the needs of children with special needs in the First Steps (Part C) program. Recognizing the needs of all young children, JCECC – as the local LICC - expanded its mission to focus on all children in the community ages birth to eight years, with an emphasis on those who have or are at risk for developing special needs.

Council members represent families and middle-management program supervisors/administrators from early intervention programs, the School Districts’ Part B preschool programs, the Division of Family Services, the Bureau for Special Health Care Needs, Parents as Teachers, Head Start, the Department of Mental Health, a community mental health clinic, and the Nurses for Newborns home visiting program. Andrea Wolf, employed by the Jefferson County ARC and a long-term member of the JCECC, serves as the liaison for the ODRC project. Andrea’s leadership, positive attitude, and commitment paved the way for the further success of this community’s efforts.

Jefferson County’s Action Plan to Increase Access to Services

Because of their understanding of the broader service system, the JCECC members were aware of the challenges for families in accessing these services. The council decided to focus on the FICC service integration strategy to develop procedures to increase access to services in an efficient, family-friendly manner. The JCECC had several ideas about strategies that could be developed to reach this goal. Before jumping into action, individuals from the council interviewed a number of families of children with special needs ages birth to five years about their needs. Based on these interviews - as well as prior family input from a previous needs assessment focus group - the council selected three strategies:
1. Joint referral form to streamline the process of connecting families to the participating agencies;
2. Parent notebook to facilitate family-provider communication as well as provider-to-provider communication.
3. Screening promotion via toll-free number to facilitate developmental screening and connect families with other resources.

1. Joint referral form.

Council members had experienced their own frustrations referring families to services due to a redundant process of completing multiple referral forms. Families reported their frustrations with unsuccessful attempts to reach agencies. With the development of a joint referral form used by multiple agencies, families would provide signed consent for agencies to make referrals directly with the other agencies.

The original plan was to develop a computerized system that would send referrals electronically as well as serve as a shared data system to monitor referrals. Shortly after Jefferson County began working on its ODRC action plan, the Missouri First Steps Part C program began a redesign effort to improve the system for children ages birth to three with disabilities. Not knowing the specifics of how the new Part C system would be changed, the JCECC revised their action plan. For example, the Missouri First Steps administration envisioned a system point of entry, whereby families would call a single number to be connected to First Steps and other related services. Wisely, the JCECC revised its plan to commit the funding dollars toward a computerized referral system to avoid incompatibilities with the state’s redesign efforts. Meanwhile, the JCECC developed a hard copy referral form that could be faxed to referring agencies.

The joint referral form was developed and interagency training helped to ensure its proper use. One critical component of the referral form’s use was the interagency agreement signed by 10 agencies, demonstrating the necessary interagency support for the form’s purpose and use.

2. Parent notebook.

Based on the needs assessment information, the JCECC targeted to development of a notebook that would serve to facilitate family-provider communication as well as provider-to-provider communication. The parent notebook is an organizational tool, making it less necessary for families to keep repeating their story over and over again. The notebook is entitled “Show Me, Me”, building on Missouri’s nick name as the “show me” state. The notebook is actually a 3-ring binder with sections to hold personal information (birth certificate, social security card, health insurance card); medical records, a full calendar for recording appointments, school events; evaluation reports; service plans; financial documents (income tax information, personal bills); a business card holder for frequently used phone numbers; and a resource directory of services and supports in the community. The “Show Me, Me” notebook was piloted, and parent comments were obtained. The following quotes best depict the families’ impressions: “I had no system in place to gather doctor’s reports, behavioral plans and IEP information for my daughter who is autistic. The notebook has a place for everything,” and “When I have an appointment scheduled for my child, I always take the notebook with me. It’s a wonderful help and keeps me organized in regard to the care of my child.”

The creation of the parent notebook provided the perfect opportunity for the Council to increase partnerships with families. Recognizing the value of the notebook, many families were excited to participate on a focused, concrete task of developing the notebook, piloting its use, and training other families as well as providers in how to use it.

As a result of their successful experience in this project, more parents were recruited to participate in the JCECC. In fact, parents currently represent one third of the council members. Kimberly Bolin, a parent representative and co-chair of the JCECC, reflected “…I have always been made to feel as though my opinion was needed and appreciated. I feel as though my contribution is an asset to the agencies involved and helps to make a difference within my community.”

3. A toll-free phone number .

The toll-free number facilitates developmental screening and connects families with other resources. In Jefferson County, the Missouri Parents As Teachers (PAT) universal home visiting program serves as the primary resource for conducting developmental screening with young children. Another role of PAT is to connect families with other resources, such as the Part C and Part B programs. There are multiple PAT offices throughout the county; contacting them is a long-distance call for many of the rural families in Jefferson County. To encourage families to take advantage of the free developmental screening offered by PAT, regardless of the family’s interest in receiving regular home visits, the Council determined that a single, toll-free number would make it easier for families to connect with PAT.
A multi-media approach was applied to promote the toll-free number. An ad in the local newspaper ran for 13 weeks, posters were displayed throughout the community, and medicine spoons with the phone number were distributed by local pharmacies. Since its inception in February, 2001, PAT - as well as the Part C and Part B programs - report increasing referrals.

Sustainability

Missouri’s First Steps program is in the process of redesigning their community-based service systems, and many of these changes will sustain the accomplishments of the JCECC. First, funds will be available to the JCECC to provide stipends to parents for their participation in council activities. These funds will replace the parent stipends provided via the ODRC grant. An outgrowth of the increased parent involvement is the creation of more formalized support groups organized by and for families. The sustainability of these groups will be less dependent of funding and more dependent on their ability to meet the needs and desires of families.

The Missouri First Steps program plans to adopt the Jefferson County Parent Notebook for statewide replication. Although communities and families will have the ability to adapt the notebook to best fit their community, Jefferson County’s notebook will serve as the foundation on which others will build.

The sustainability of the common referral form and the toll-free number also will be influenced by Missouri’s First Steps redesign effort. The state intends to identify a “system point of entry” for children potentially eligible for the First Steps Part C program. This involves a new toll-free number to connect families with an interim service coordinator, to receive necessary evaluations, and to determine eligibility for First Steps services. Jefferson County council members would like to maintain their expanded focus on children birth to eight and will need to coordinate their efforts with the state’s “system point of entry” requirements. The joint referral form will continue to fill a need to serve the broader population, particularly those who do not qualify for the First Steps program. Given the active participation that JCECC members play in the state-level planning activities, the community is in a position to ensure state-community coordination to sustain their mission to ensure access to services for young children and families.

For further information about Jefferson County’s service integration efforts, contact:

Andrea Wolf
Jefferson County ARC
Tel: 636-931-6644
E-mail her at aawolf@jcn1.com.

 

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Last Revision: October 18, 2001