Transition/Least Restrict Environment (LRE) Workgroup
July 30, 2007 - Meeting Minutes
Note: the remaining workgroup meetings will be at NYSUT Headquarters, 800 Troy-Schenectady Road, Latham

Attendees

Kim Fine, Bradley Hutton, Christine Vogelsang, Mary Garrett, Michael Dedee, William Combes, Cindy Gallagher, Robert Frawley [Additional people observed the meeting and were asked for input during select discussions.]

Facilitator

Bonnie Edelstein

1. Discussion about full task force meeting (Kim Fine)

• The full Task Force endorsed the approach proposed at the initial workgroup meeting.  No adjustments to the workgroup’s plans are needed.
• Proposed statement of purpose: The intent is to provide direction for all workgroups to prepare recommendations that are consistent with a core set of principles.  The text of the working draft Statement of Purpose was revised to read as follows:

New York provides a broad range of services to help children minimize the limits imposed by disabilities and prepare them for success in school.  The numbers of children identified as needing services has been growing, as have the associated costs.  This creates a risk to the State’s ability to sustain service levels and quality for the long term.  It is the purpose of the Task Force on Preschool Special Education to recognize New York’s strengths and challenges and offer recommendations to policy makers for an improved service system that advances the following principles:

• Children and their families should experience transitions that are as seamless as possible.
• Families must be partners in decision making.
• Children should be served in the most appropriate setting and, while some will require care in a specialized environment, all child care settings should be equipped to help children with disabilities succeed.
• Regulation must be reasonable and as consistent as possible across settings and oversight agencies, and rates must reward quality and encourage efficiency.
• Payers and decision makers must share a goal of ensuring that students receive the services that meet their needs and are delivered in a cost effective manner.
• All available resources and funding must be employed to benefit the child.
• There should be as much consistency as possible in decision making across the State.
• The State must be able to measure outcomes for the children who participate in preschool special education services, including their success in school.

As a next step, each workgroup will discuss the proposed Statement of Purpose and recommend amendment or adoption.  While it might be preferable to develop such a document as a full Task Force, this was the best available approach given time constraints.

2. Workgroup Member Outreach Updates (Mike Dedee)

(Handout: Summary of Responses from Stakeholders)

• Mike D. reported on the results of the survey he distributed, as summarized in a document he sent to workgroup members prior to the meeting (attached).
• Mary G. noted that the document was very helpful. In cross referencing with other Task Force material, Mary noted that Michigan has a birth to 7 system, explaining the respondent comment that “3 was 3” was not an issue in Michigan.
• Christine V. expressed that the responses would be similar across the State.
• Mike D. noted that the survey results caused him to question the decision by the full Task Force to focus on a 3-21 system and asked Brad H. to offer perspective on options for a birth to school age EI system.
• Brad H. summarized Department of Health (DOH’s) concerns about the proposed federal regulations providing for a birth to school age EI system that are expected to be published as final in December 2007:

• Educational component required for over age 3
• Change transition timeframe to start of school year
• Child would stay in Early Intervention (EI) until Committee on Preschool Special Education (CPSE) determination was made – removing incentive for timely eligibility determination
• No additional federal funding is anticipated and the appropriation trigger is too high to expect funding increase
• From 3 to school age child would lose FAPE rights
• Risk of delayed integration since EI services are provided primarily at home
• No states are interested in pursuing this option– including State where education agency already manages EI (Hawaii may be the single exception)
• Some states are questioning whether participation in the federal program is worthwhile since only 3% of New York’s funding comes from feds
• State Education Department (SED) also evaluated the proposed change and saw no benefit for children and families (Christine V.)
• (additional information is available at www.regulation.gov & click on MPRN)

 3.   Identifying Future Challenges (Members offer their perspective and data)

Aggregate/Statewide Trends (K. Fine)

Enrollment

• Total program enrollment has increased on average 5% per year driven mostly by the growth in enrollment in SEIT programs (13% per year) and Related Services Only (RSO - 7% per year).  Enrollment in center-based program has grown on average under 2% per year since 2001-02.
• As of 2003-04, total program enrollment (verified as of 07/05/07), was 77,550.  Approximately 60% of total enrollment comprises of children in non-center based RSO programs (42%) and SEIT (18%) programs.
• The number of children in RSOs is almost equal to the number of children in center-based programs.

     Costs

• Total program costs increase on average 4% per year with the highest percentage costs increase in the SEIT program (23%).  Costs for center based programs increase on average 4% per year. 
• As of the 2003-04 school year (the last final year), total verified costs for the preschool program are $876M of which the State share is 59.5% and the remaining 40.5% paid for by counties.  Total transportation costs are approximately $120M of 14% of program costs.
• In 2005-06 total State spending for the preschool program was $602.2M while in 2006-07 actual spending totaled $648.4M.  Spending for the 2007-08 FY is estimated to be $663.1M.  FY spending has increased on average 9% per year since 2001-02. 
• 85% of fiscal year spending reimburses costs for the most recent completed school year (i.e, in 2007-08, 85% will reimburse costs incurred in the 2006-07 FY).  Providers have 3 years within which to file their claims.

Mary G. noted that in some States, children receiving related services only are not considered pre-school special education students.   She raised the question of whether, by using preschool special education funding for related services only, are we using the money as we should?  If services are not for special education purposes, should they be covered by another payment source – insurance? 

Trends in numbers of children being served & types of services and setting for service delivery (Christine Vogelsang & Mary Garrett)

Trends in Children Being Served:

Christine V. noted that too often we fit kids into programs instead of designing programs for kids. Need to build programs around children’s needs.  In the case of Asperger’s Syndrome – CPSEs need more training on the ability of these kids…they tend to be placed in settings that are too restrictive.

• More children with cochlear implants
  1. greater need for auditory verbal therapy
  2. need for staff development for teachers of the deaf, speech, therapists and general early childhood teachers. There are 11 auditory/verbal therapists in NYS. Strong need for therapists
  3. Earlier referrals for children with hearing loss due to newborn screenings and greater awareness of physicians and speech pathologist. Need for increased number of teachers of the deaf.
• More children with Mental Health Issues

  1. Includes Bi-polar, Obsessive-Compulsive Disorders (OCD), Attention Deficit Hyperactive Disorder (ADHD) and mental health.
  2. Need vs. service gap.
  3. Hard to seek coordinated efforts. According to the Mental Health Project, this is a national problem not NY only.
  4. Children with MH issues may not otherwise qualify for special education services because they don’t have developmental delays.
  5. Need to increase access to school psychologists.
• Increase of number of children where English is second language: challenges for evaluations and in determining eligibility. Shortage of speech pathologists.

Trends in Types of Services and Settings

• Related services Only:
  1. Shortage of providers
  2. Individual v. group
  3. Pullout v. integrated
  [SED says individual services can be provided in group settings but CPSEs do not always know this or recommend it.]

• SEIT:
  1. SEIT not the same as ABA
  2. Location of Services (home, hospital, childcare, Head Start, Pre-K and nursery schools)
  3. Caseloads: If in multiple locations (especially rural areas) need for smaller case loads: some of our SEIT teachers travel 1,000 miles per month. Travel time is enormous.
  4. Minimum service allowed 2 hours/week; Missing opportunity for front-loaded work directly with student and with monthly consultations. Waiting may delay start without services.
• Integrated Classes
  1. One teacher model – dually certified in Special and Regular Education
  2. Two teacher model – Special Education teacher co-teaches with regular education.In Syracuse, one teacher can cover 4 classes:  2 AM and 2 PM
  3. Location/Collaborations: Challenges: Different calendars, slow response from SED approval on transportation (no program until October because of delay).  Little notice with building moves, Different hours (5 v.6 or 6.5)

Data shows that for optimal learning, 1/3 or fewer of the class should be children with disabilities.

Trends in EI (Brad Hutton)

Over the past three years EI has experienced a stabilization in growth in enrollment and State cost.

Cost moderation achieved through maximization of Medicaid and increase in recovery from 3rd party insurance (more to be done) [There is a risk to Medicaid funds for certain EI services.]

Growth moderation has been achieved through better evaluation and eligibility standards and fewer children staying beyond age 3.

Trends in other indicators (Head Start Participation) (Bob Frawley)
(Handout – 2005-06 Program Year Data)

• Head Start was started in 1967. Serving 3-5 year olds from families at or below the federal poverty level. Head Start programs are unique in that they are directly federally funded. Most Head Starts are licensed as child care centers.
• Over 8,000 children or 18.2% of children served in Head Start were children with disabilities. That represents 10 percent of the children in the Preschool Special Education program.
• Collaboration:  Each Head Start program has a person designated as a Disability Services Coordinator.  In addition, each Head Start program has a health service, child development, and family services and community partnership coordinators.  These people facilitate relationships with other services providers to ensure that all child and family needs are addressed
• Head Starts are required to develop MOUs with School Districts to describe how they will work together to ensure that children with disabilities receive the preschool special education services they need.

Potential Opportunities – UPK  (Cindy Gallagher)
(4 handouts: NYS UPK pamphlet, 2005-06 UPK Program Annual Report to the Legislature, Chart on Percent of Students in NYS Prekindergarten Programs by Need Category and UPK New Districts/Total Districts in County)

• “Universal” a misnomer
• 4-5% of children served in UPK are children with disabilities
• 8% of UPK programs have partnerships with 4410 providers (need to increase this percentage)
• UPK managed within SED with early education and reading initiatives
• UPK fact sheet (handout)
• Statutory requirement to serve four year olds

• Money goes to school districts
• Requirement that at least 10% of programs involve CBOs
• Initially about 40% of funds were used for programs in collaboration with CBOs, the figure is now 60%
• PreK is not mandated

• $146 million increase provides funding of $2,700 - $4,000 per student (covering approximate costs of half-day program) – most school districts want funding to provide full-day

Kim F. asked why, unlike other education programs, there seems to be no assumption of local share and Cindy explained that it is part of the evolution from a grant program.

Cindy G. described several challenges to getting school districts to start UPK programs and noted that SED is working to encourage them and to identify ways to overcome challenges.

Training Early Childhood Educators
(several handouts)
Representatives from SUNY Cobleskill provided the group with an overview of the curriculum for people pursuing careers in early childhood education.  A small number of students pursue a one-year certificate, about a quarter pursue associates degrees and the majority is on a teacher certification track that would lead to a BA.  All require core courses that educate students about “typical behaviors” and there are courses about children with special needs.  There is a concerted effort to teach students how to adapt activities to integrate children with disabilities.

Through practicum and internships try to help students:

• Understand their role in the network that provide services to the child with a disability
• Build awareness of needs of children with disabilities
• Develop a positive attitude toward integration
• Develop skills in classroom management that prepare them to address special needs (if classroom is in control it is easier to provide extra help to the students who need it)

Christine V. noted the importance of preparing early childhood teachers to assist children with oral language development.

The group discussed the need for:

• Better communication between providers coming into an early childhood setting and the classroom teacher – better appreciation for the role and expertise of each.
• Better supports in the child care setting for children with disabilities – too many children with behavioral issues are kicked out.
• Better preparation of students pursuing careers in early childhood to help children develop early reading skills and oral language skills needed.
• Methods to update skills of people who have been in child care settings for a long time
• Methods to improve retention in child care centers
• Early childhood teacher participation in team meetings

Integration has been a focus of national early childhood provider organizations and the SUNY Cobleskill representatives provided numerous materials describing these initiatives.

Group Discussion of Potential Recommendations from Today’s Discussion:

Transition:

• Linkage of children records through the different systems – child identifier that could follow child through system (EI and SED system development collaboration… this is a recommendation that can’t wait until November because decisions are being made now)
• Standardize practices (Training modules exist – they should be updated and all involved in evaluations and decision making reminded of the standards)
• Ongoing Mandated Training (w/evaluators & regulators) – identify existing opportunities for training like existing regional CPSE Chair meetings, role for Early Childhood Direction Centers  
• Monitor compliance with standards -- QA systems exist; in Monroe County a peer review system is employed – possible model

        
LRE:

• Look at range of options for payment of RSO (Related Service Only) – third party insurance

Next Steps

All workgroup members will develop recommendations for discussion at the next meeting.  (They will be sent to Anne Campbell by Thursday August 2, compiled into a single document identifying source of recommendation and shared with the full workgroup.)