Recognizing that programs serving young children and their families are most effective when they are integrated, Vermont has taken several steps to build a coordinated system of child development and family support services.
Children’s Integrated Services (CIS) co-locates Part C early intervention, early childhood and family mental health, nursing and family support, and specialized child care services in the Department for Children and Families. These services were previously provided through separate programs with distinct funding streams and procedures. Now each of Vermont’s 12 regions has a CIS coordinator who oversees multi-disciplinary teams responsible for CIS intake and review, and policy and administration.
CIS teams across the state use common referral and intake forms, as well as a recently developed planning and case management document, One Plan. One Plan is a vehicle for developing a comprehensive and individualized child and/or family plan with the goal of supporting families’ competency. It includes several questionnaires meant to guide discussions with families to identify resources and document their concerns. It also links to a toolbox of additional forms specific agencies may be required to complete, such as a mental health status or developmental assessment. The One Plan process results in a service plan comprised of a prioritized list of family concerns, measurable outcomes and strategies addressing these concerns, and a chart specifying the details of services being provided. Progress toward outcomes is regularly measured to ensure the best strategies are being employed to help families achieve success.
Three regions took an additional step toward integration by piloting a single fiscal agent structure in 2011, which allocates all CIS funding for the region to one organization. The fiscal agent is responsible for ensuring that all CIS services are provided, and programs are working together. The pilot found that tying funding to a requirement for collaboration drove significant changes in practice. Participating regions saw increased integration between programs and services and were able to collect more meaningful data on families served. As of July 2012, nine of the twelve regions have a single fiscal agent structure in place.
Additional efforts to continue moving Vermont’s initiative for improved service delivery and outcomes forward have since been developed. The state developed a central web-based data management system to support service providers and state-level CIS staff document outcomes and make informed decisions about policy and practice. With the Vermont Early Childhood Data Reporting System (ECDRS) being fully developed, Vermont policymakers and practitioners are now able to track early childhood outcomes, measure the return on investments, inform program planning and policies, and drive continuous improvement. Vermont’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is also embedded in CIS, ensuring MIECHV services are integrated into the existing prenatal and early childhood health and social support system.
Reviewed July 2018.