1 community provider spring meeting space coast early steps april 8, 2011

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CommunityCommunity ProviderProvider

Spring Spring MeetingMeeting

Space Coast Early Space Coast Early StepsSteps

April 8, 2011

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WelcomeWelcome

House KeepingHouse Keeping

Meeting AgreementsMeeting Agreements Turn cell phones on silent/vibrate Turn cell phones on silent/vibrate No text messaging during meetings No text messaging during meetings One person talks at a time One person talks at a time No side conversations No side conversations Listen as an ally Listen as an ally

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SCES UpdateSCES UpdateProgram Director Program Director

ITNITNInvitation To NegotiateInvitation To Negotiate

Budgetary ExpectationsBudgetary Expectations

TPATPA

PSP Monitoring Data PSP Monitoring Data

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SCES UpdateSCES UpdateBilling DepartmentBilling Department

Medicaid HMOMedicaid HMOInsurance ChangesInsurance ChangesProvider InvoicesProvider Invoices

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New Contracts will be New Contracts will be reflective of new reflective of new

policies policies

Expect new Contracts Expect new Contracts

mid June 2011mid June 2011

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Early Steps Early Steps StatewideStatewide

ProposedProposed Policy Policy ChangesChanges

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Proposed Changes to ES Proposed Changes to ES PolicyPolicy

3.1.4 B. Children made eligible by 3.1.4 B. Children made eligible by Informed Clinical Opinion (ICO) (not Informed Clinical Opinion (ICO) (not standard scores)standard scores)

Must be re-evaluated using a standardized Must be re-evaluated using a standardized test in the area/s of concern no later than test in the area/s of concern no later than the end of the 6 month service the end of the 6 month service authorization periodauthorization period SCES will authorize a re-evaluation

This information is then used by the team to This information is then used by the team to determine the child’s eligibility determine the child’s eligibility

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For children between 24 and 36 months of ageFor children between 24 and 36 months of ageadditional testing is required when:additional testing is required when:

* standard scores do not meet eligibility* standard scores do not meet eligibility

* scaled scores for the expressive and* scaled scores for the expressive and receptive language sub domains show receptive language sub domains show a discrepancy of 3 or more points & ata discrepancy of 3 or more points & at least one sub domain is 5 or belowleast one sub domain is 5 or below

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Eligibility based ICO is ONLY Eligibility based ICO is ONLY allowed at the INITIAL allowed at the INITIAL

determination of eligibilitydetermination of eligibility

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3.1.11 Determination of continuing 3.1.11 Determination of continuing eligibilityeligibility Annual re-determinationAnnual re-determination BDI-2 ScreenerBDI-2 Screener

Completed by Staffed SCES ITDS 1 to 2 months prior Completed by Staffed SCES ITDS 1 to 2 months prior to annual IFSP meetingto annual IFSP meeting

Screen report provided to FSC for annual IFSP Screen report provided to FSC for annual IFSP meeting to assist with determining continuing meeting to assist with determining continuing eligibilityeligibility

If screener indicates child is functioning comparably to same-If screener indicates child is functioning comparably to same-aged peers team should determine whether the child should aged peers team should determine whether the child should be closed or if an additional assessment is necessary to be closed or if an additional assessment is necessary to continue eligibilitycontinue eligibility

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4.2.18b Family Service 4.2.18b Family Service Coordinators Coordinators (FSC’s)(FSC’s)

Must explain to the family the basis on Must explain to the family the basis on which the child is being made eligiblewhich the child is being made eligible

Services may be provided for a limited Services may be provided for a limited period of up to 6 months unless the period of up to 6 months unless the child is re-determined eligiblechild is re-determined eligible

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5.6.4A5.6.4A

If unable to attend the periodic review = If unable to attend the periodic review = facilitated participation through facilitated participation through telephone conference call, designated telephone conference call, designated representative, making available representative, making available pertinent records via mail or fax and/or pertinent records via mail or fax and/or videoconferencing is acceptablevideoconferencing is acceptable

Emails and Text messaging is NOT to be Emails and Text messaging is NOT to be used used

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5.6.4 1. 5.6.4 1.

When a provider is providing an When a provider is providing an update update

on progress of the child toward on progress of the child toward

achieving the outcomes on the achieving the outcomes on the

IFSP they are expected to be IFSP they are expected to be

involved in the reviewinvolved in the review

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6.12.1.6.12.1.At the periodic or annual meeting At the periodic or annual meeting the IFSP the IFSP teamteam may decide to close may decide to close the child & family to ES if the child the child & family to ES if the child is functioning comparably to same is functioning comparably to same aged peers and there is no reason aged peers and there is no reason for the child or the Family to for the child or the Family to continue in EScontinue in ES

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12.6.2 B.12.6.2 B.

There is a There is a MAXIMUMMAXIMUM

travel reimbursement travel reimbursement

of of 60 minutes60 minutes

per child per dayper child per day

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Early Steps Early Steps Homepage Homepage

New New Message Message

to to FamiliesFamilies

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Early Steps Homepage Early Steps Homepage MessageMessage

Shows a focus on interventions …Shows a focus on interventions …

* Services are provided to the family and child * Services are provided to the family and child

where they live, learn and play, to enable thewhere they live, learn and play, to enable the

family to implement developmentally family to implement developmentally appropriate appropriate

learning opportunities during everyday learning opportunities during everyday activities andactivities and

routinesroutines

* Most services will be early intervention home * Most services will be early intervention home visitsvisits

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See you in 20 See you in 20 minutesminutes

BREAK

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Primary Primary Service Service

Provider Provider ApproachApproach

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What does it mean to you?

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Primary Service Provider Primary Service Provider ApproachApproach

Primary Service Provider (PSP) Primary Service Provider (PSP)

is the identified professional on the is the identified professional on the IFSP team that works with the IFSP team that works with the

child/family/primary caregivers child/family/primary caregivers

on a regular basis on a regular basis

and with other members of the and with other members of the team providing services directly, team providing services directly,

through consultation and/or joint through consultation and/or joint visitsvisits

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The primary purpose is to The primary purpose is to pool and integrate the pool and integrate the

expertiseexpertiseof team members of team members

so that more so that more efficient and comprehensiveefficient and comprehensiveassessment and intervention assessment and intervention

services may be providedservices may be providedCoston, ABD, CCC-SLP 9007

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In order to decide who on the In order to decide who on the IFSP teamIFSP team should be a particular family’s PSP, the IFSP should be a particular family’s PSP, the IFSP team should consider the following factors: team should consider the following factors:

IFSP IFSP outcomesoutcomes and strategies and strategies Relationship(s) with learner(s) (e.g. Relationship(s) with learner(s) (e.g. familyfamily

members, other caregivers, other professionals) members, other caregivers, other professionals) Expertise (i.e., not solely discipline) in the areas of Expertise (i.e., not solely discipline) in the areas of

support needed by the child and family/caregivers support needed by the child and family/caregivers Logistics (i.e., schedules, areas, availability)Logistics (i.e., schedules, areas, availability)

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PSPPSP

Services determined based solely on Services determined based solely on evaluations and assessment reports evaluations and assessment reports = operating under a “problem-= operating under a “problem-centered framework”centered framework”

Services determined based on family Services determined based on family priorities and concerns = “outcome-priorities and concerns = “outcome-guided framework”guided framework”

Coston, ABD, CCC-SLP 9007

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The PSP is chosen The PSP is chosen afterafter

outcomes, goals, and outcomes, goals, and strategies are developed strategies are developed

and services/supports and services/supports are identifiedare identified

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Benefits of the PSP Benefits of the PSP modelmodel

One Point of Contact

Whole Child is Addressed

Empowerment

More Time to Be a Family

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Service Service Decision Decision

RemindersReminders

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Service Delivery it is Service Delivery it is NOT…NOT…

More is better

Get as much as you can before they turn three

This Diagnosis = all interventionists regardless of child’s abilities

I’m entitled as my tax payer dollars fund your program

With this XYZ insurance we can see the child 3 times per week

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Service Delivery IS…Service Delivery IS…

6.1.18 6.1.18

The minimum The minimum frequencyfrequency and and intensityintensity of supports to achieve of supports to achieve MAXIMUM progress toward an MAXIMUM progress toward an outcomeoutcome

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Service Decisions Service Decisions RemindersReminders

6.1.16 6.1.16 Early intervention servicesEarly intervention services and supports and supports decisions must not be based solely on the decisions must not be based solely on the following:following:

A. A specific diagnosis – (med/dev)A. A specific diagnosis – (med/dev) B. Provider/therapist biasB. Provider/therapist bias C. Nature or severity of disabilityC. Nature or severity of disability D. Age of childD. Age of child E. Availability of servicesE. Availability of services F. Availability of space F. Availability of space G. Administrative convenienceG. Administrative convenience H. Payment method or amount (private)H. Payment method or amount (private) I. Preference of any single I. Preference of any single IFSP teamIFSP team

membermember

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Determine PSP &

Supports

Coach theFamily

Develop Outcomes&

Strategies

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WHAT IS WHAT IS COACHINGCOACHING

TO YOU?TO YOU?

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COACHINGCOACHING Building on what the parent is Building on what the parent is

currently doing and teaching them currently doing and teaching them to identify and implement other to identify and implement other ideas and strategies in the current ideas and strategies in the current and future situations without and future situations without dependence on the coachdependence on the coach

Rush & Shelden 2008Rush & Shelden 2008

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Coaching isCoaching is NOT a model of service deliveryNOT a model of service delivery

It IS an evidence-based adult learning It IS an evidence-based adult learning strategy the practitioner uses to interact with strategy the practitioner uses to interact with parents and care providers to maximize child parents and care providers to maximize child progress both when the practitioner is and is progress both when the practitioner is and is not presentnot present

NOT Telling a family what they need to NOT Telling a family what they need to do or doing something only with the child do or doing something only with the child

It IS purposefully interacting with another It IS purposefully interacting with another adult in order to build their capacity to adult in order to build their capacity to support child learning and development support child learning and development within the context of everyday activitieswithin the context of everyday activities


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Coaching is...Coaching is...

NOT something that only works with NOT something that only works with certain families certain families Promoting their strengths and abilities Promoting their strengths and abilities

rather than limiting them by their rather than limiting them by their presumed deficitspresumed deficits

(Dunst & Trivette, 1996)(Dunst & Trivette, 1996)

NOT useful for only certain childrenNOT useful for only certain children Useful for all children when we focus on Useful for all children when we focus on

child participation in meaningful activitieschild participation in meaningful activities


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Coaching is…Coaching is…

NOT “parents becoming the therapist”NOT “parents becoming the therapist” Parents participating in the recognition, Parents participating in the recognition,

development, and use of ideas to help their development, and use of ideas to help their children learn and grow as a natural part of children learn and grow as a natural part of family and community lifefamily and community life

NOT a hierarchical relationship between NOT a hierarchical relationship between the practitioner and the parentthe practitioner and the parent A mutual sharing of information that defines A mutual sharing of information that defines

the plan and embeds strategies to get to the the plan and embeds strategies to get to the destinationdestination


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Federally Federally CompliantCompliant

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NOT a technique to get people to do what NOT a technique to get people to do what you wantyou want Building on the family’s current activities and Building on the family’s current activities and

teaching them to identify and implement other teaching them to identify and implement other ideas/strategies in the current and future ideas/strategies in the current and future situation without dependence on the coachsituation without dependence on the coach

NOT the same as consultation which is an NOT the same as consultation which is an indirect model of service deliveryindirect model of service delivery Not showing a difference between direct or Not showing a difference between direct or

indirect, hands–on or hands-off interventionindirect, hands–on or hands-off intervention


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Purposefully interacting Purposefully interacting with another adult in order with another adult in order

to build their capacity to to build their capacity to support child learning and support child learning and development with everyday development with everyday

activitiesactivitiesRush & Shelden 2008Rush & Shelden 2008

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ExpectationsExpectations

Tell the family exactly what Tell the family exactly what youyou will be providing will be providing

Tell the family exactly what you expect of Tell the family exactly what you expect of themthem during visitsduring visits InvolvementInvolvement Follow up activities Follow up activities Having them show you what they worked on Having them show you what they worked on

and howand how

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EXPECTATIONSEXPECTATIONS SCESSCES

Drafting a letter that will go out to all families Drafting a letter that will go out to all families explaining the PSP model and coachingexplaining the PSP model and coaching

Currently partnering with:Currently partnering with: Early Learning CoalitionEarly Learning Coalition Early Head Start Early Head Start To promote education of the PSP model and how To promote education of the PSP model and how

that can positively affect not only the child and that can positively affect not only the child and the teacher/provider but the whole classthe teacher/provider but the whole class

Provide at least half of your visit in Provide at least half of your visit in

the natural the natural environment with the child instead of environment with the child instead of pull outpull out

Possible liability issues Possible liability issues

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HIPAA &CONFIDENTIALITY

Email

Text

Facebook

Professional Courtesy Judgments

FriendshipsPersonal Turmoil

Comments

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Outcomes and Goals

Determine the PSP &

Supports & you’re ready to

Coach….

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EMBEDEMBEDEMBED EMBED EMBEDEMBED

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EMBEDEMBED

With the family outcome and their With the family outcome and their challenge in mind challenge in mind

Provide activities to family that can help Provide activities to family that can help reduce the challengereduce the challenge Then ask the family; are there routines they Then ask the family; are there routines they

already do that they could use some of the already do that they could use some of the activities in?activities in?

Diaper changingDiaper changing Walking to the mail boxWalking to the mail box Eating a meal with the familyEating a meal with the family

Grocery shoppingGrocery shopping

EmbedEmbed

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GAME TIMEGAME TIME

With Rewards!With Rewards!

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ITDSITDS

EMBEDDED EMBEDDED ROUTINEROUTINE

GOGO

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PTPT


GOGO

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SLPSLP


GOGO

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OTOT


GOGO

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FSCFSC


GOGO

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LMHC/LSWLMHC/LSW


GOGO

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WILD CARDWILD CARD


GOGO

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Who Can Support Who Can Support You?You?

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Family Service Family Service Coordinator Coordinator

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The role of a Family Service The role of a Family Service Coordinator is…..Coordinator is…..

SpokespersonSpokesperson

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is…..

SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator

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SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is….. SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter Support networkSupport network

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is….. SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter Support networkSupport network CounselorCounselor

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is….. SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter Support networkSupport network CounselorCounselor ““Mediator”Mediator”

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is….. SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter Support networkSupport network CounselorCounselor ““Mediator”Mediator” ConnectorConnector

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The role of a Family The role of a Family Service Coordinator is…..Service Coordinator is….. SpokespersonSpokesperson ““Representative” for the familyRepresentative” for the family Record keeperRecord keeper AdvocateAdvocate Point of first contactPoint of first contact Idea generatorIdea generator FacilitatorFacilitator Investigative reporterInvestigative reporter Support networkSupport network CounselorCounselor ““Mediator”Mediator” ConnectorConnector Active Essential Team MemberActive Essential Team Member

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Research Indicates Research Indicates that children learn that children learn

through through opportunities to use opportunities to use

their skills within their skills within the context of real the context of real life activities they life activities they

find interesting and find interesting and their families find their families find

important.important.Dunst, Hamby, Trivette, Raab, & Bruder 2000

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REMINDERS

Interpreters Spanish Creole Deaf

Provider Management Unit c

[email protected]

Must be current on you!

ESSO WEEKLY MEMO

Have G FORM authorizatio

n

in hand prio

r to se

rvice

provision

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How Do I Know You? Let Me Count the Genes…What: Genetics Training sponsored by Space Coast Early StepsWhen: April 15, 2011 (Friday)Time: 9am-3pmWhere: Viera Children’s Medical Services/Early Steps office

Cost: $40 for the course to include 5 CEU’s. Checks are the only form of payment and must be made payable to CATCH/Early Steps

Instructor: Karlene B. Coleman, RN, MN, CGC (registered nurse and certified genetics counselor); clinical instructor at Emory University in Atlanta; and credited with more than 30 publications in her field

RSVP:Must respond by April 11, 2011 at 321.409.2136 x 203 or [email protected]

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QUALITY ASSURANCE

AWARDS

OCTOBER 2010MARCH 2011

1 community provider spring meeting space coast early steps april 8, 2011

Documents

child family

proposed policy changes

eligible slide

es policy eligibility

proposed changes

review slide

childs eligibility slide

ally slide