The Chester County Intermediate Unit [CCIU] is concerned with the uncertain identification and fragmentation of services offered to children with autism. There is no system of care in Chester County. Despite the advent of established clinical guidelines in the field, differing conceptual perspectives continue to allow children to be misidentified. Once identified, parents are often left to find out for themselves what types of services and supports are available and to ‘fight’ for the opportunity to be served. There is a tendency for providers to become ‘experts’ in a single approach and to apply that approach to all children, rather than seek alternative methods. This ‘one size fits all’ tendency leaves a great deal to be desired. When this tendency is combined with a failure to create effective ways to use categorical resources, the outcome is one that is not supportive of families may be detrimental to their children.
In response to this increasing need to offer effective services to children with autistic characteristics, CCIU is seeking to:
- develop a comprehensive array of interventions that are age appropriate and based on full assessment.
- develop clarity of responsibility for assessment, assignment, funding, & monitoring of service outcome so that the system learns from its experiences.
- develop a comprehensive and coordinated program that provides parents with understandable local options so that they may make informed decisions.
This proposal describes an approach to development of assessment and planning for children with autistic characteristics. The approach is designed to help parents, school district staff and multiple child and family service agencies improve their understanding and skill in identifying and implementing special techniques, services and programs for this population. The intended outcome of this approach is a to provide a comprehensive system for assessment, service design, service delivery, monitoring, staff development and quality feedback that documents effectiveness.
In order to achieve this goal, it will be essential to elicit political, professional and parental constituents to support and sustain this effort. The Autism Network is designed as process of whose growth and development is determined in its actualization by the constituents themselves. This proposal provides a ‘road map’ for consideration.
A Coordinator will be charged with providing leadership in enlisting constituents to participate effectively in the process. Along with recruiting substantive support and direction from these constituents, the Coordinator will participate in the process of resource generation and development which will include, but not be limited to:
Establish a screening process that can be used by medical doctors to determine whether the characteristics of autism exist.
Early assessment and confirmation before the age of three is still rare. “The first professionals to come in contact with an autistic child are the obstetrician and pediatrician. Yet, it appears that, in the majority of cases, these medical professionals have had little or no diagnostic training in identifying a child who shows symptoms of being autistic. As a result, 90 percent of the 20,000 autistic children, youth and adults in Pennsylvania, are misdiagnosed, inappropriately placed and inadequately treated” [Report on House Resolution 104 – 1988]. Since that time, little has changed even though “(c)linicians and researchers have achieved consensus on the validity of autism as a diagnostic category and on the many features central to its definition” [Rutter, 1996]. “In contrast with autism, the definitions of autistic-like conditions remain in need of more clarification” [Rutter & Schopler, 1992].
Despite a recommendation in the House Report that medical doctors should be exposed to autism while in training, we find in 1997 [Howlin & Moore] that the average age for confirmation of autism was 5.5 years. For children with Asperger syndrome the age was considerably later, at 11.3 years. This would suggest the need for a much more formal system of identification and assessment than presently exists. Presently pediatricians are the primary source of initial assessment. To ensure accuracy and consistency in their diagnosis, some central process must be developed and made publicly accessible.
The availability of a shared clinical concept and language for differential diagnosis is a great asset for clear communication among clinicians, physicians, advocates and social policy formulators.
Recommendation: Create a screening procedure based upon consistent clinical concepts and language that can be used by the medical profession and engage pediatricians, obstetricians and general practitioners in training in its use and in referral.
Development of a single, comprehensive assessment team to which medical doctors and others who have suspicions of autism syndrome can refer for confirmation and recommendation.
Centralization would allow for evaluation by highly qualified individuals familiar with the disorder and for a continuity of identification and intervention. All assessment must include very thorough and specified medical examination. Allergic intolerance to food and/or chemicals, reaction to vaccination, myelin basic protein [MBP] antibodies, candida overgrowth and others physical circumstances have been linked to autism and vitamins and other food supplements have been reported to have positive effect. Just as we will be more prescriptive in developing an optimistic ‘menu’ of preferred services, so too, we need to begin to recommend these therapies on the basis of biological evidence.
Thus not only does the assessment process need to be accessible, it must be attractive enough to overcome the resistance that parents feel about finding something ‘wrong’ with their child. It is not unusual for people in our society to deny very serious problems in the hope that they will go away rather than face the consequences of finding out that something is not right. This is difficult to overcome and once overcome, such people often reach a state of panic seeking any means to find resolution. A service that offers hope, security and confidence represents a possible way of diminishing this behavior.
Recommendation: Under the guidance of an Assessment Specialist, a process be developed in which contracted experts are available to pursue a consistent pattern of evaluation and assessment to determine the existence of characteristics of autism and a diagnostic classification
Development of a comprehensive program design that will enable families to have options concerning the direct services offered to their child and a ‘road map’ of potential services over time.
There is evidence that the most effective intervention programs are those that begin between the ages of 2 to 4 years. For example, the development of effective communication strategies from early childhood will almost certainly help to reduce or avoid disruptive behavior in the future.
Additionally, the establishment of child management strategies in these early years can help to minimize, or even avoid, subsequent behavior problems. It is essential not to allow or encourage behaviors that will be viewed as ‘challenging’ or unacceptable as they grow older. Such problems arise not because the behavior has changed, but because other people’s attitudes to it alter.
Recommendation: That through the process of development and actualization, there be considerable time spent reviewing intervention approaches from a ‘cradle to grave’ perspective and that a ‘menu’ of options be developed to ensure that children and their families will have a ‘future’ with the supports necessary to optimize quality living.
Development of a ‘best practice’ search that will identify research documented approaches that are characteristic specific.
There seem to be no universal autism interventions that are effective with all children who have autism. In part, this is because autism is not a singularly defined experience, but rather an array of complex learning needs, which cover sensory, social and broadly defined communication deficits. While we may not have specific, all encompassing interventions, there seems to be a well-developed technology to teach young children with complex learning needs. The specific features of this technology, to be applied in home, school and community settings include:
- Identification of the specific task skills needed
- Selecting the most appropriate [likely to be effective] intervention
- Identifying motivational incentives for specific children
- Incorporating instructional goals within daily routines and activities across all environments
- Ensuring an adequate intensity and quality of instruction
Thus an appropriate system allows for both consistency and individualization, while providing a clear picture of what is available, at what times, and with what expectations.
Families need detailed information on local options and the local system managers need to be informed as to the efficacy of local implementation. It is not the goal to provide a menu of options that cannot be effectively delivered. The detail of the process is to identify what might be, as a basis upon which to determine what will be. Once the array of options is defined, and the system managers are assured of what is required to ensure the quality of delivery; an optimistic menu of technologies can be locally shaped to define what will be available, who will provide the services, who will fund the services, and what are expectations for families.
This final ‘menu of options’ can then be appropriately shared as a means of helping parents make informed and realistic decisions about their preferences.
Recommendation: That an academic institution be included that will take the responsibility of mutual employment of a researcher who will lead a concerted effort to locate ‘best practices’ that are research supported, help to design program responses, and measure outcomes.
Formation of a staff development component that can train local professionals to provide ‘best practice’ services.
If the policy and service agencies are to find effective approaches, they will need to develop a learning system that identifies, tests, measures and adjusts based on empirical experience. The creation of a comprehensive plan is but a beginning to the development of a ‘cutting edge’ system. If the comprehensive plan is to become a comprehensive system there must be assurance that clinicians are providing the techniques appropriately. This will require both a certification and monitoring process. If we are assured that the technique is being directed at specific characteristics and being delivered correctly, we can then determine whether the technique is effective in reaching outcomes. If it is, we must work to continuously improve it. If it is not, we must abandon it for other promising approaches. This is not a ‘scattergun’ approach, but an orderly process of analyzing best practices over time for the maximum gain in both individual children and all children collectively.
Recommendation: that an ‘institute’ be developed that is able to use the knowledge acquired through the research component to build a curriculum to train professionals, paraprofessional, parents and other natural supporters in the preferred protocols, techniques and procedures.
Development of a plan management system that will ensure that ‘best practices’ are carried out and families are supported.
The Social Security Act requires that states provide all medically necessary services including case management. The EPSDT implementation guidelines describes case management as a comprehensive service to eliminate the fragmented approach to needed services [emphasis added]. This means that states must provide case management services to children where it is deemed medically necessary. In implementing an ideal system of care for children with autism, it will be necessary to ensure that these guidelines be applicable to all children and their families regardless of medical assistance status.
Additional considerations, to make this position more comprehensive and valuable include:
- a clear positioning ‘outside’ of a child serving system through placement in context of a community advisory council that will manage care
- a clear focus on goals instead of needs, thus placing the child/family in a position to ‘steer’ the services towards personal outcome expectations
- a clear development of a single plan to be implemented by multiple providers according to the expectations of the child/family, the constraints of the comprehensive plan, and the monitoring by a plan manager.
As much as possible, these plan managers will be selected from each locale providing community sanction, decentralization and accessibility. They will, however, be centrally trained and coordinated through the Comprehensive Assessment & Planning component. A plan manager would be assigned to each family at the development of a new plan. They would be paid as ‘as needed’ staff, the equivalent of a one on one Medicaid staff. It is projected that each child/family would have direct access to a plan manager for eighteen weeks at four hours per week for a total of three hundred and twenty four hours.
Recommendation: It is intended that the Autism Network will recruit at least five  candidates who meet these requirements and live within each local school district, maximizing local control and providing a mutual support and resource group.
Development of a ‘secondary client; focus that will both enhance ‘24/7’ services and increase community consciousness of autism.
There exists a paradox that children with autism and their families require intensive services across every context, while at the same time being given opportunities for an everyday life.
What this will require is a planned intensity that uses natural supports in a thoughtful and sensitive way.
While there is considerable controversy about what constitutes sufficient intensity, there are certain principles which policy makers might consider:
• services need to be provided throughout the year.
This requires that an individual family service plan [IFSP] be developed that considers specifically what will be provided to the child through vacation and family respite time. These interludes need not be professionally provided, but they must be planfully provided and monitored.
• educational services range from three to six hours, five days per week.
Since schools need to provide social as well as educational experiences, and since social experiences are a teaching focus for children with autism, the individual family service plan should identify the specific social needs that might best be emphasized in school as opposed to home and community and the two must be planfully coordinated.
• total intervention services, from the perspective of social and communicative growth and development is a significant part of mutual interactions that occur whenever the child is awake and in proximity to other people.
This suggests what people in the field refer to as a 24/7 program. It does not require that the ‘other’ is specifically involved in teaching a program; but insists that the ‘other’ be sensitive to opportunities to identify and reinforce developmental events and able to respond and facilitate effectively and in a manner which is consistent to the other parts of the service. This requires an emotional commitment and value of the goals specified in the individual family service plan as well as learning to use specific skills in facilitating the social, communicative and behavioral activities of the child.
Thus the intention and delivery of services may differ, but the scope of service should be consistent with the intention and style and delivered for all children across all environments and experiences.
Lest it appear that children with autism should become victims of overly prescriptive interventions that reduce the potential for typical childhood, it must be emphasized that:
- children with autism must be provided with regular and planned opportunities to interact with typical age-peers;
- services need to be delivered across many different social contexts; and
- parents must be acknowledged as the primary teachers of their children while age-peers are their primary ‘coaches’.
The intensity dimension of scope is best served through the development and use of ‘natural supports’ in very specific ways. Teaching significant others [e.g., parents, siblings, child care workers, extended family members, and age-peers] to employ specific teaching [modeling & response] behaviors can have a significant impact on the scope of service intervention providing continuity over time as well as reducing overall costs.
We must equip such natural support people with training, values and direction and provide them with written performance criteria including specific evidence of skill generalization. We must ask them to interact consistently with the child with autism and to collect and record data over time to help us allocate resources towards effective social participation.
An additional problem is that social behavior is not governed by simple rules. The same behavior may be acceptable or unacceptable by age or context. Providing the structure and behavioral responses to address such issues will require an inordinate expenditure of parental energy since they will need to be ‘on’ all the time they are with their children with autism in order to be consistent in their modeling and reinforcement. This will require that the local system not only offer child management training to parents, but they will need to provide respite services for parents on a planned and regular basis, with the assurance that surrogate care takers are also consistent with the selected child management strategies and the goals of the individual family service plan when providing behavioral response and reinforcement.
Probably the most pervading and important of all the affectional systems in terms of long-range personal-social adjustments is the age-peer affectional system. Typical age-peers can be taught easily to facilitate the social and communicative abilities of their classmates with autism, and this option should be pursued.
Recommendation: This is a two part recommendation. First, the resources to provide respite to parents and families needs to be identified. Second, the resources to train natural peer and support people who can provide the respite is required. The second aspect can be accomplished through the ‘institute’ training for through professional intervention.
Development of a longitudinal process to study the short and long term effects of the system’s practices.
Identification of effectiveness, which is critical to a successful system, requires that the baseline issues are identified and measured by someone other than the provider of services. Informants repeatedly report that provider’s insist that the child has made gains with behaviors that parents say already exist. The provider, of course, would probably suggest that such behaviors never existed – and they may not have. But neither has documented either baseline nor benchmark performance in a non-biased way.
A comparison of baseline performance to benchmark performance is critical if we are to document effective services. A comprehensive plan for providing services to children with autism must avoid extravagant claims and zealous marketing of ‘one size fits all’ models of intervention. Such avoidance requires that the plan implementation be based upon data collected in formative, summative and cumulative form.
- Formative data is that individualized data that comes from functional assessment and sets baseline behavior levels. Such formative data changes over time as new benchmark behaviors are reached and new achievement goals are identified.
- Summative data is that individualized data that comes from keeping a continual record of individual performance and achievement over time and provides a documented record of what worked and what did not work for this individual.
- Cumulative data is the collective data of summative data on all individuals [intentions & achievement] that allows for an analysis of effective practices over time and large numbers of constituents.
Recommendation: That an academic institution be included that will take the responsibility of mutual employment of a researcher who will lead a concerted effort to locate ‘best practices’ which are research supported, help to design program responses, and measure outcomes.
Development of the resources to develop and maintain the system.
“No one system: Education, Mental Health/Mental Retardation, Health or Human Services [is] able to handle the complexity and multitude of services and programs autistic children and their families need” [Jean Ruttenberg]. The development of a regional system can only provide a comprehensive approach if the ‘thresholds’ of each system are examined for continuous entrance and exit criteria. Only by articulating an ideal system and then placing our present system on it, can we identify the ‘gaps’ that must be closed. There has been little regard for the total overall needs from cradle to grave. No all-encompassing plan has been developed to elicit and enhance the innate potentials of each child so that society would reap the benefits of their collective abilities. The program goal should be to assist every individual to achieve their highest functional potential.
Recommendation: The participating constituents begin to assess the present expenditures made for children with autism and place those funds into a ‘children with autism fund’, which will allow for services to be purchased from provides ‘as necessary’ without discussion of ‘who pays’.
This plan, initially developed by a committee of providers, has several specific recommendations for implementation, all of which are subject to the input of the major constituents identified above. Since the program model is conceived as a developmental process, the structure and budget are not ‘etched in stone’.
At present, the organizational structure has three components requiring the employment and deployment of:
A Coordinator, who will, with appropriate clerical support, oversee the process.
An Assessment Specialist, who will, with appropriate clerical support, oversee the development of the assessment process and assign Plan Managers. If possible, this person and the clerical staff should be employed in month 1 of the process.
A Researcher, who will, with appropriate clerical support, provide expertise on literature search, program design, management information and outcome measurement and coordinate the Data Specialist in the development of a data management system, and the Training Supervisor in the development of knowledge transfer to professionals, paraprofessional, parents and others providing natural support. If possible, this person and the clerical staff should be employed in month 1 of the process.
Five  full time professional staff and three  clerical staff are required. In addition, an unspecified number of Plan Managers will be employed.
Process & Rationale
COMPONENT #1: LEADERSHIP
The Coordinator of the Autism Network, employed in month 1 of the project, is the chief staff officer of the Autism Network and is charged with both internal and external leadership. The incumbent will be charged with the development of external support and relationship with the policy makers, professional experts and parents and families. It is the cohesion of these constituents which will make the AN an effective approach to the needs of children with autism.
A full time administrative assistant will be assigned to this component and will oversee the clerical activities in the other components.
COMPONENT #2: QUALITY ASSURANCE
The Assessment Specialist, employed in month 2 of the project. will be a licensed clinical and certified psychologist with experience in multidisciplinary evaluations. The incumbent will be responsible for the establishment of a ‘screening’ process for medical practitioners and uniform diagnostic criteria for the Comprehensive Assessment & Planning team. Additionally, the incumbent will recruit and contract with experts in various fields to complete the assessment process and assign Plan Managers.
A full time administrative assistant will be assigned to this component.
Plan Managers: these positions will be employed as the first assessment and plans are developed – probably starting in month 6 of the program.
The incumbent will recruit and arrange for training for Plan Managers who will act as a ‘keeper of the vision’ for the child/family. The incumbent will assign a Plan Manager to each child/family as the assessment is finalized and the recommended plan is being developed.
The Plan Managers will be contracted employees used on an ‘as needed’ basis. There costs should substantially be covered by Medicaid funds as a medical necessity. However, there will need to be training subsidies.
The difficulty of providing plan management to children who do not have medically necessary requirements is an area of minor concern. Unless one defines any child needing services and supports from more than one child serving agency across several life domains to, a priori, qualify for medically necessary services based upon the context of prevention, another manner of funding will need to be found for some of the identified children.
An alternative funding possibility exists in the use of the Educational Rehabilitation Agency or Provider Certification #47 of the Office of Medical Assistance Programs, commonly referred to in Pennsylvania as ACCESS.
COMPONENT #3: QUALITY ENHANCEMENT
Researcher – Should be employed in month 1 of the program. It is proposed that this capacity be developed through a public/private partnership with an academic institution. Having an academic institution involved in the change process enhances the potential for a change curriculum through which new professionals develop.
The researcher must be a person who is new to both the academic institution and the AUTISM NETWORK [AN] and is co-employed. AN is seeking a practical researcher with academic potential, not a person who is incapable of performing in the ‘real’ world outside of academia.
If this dual employment can occur, both the AN and the academic institution have a great deal to gain. An academic institution that provides educational curriculum across education and welfare professions has the opportunity to tie directly to information about what is working and not working and what is ‘cutting edge’ technology. This provides them with the data to retool their own curriculum to meet the needs of expanding human service technologies and values. Finally, the partnership gives the academic institution the opportunity for field placement for doctoral research students.
The AN requires the data not only to ‘learn’ what works and what does not, but also to be able to develop remedial actions for what is not working. Additionally, such data helps in social planning requirements.
The researcher will be the lead staff person of the Quality Enhancement Component, reporting directly to the Coordinator of AN.
A full time administrative assistant will be assigned to this component.
Data Specialist – This person should be employed in month 2 of the program.
Quality Enhancement will require electronic technology support to provide management information [MIS] and performance outcome [POMS] data. Data Specialist support may be purchased from the CCIU or employed directly. Quality Enhancement is responsible for the design and implementation of a data management system that meets the requirements of a learning system. The design of a Comprehensive Data System has as its goal to provide quality data in a timely fashion to policy makers. The CDS must integrate the collection of institutional and client level data from all institutions whose primary purpose is to provide services to children and their families. Pursuant to meeting these mandatory requirement and needs, data collected must be comprehensive and coherent across systems while still maintaining the integrity of the confidentiality regulations that are required of these organizations.
Changes in technology for data collection and dissemination should make the design and development of such a system timely, effective and secure. Policy makers, researchers, districts, teachers, clinicians and parents want more timely data that are easy to access and easy to use. QE also wants the provision of data to be less burdensome to the consumer of information. The goal of the design is, therefore, to have a system that will incorporate all the data requirements and address issues relating to security, timeliness, coverage, quality, comprehensiveness, accessibility, utility, burden and cost. All data can be collected through a Web-based mechanism because it can incorporate data editing and other quality controls at the time of data submission and will subsequently reduce the effort required for follow-up and survey operations. To achieve this goal, QE should develop a web-based capacity in which each institution has its own password to access and enter requested data. Once the data pass the editing checks and are approved by the coordinators they may be submitted directly to the public agencies [local or state] for value added reviews.
A Data Specialist will operate as a chief information officer for the AN. S/he will require knowledge of information systems and networks as well as having programming abilities. It is unfortunate that most data experts are expert in the management of financial or inventory data, rather than human services data. Accepting this, it is incumbent upon the researcher to have primary responsibility for the design of the system. The DS should have knowledge about design, particularly outcome data management.
It is proposed that this expertise could be purchased from the CCIU which has an large data and computer capacity. However, this will need to be determined by the researcher.
Training specialist – This person and the clerical staff should be employed in month 4 of the program.
The Training Specialist, will over see the development of an ‘institute’ for training professional educational and clinical staff, paraprofessional, parents and other people who provide natural supports in the philosophy, theory, protocol, techniques and procedures of the Autism Network
The Training Specialist will need to be a person who is both capable of providing the training, and is able to coordinate the actual implementation: including such functions as:
- recruiting, selecting, employing and training trainers
- organizing the curriculum for training
- developing new training modules
- developing PDE certification
- marketing the training to customers
- registering customers
- scheduling the rooms and times for training & assigning trainers
- maintaining the revenue and costs structure
AUTISM NETWORK – BUDGET
PERSONNEL & SALARIES
|Subtotal – Professional Staff||$282,825|
|3||Administrative Assistant(s) @ $30,500||$91,500|
COORDINATOR: As the project director, the salary range will be compatible with other such positions within the CCIU and range from $80,000 to $100,000.
ASSESSMENT SPECIALIST: will be a licensed clinical and certified psychologist and the salary is based on the CCIU payroll plan.
TRAINING SPECIALIST: It is likely that the training leadership will cost somewhere in the $39,600 to $51,600 salary range or $45,600. This estimate is based on a review of training salaries.
DATA SPECIALIST: based on salaries for a Certified Systems Manager and CCIU technical staff salaries.
ADMINISTRATIVE ASSISTANT: the salary is based on an average of the mid-points of three levels of administrative assistant positions within the CCIU.
FRINGE BENEFITS [33.8%]
NOTE: Benefits vary by type of position and cannot be determined by a percentage. However, the benefits and taxes as listed are equal to 33.8% of the federal request.
|TOTAL FRINGE BENEFITS||$126,522|
Plan managers $365 x 10 = $ 3,650
Local Travel is calculated at 36.5¢ per mile.
Plan Managers are projected at 4 miles per day for 250 days or 1,000 mile per year
Other staff, with the exception of clerical staff are projected at 500 miles per year.
plan managers x 1,000 x .36.5 = $ 365 each
other x 500 x .36.5 = $ 183 each
Out of Town Costs are scheduled at $1,000 per full time staff person
|No expected costs||$0|
Each full time person should have:
|Desk @ 600|
|phone @ 132|
|Computer @ $2,500 [Desk Top]|
|2 drawer file cabinets @ 75|
|book case @ 300|
|guest chair @ 170|
|desk chair @ 170|
|8||$ 3,947 per person||$31,576|
There should be a:
|Table @ 250||$250|
|8||Table @ 250||$1600|
|printer @ 500||$500|
|Copy Machine @ $2,500||$2500|
|FAX Machine @ 250||$250|
Justification: For purposes of occupancy and supplies, we have determined projections based on 5 professional staff and 3 clerical positions.
We are projecting 08 individual desk area set-ups and one conference room.
|8||08 x office space @3,947||$31,576|
|1||conference spaces @ $5,100||$5100|
|1||copy machines @ $2500||$2500|
|1||FAX machines @ $250||$250|
|8||Office Supplies $500 each person||$4,000|
|3||Books & Periodicals||$900|
|8||Computer Software $500 licensed contract for each computer each year supplies full range of software including, but not limited to: Microsoft Office, Coral Word Perfect, Adobe Acrobat, Adobe PageMaker, Claris Works 4.0, GroupWise 4.1, Norton Utilities.||$4,000|
|8||computer licenses @ $300||$2,400|
|TOTAL OFFICE SUPPLIES||$15,800|
|4||Research Interns @ $ 10,000 per||$40,000|
|10||Plan managers @ $6,800 per||$68,000|
|10||Training $20 x 15 hrs||$3,000|
Justification: The average salary of a full professor in a small institution such as West Chester University is about $80,000 plus 30% or $24,000 benefits equaling an average expenditure of $104,000 . At a large institution such as University of Pennsylvania the average is closer to $115,000 plus $34,500 or $149,500 total. Thus, the contractual arrangement will probably cost from one half to three quarters of a range from $104, 000 to $149,500 or approximately between $74,750 to $112,125. On the average, a required commitment for a researcher would be about $95,438.
The Research Interns will be responsible to the Researcher of Quality Enhancement and will provide support to that Component.
The Plan Manager Projected Budget Formula = 18 weeks x 4hrs/wk = 324 hours x $21.00 average per hour = $6,800 per child/family.
Training Stipends are not presently covered by Medicaid and resources need to be found to cover this responsibility. There is, as yet, no ability to identify the numbers of hours of required training that will be necessary for certification as a Plan Manager. It is suggested, however, that a $10.00 per hour stipend be paid directly to the employee. An additional $10.00 per hour of training costs for each employee can be considered a baseline [however, certain savings may be possible].
Implementation of focus groups and town meetings = $20,000. This will include meetings in each of the school districts as well as within in special settings to create an understanding of citizen expectations and to give an understanding of new social policy and the comprehensive system.
Web Site development and maintenance = $3,500. This will provide information on both the system and access points and service delivery vendors; social learning theory and technology; and provide training programs for people who provide natural supports.
Training = $45,000 The comprehensive system interjects risk through competition and change which is intended to generate creative action. In order for it to do so without overwhelming staff who never thought that risk should apply to them, we are required to “create incentives to ‘pull’ behavior toward those goals – [Osborne & Plastrick]. One of the most important answers is training – making sure that employees have the skills and knowledge they need to perform well. Since, for many in the system, we may be interjecting new service delivery technology, we are required to empower them with the resources to compete effectively. Such training will need to be an on-going part of the Project and will utilize both internal and external resources.
|Sub-Total Social marketing||$68,500|
This includes costs for utilities [$2,000], rental [$20,000]], and repair & maintenance [$4,000].
The expectation is that we will need space at any given time for 08 people. A space of 2,000 square feet at $10.00 per square foot may be available to us. We would expect minor cosmetic upgrade and minimal repair an maintenance during the first year.
|8||Phone installation @ $55 per||$400|
|8||Local & Long Distance $20.67 month x 12 mo||$2,000|
7.49% of total costs – Copy of negotiated indirect cost rate agreement attached.
BUDGET CATEGORY 2002/2003 ANNUAL
That Ad Hoc Design Committee was composed of professionals from both counties and across child serving domains. Included at different times with the major contributors underlined were Terry Allison &/or Etta Nuerick of the Montgomery County Intermediate Unit; Becky Austill of Austill Rehabilitation, a provider of specialized therapies to both counties; Gina Buckman, Assistant CASSP Coordinator of Chester County; Richard J. Hess, Jr. & Sherry Sterling-Holt of the Chester County Intermediate Unit; Scott Helsinger, Steve Mason and/or Christine Ivanick of ReMed a provider of behavioral services in both counties; Randy Laborde from Milestones, a provider in both counties; Donna Salkin from the Eastern Instructional Support Center; Vince Winterling from Devereux; and Trisha Mallot, CASSP Coordinator from Montgomery County. In all approximately 150 person hours were spent in discussion and debate.
Jerome R. Gardner from the Chester County Intermediate Unit facilitated the general meetings. Richard Hess chaired the meeting concerned with Assessment, Evaluation & Training and Randy Laborde chaired meetings concerned with Program.