Northern Community Resources
P. O. Box 7034
Ketchikan, Alaska 99901
INTEGRATED QUALITY ASSURANCE REVIEW
Homer Children’s Services Infant Learning Program
May 22-24, 2001
Site Review Team
Abbey Kucera, Community Member
Jean Steele, Community Member
Kari van Delden, Peer Reviewer
Carol Manninen, ILP Technical Specialist
John Havrilek, Facilitator
A review of Homer Children’s Services’ (HCS) Early Intervention/Infant Learning Program (EI/ILP)
in Homer was conducted from May 22-24, 2001 using the Integrated Quality Assurance Review
This report is the summation of the impressions of a community team after interviewing 13
consumers, 4 staff members, community members, and 13 staff of other related agencies. It also
includes a limited administrative review. It does not represent or reflect a comprehensive review of
this agency. The community team has collaborated on this report and the findings represent their
Description of Services
Homer Children’s Services’ ILP has provided services to this area since 1982. The agency serves
25-30 children and their families in Homer, Ninilchik, Happy Valley, Anchor Point, Nikolaevsk, Fritz
Creek, Halibut Cove, Razdolna, Voznesenka, Kachemak Selo, Nanwalek, Port Graham, and
EI/ILP has 2.75 staff, plus a 0.5 Parents as Teachers staff member serving these families with the
assistance of contract help for occupational therapy and physical therapy services. Present staffing
and contract services have enabled EI/ILP to serve all its families and at this time there are no
children on an ILP wait list.
The EI/ILP staff offer the following services: Child Find activities using the “Ages and Stages
Questionnaire;” evaluation to determine eligibility; development of the Individualized Family Service
Plan (IFSP); home visits; family assistance activities; family service coordination; monthly parent
discussion groups; weekly play groups; loan of developmentally appropriate toys and equipment;
monthly newsletter; access to the internet; transition assistance; contract services from private
therapists and a “Parents as Teachers Program.”
These services are funded through Alaskan Children’s Trust and United Way grants.
Description of Process
A team of five conducted the consumer-centered site review. The team members included two
community members, a peer reviewer, an ILP technical specialist and one facilitator. Over the
course of the three-day review the team conducted 31 interviews with 1 Board member, 13
representatives of related agencies, 13 EI/ILP consumers or their parents or guardians, and 4 staff
The interviews lasted from 15 minutes to one hour and were conducted by telephone or in person,
in private homes, at the HCS EI/ILP office or at other community agencies.
There was an Open Forum held the first night of the review at Homer City Council Chambers. The
forum was advertised in the newspapers, on the radio stations and through newsletters. The
advertising was extremely complete and the agency is commended on their very thorough efforts.
One team member and the peer reviewer attended the forum on a beautiful sunny evening. No one
from the community attended the forum.
Progress Since Last Review
1. “Continue to work towards improving collaboration on local Child Find activities, including
efforts with Public health (1.2.1).” This is still an area of concern. The ILP Director said this
it would be a target area for the upcoming year to get Public Health more involved and to
do Child Find in the villages. Standard not met.
2. “Explore ways to improve follow-up with referral sources (1.3.3).” This area remains a
problem, especially in the area of referrals. The ILP staff needs to document phone calls,
e-mails and letters regarding referrals and related follow-up. Standard partially met.
3. “Consider using new ISFP form to include how natural supports can help families meet
their goals (3.1.6).” ISFP forms now include this information. Standard met.
4. “Revise the MOA with KPBSD to include reference to parents participating in their child’s
MDT meeting (5.1.1).” Standard met.
5. “Assure transition planning activities are documented (5.2.2).” These activities need to be
clearly documented on the ISFP and in the transition meeting notes. Standard partially
6. “Reinstate the practice of informing local school providers of upcoming referrals (5.2.3).”
Standard met. It would also be beneficial to notify Headstart.
7. “Develop a policy that insures that parents may accept or decline ILP services without
jeopardizing other services (6.1.6).” A rights form was developed and is used. Standard
8. “Develop a policy regarding notice of changes in service (6.1.8).” Policy and form
developed. Standard met.
9. “Evaluation of program director overdue (8.5.2).” Standard met.
10. “Explore ways to retain specialized personnel (8.4.3).” This an on-going problem but some
progress has been made. Standard partially met.
The Five Life Areas
Choice and Self Determination
The review team feels that interviews show ILP staff is offering Choice within ILP’s limited staff
resources. There was a lot of knowledge shown by families regarding services and service
providers. They are happy with ILP’s quick response for evaluations and services and working
around families’ schedules.
The team identified the following strengths in the area of Choice and Self-Determination for those
receiving EI/ILP services:
+ “ Infant Learning bends over backwards to meet my needs.”
+ “ILP tailors their services to what I needed.”
+ “She always asks my opinion.”
+ “They always show concern for my needs.”
+ “They always give me a choice.”
+ “She has a nice way of explaining what my child needs and then asks what services I am
+ “I could not ask for better.”
+ “It makes it very convenient for them to come to my house.”
+ “The ILP Director does a great job of writing grants and bringing monies into ILP.”
The team identified the following weaknesses in the area of Choice and Self-Determination for
those receiving EI/ILP services:
- “I was a little confused in the initial evaluation on what the program provides, but the follow-up
eval. made things more clear.”
- “Hard to get enough PT with what is provided. My child needs PT more often.”
- “Overall I’ve had a good experience, but initially I felt pressured to take ILP services and come
Dignity, Respect and Rights
The review team found this to be a definite area of strength. Parents consistently report they are
told their rights right away and feel respected by staff.
The team identified the following strengths in the area of Dignity, Respect and Rights for those
receiving EI/ILP services:
+ “They are very respectful of different parenting styles.”
+ “(ILP) makes you feel good about services. They use a menu style.”
+ “(They are) very respectful. ILP always tries to fit our schedule.”
+ “(They are)very good with children and I like them coming to my house.”
+ “They showed me how to work with my son. Now I am more confident.”
+ “Absolutely, she is wonderful. She has become part of our family.”
+ “Definitely, my son loves working with her. He gets excited as soon as she comes in.”
+ “The best things are the cool things she brings in for my child to do.”
+ “She is always there to meet my needs.”
The team did not identify any weaknesses in the area of Dignity, Respect and Rights.
Health, Safety and Security
The team heard no concerns from parents regarding safety issues. All the comments were very
positive in this area from parents. The staff appears very aware of safety issues and very proactive.
The team identified the following strengths in the area of Health, Safety and Security for those
receiving EI/ILP services:
+ “I always see them cleaning the toys.”
+ “Yes, they caught things I was unaware of that were important safety concerns.”
+ “The children come first with them.”
+ “The playroom is safe and everything in there is for children.”
+ “They give really good suggestions of where to go for what my child needs.”
+ “The P/T has been a life-saver.”
+ “Their evaluation lead to my child needing surgery to hear.”
+ “The newsletter gives a lot of safety and health tips.”
+ “Safety is not a problem since one provider left.”
The team identified the following weakness in the area of Health, Safety and Security for those
receiving EI/ILP services:
“They should feel freer to set up safety rules during playgroup.”
The review team felt that the ILP staff absolutely supports and involves families in service delivery.
The team identified the following strengths in the area of Relationships for those receiving EI/ILP
+ “She works well with me, my husband and my mother (and) teaches us all to work with my son.”
+ “Absolutely, they involve and support my whole family.”
+ “The playgroups really help in our parent-child relationships.”
+ “Now that our child’s hearing has improved, our child plays with other kids and relates better with
our whole family. This free service of evaluation kept our child from being deaf.”
The team did not identify any weaknesses in the area of Relationships.
Homer Children’s Services ILP staff involves children in the community through playgroups offered
at the center.
The team identified the following strengths in the area of Community Participation for those
receiving EI/ILP services:
+ “Playgroup is a great social format to meet people and other families.”
+ “Playgroups have helped a lot, especially on how my children relate to other children.”
+ “(Playgroup is) a good place to meet other parents and share resources.”
+ “The monthly newsletter is very informative and explains a lot of what’s going on the community.”
+ “ILP is a great resource. I never feel alone.”
+ “Information being learned from ILP is being shared with friends and neighbors that have kids.”
The team identified the following weakness in the area of Community Participation for those
receiving EI/ILP services:
-“ I wish more parents of children with severe disabilities would come to the playgroups.”
Note: The team also received several positive comments regarding the Parents as Teachers
program that provide a further insight into the quality of services.
+ “Parents as Teachers Program compliments ILP services, it’s a nice, soft stepping stone into
+ “The staff tailors services to what I need.”
+ “I feel a personal connection with staff that made it a very positive experience for me.”
+ “(A real strength is) meeting other parents to share resources.”
+ “Five children came from basic services into ILP.”
A total of 4 staff members from HCS EI/ILP were interviewed. The staff interviewed had been with
the agency from 8 months to 14 years. The overwhelming attitude in responses to the 5 life areas
is that the staff feel that services are very consumer-driven and consumer-responsive.
All staff feel that the orientation to the agency and its mission is very good. Staff say they have
good support in their job and for training experiences. They also report being evaluated on a
regular basis and having input into that evaluation process.
Administrative and Personnel Narrative
Of the 43 standards for EI/ILP services, HCS fully meets 41 of them. There is concern regarding
the long periods of closure in December and January and again in July and August. This results in
a partial compliance with Standard #15 requiring services to be provided year round.
The other concern is Standard #26 on volunteerism. The agency does not have a policy to recruit
volunteers, but does have a policy that a student teacher must volunteer 8 hours to the agency
during their student teaching experience.
File Review Summary
The ILP Technical Specialist, Carol Manninen, reviewed several files and will file her report
separately from this one.
Interviews with Staff of Related Agencies
There were 13 staff interviewed from 7 different agencies. Four of those interviewed represent the
same agency and their responses, all identical, were counted as one interview in the tally of related
The related agency staff are fairly positive regarding their feedback about the Infant Learning
+ “Absolutely, the agency follows through when we refer a child.”
+ “Absolutely, the collaboration has positive outcomes for children.”
+ “ILP is an invaluable resource to our community.”
+ “We mainly just exchange papers but I have no problems with the program. I’m glad they are
+ “I’d like to collaborate more with them. What we’ve done works well.”
+ “The Mental Health/ILP collaboration has been very positive. I wish we could get the dollars to
expand it and help more families, focus on parenting skills and prevention.”
Several concerns were also noted and were consistent throughout the interview process.
- “ILP is getting better at referring to agencies, but there are still problems in the transition
- Agencies are requesting more meetings and collaboration with ILP.
- Agencies and parents express concern about long closures of ILP in Dec./Jan. and July /August.
- More Child Find activities in the villages and outlying areas are needed, as well as rebuilding
relationships in those communities.
- Agencies report a larger ILP need than that now being served.
- Better public relations, communication and collaboration are needed.
- Referrals to Headstart seem to be left to parents.
- Referring out from ILP appears to be a problem.
- Records from ILP are not making it to direct service providers like the school district and
- There are concerns in the community that the school system is denying children services.
- ILP needs to prepare parents for the change in qualifications to Headstart and the school district.
- The self evaluation process of the agency is not confidential.
- Agencies and families feel that there are enough OT and PT needs to support full time providers.
Areas Requiring Response
1. Seek to decrease long periods in which services are not offered. Standard #15
2. Create a policy on volunteerism. Standard #26
3. Continue to work towards improving collaboration on local Child Find activities, including
efforts with Public Health (1.2.1). This is still an area of concern especially in outlying
areas. The director states that this is a target area for the upcoming year. (Prior and
4. Explore ways to improve follow-up with referral sources (1.3.3). This remains a problem
especially in the area of documenting referrals. The ILP staff needs to document phone
calls, e-mails, letters, etc. regarding referrals and related follow up. (Prior and current
5. Assure transition planning activities are documented on the IFSP or referred to an
attached form (5.2.2). (Prior and current reviews)
6. Increase collaboration and communication with other agencies.
7. Seek to increase the number of specialized personnel for occupational and physical
therapy. (Prior and current reviews)
8. Specifically aid the transition of children from EI/ILP to Headstart and to the school system,
including providing records.
9. Seek to increase the number of children served.
The final draft of this report will be sent to Northern Community Resources for review. You will
receive the final report within approximately thirty days, including a Plan of Action form, listing the
Areas Requiring Response. You will then have an additional thirty days to complete the Plan of
Action. The directions on how to proceed from there will be included in a cover letter you will
receive with the final report and Plan of Action form.
Once NCR has reviewed the completed Plan of Action, it will be sent to the Early Intervention
Technical Assistant, Division of Public Health. The Early Intervention Technical Assistant will then
contact you to develop collaboratively a plan for change.
Attachments: Administrative and Personnel Checklist, Interview Form for Staff of Related Agencies
(tallied), Score sheet (tallied)