Kentucky’s Early Intervention System
November, 2011

Kentucky’s Early Intervention System (KEIS) has been
in existence since 1994. The Cabinet for Health and
Family Services, Department of Public Health is the lead
agency.

First Steps Regulations address CAPTA:
◦ 902 KAR 30:110 (1)(a) The point of entry (POE) staff shall serve
as the local lead agency and shall coordinate child find efforts
with:
◦ 6. The local Department for Community Based Services (DCBS)
office for cases with a sustained or negligent complaint;

Section 5.4 of the First Steps Policy and Procedures
Manual addresses referrals from DCBS in detail.

“The Individuals with Disabilities Education Act (IDEA) 2004

requires states participating in Part C to refer for early
intervention services any child under the age of three (3) who is
involved in a substantiated case of child abuse or neglect
and/or is identified as affected by illegal substance abuse or
withdrawal symptoms resulting from prenatal drug exposure.
All children referred from DCBS/foster parents with a
developmental concern must be screened with both the ASQ-3
and the ASQ: SE as appropriate for age. (ASQ: SE begins at
age three (3) months, ASQ-3 begins at age one (1) month).”

Detailed procedures are found at:

http://chfs.ky.gov/NR/rdonlyres/2FA68DC3-86FD-424C-9DB399BE1C03021C/0/FirstStepsPolicyProceduresManual7511.p
df (page 32 of 149)

First Steps website:
http://chfs.ky.gov/dph/firststeps.htm
Cabinet for Health and Family Services
Department for Public Health
Division of Maternal and Child Health
Early Childhood Development Branch
First Steps

There are fifteen (15) regional Points of Entry
(POEs) who serve as the local lead agency. All
serve a multi-county district.

POEs accept referrals, handle all intake activities
and provide ongoing service coordination.

IFSP early intervention services are provided by a
network of approximately 1500 providers
(independent and agency)
First Steps Phase of Service
Number of
Children
Referral & Screening
903
Evaluation
220
Eligibility Determination
65
IFSP (ongoing services)
4675
Total touched by First Steps on a typical day
5863

First Steps providers are expected to
understand and implement early
intervention services by:
◦ Focusing on the family/caregiver as the primary
target for intervention
◦ Coaching/consulting the family/caregiver using a
Primary Service Provider (PSP)
◦ Providing services and supports in settings
where the family lives and plays

Anyone can call or fax the Point of
Entry (POE) office to refer a child to the
First Steps service systems who may have
a developmental delay or affecting
medical condition.
All Referrals
CAPTA Referrals
Data Source: TOTS


6628
3754
Referrals
Eligible
Data Source: TOTS


651
515
Referrals
Eligible & In
service
Note: Part C data collection
changed to capture CAPTA
referrals mid-year so data
represents half a year.

DCBS services are administered through a network
of 9 service regions and offices in each of Kentucky's
120 counties.

Programs provided by DCBS include: family support;
child care; child and adult protection; and eligibility
determinations for Medicaid and food benefits.

DCBS also administers the state foster care and
adoption systems and an energy cost assistance
program.

DCBS is a primary referral source for First Steps
and is a required child find partner.

District Early Childhood Committees (DEICs) are
required by the First Steps statute and mimic the
state Interagency Coordinating Council (ICC).
DCBS participates as a member of the DEIC in
some regions of the state.
Inquiry
Screening
Eligibility

Children referred due to a suspected
developmental delay are screened using
two instruments:
◦ Ages and Stages Questionaire-3 (ASQ-3)
◦ Ages and Stages Social-Emotional (ASQ: SE)
◦ Established Risk Condition—list of over 240
medical conditions with high probability of disability
or developmental delay
◦ Significant Developmental Delay– 2 S.D. in one
area of development or 1.5 S.D. in two
◦ Professional judgment also allowed for eligibility
determination in some cases—this is currently used
for children with social-emotional disorders.

Children referred due to the diagnosis of an
Established Risk Condition are not screened.
These children move directly to evaluation for
eligibility.

Established Risk Conditions include: Fetal Alcohol
Syndrome/Effects, Shaken Baby Syndrome, Head
Trauma with Neurological Sequale

What’s not included at this time:
◦
◦
◦
◦

Failure to thrive
Severe Attachment Disorders
Anxiety Disorders
And other social–emotional disorders
Kentucky will need to add social-emotional
disorders that have a high probability for
developmental delay to the Established Risk
Conditions as a result of the new federal
regulations for Part C.

Terminology..what does Referral mean?

Who is making the referral?

When is the referral made?

Data collection—definitions/standards

Understanding eligibility for First Steps
http://chfs.ky.gov/dph/firststeps.htm
Paula E. Goff
Part C Coordinator
Kentucky Department of Public Health
Paula.Goff@ky.gov