Quality Indicators Rating Scale (QIRS)

As part of the ongoing effort to insure that we are providing quality services to the families we support in First Steps, the state developed guidance with the help of local stakeholders and national experts from NECTAC in 2004 (Revised in 2005 and 2011) for writing quality IFSPs. This guidance was provided to each SPOE and all Family Service Coordinators are provided training to incorporate these standards into the IFSPs they were helping to develop and write.

As part of the new guidance document, a rating scale was developed as a mechanism for reviewing IFSPs and rating the various components within them on a scale of 1 (Unacceptable), 3 (Acceptable), or 5 (Best Practice). DESE continues to use this document and rating system to periodically review the plans written within each region and provide individual feedback/scores for each Family Service Coordinator, as well as collectively for each SPOE. As part of the contractual obligation with DESE, each SPOE has to meet a certain percentage of plans at acceptable or higher in order to remain in compliance and to avoid penalty.

Until now, this QIRS guidance was mainly directed toward Family Service Coordinators and was not distributed or readily shared outside of the SPOE. However, we feel that this information should be common knowledge amongst all the First Steps providers who participate and contribute to the development of an IFSP.  In order to make sure we continue to meet these standards, it is important that everyone is aware of what is expected and how we are being rated.

Documentation regarding QIRS can be found on the DESE First Steps page at the following link:
DESE QIRS Guidance

QIRS relates to the follow elements of the IFSP (for example):

• Successful completion of all required sections of the IFSP
• Information is specific to the child/family
• Information is written in clear family-friendly language (less jargon)
• Information is routine based
• Family concerns, priorities, resources are clearly documented
• Outcomes are individualized, functional, measurable, and relate back to routines
• Strategies within the outcomes relate back to the family routine and support the outcome
• Services and service levels are appropriately related to the outcomes and support the methods of coaching per the Missouri First Steps model of Early Intervention

We ask that everyone review this guidance and be familiar with the expectations related to writing quality IFSPs. If you have any questions, please don't hesitate to contact the SPOE.

Provider Progress Notes & Family Service Coordinator Case Notes

Reminder to all providers regarding the importance of  Provider Progress Notes and FSC Case Notes:

The timely and accurate entry of provider progress notes into WebSPOE is vital to the continuity of service delivery. Progress notes not only help to document that services are being delivered in accordance with the IFSP but also serve as a way to communicate strategies and activities amongst all team members!

Provider Progress notes are also used by Family Service Coordinators when preparing for IFSP reviews and are very important in the conversation of reviewing outcomes.

Did you also know that Early Childhood Special Education diagnostic teams review provider progress notes in addition to the IFSP and/or evaluation and assessment reports when determining if a child is eligible for Part B? Provider progress notes also become part of the child's EI record and can be helpful in determining a child eligible for other resources and services such as Regional Office and Social Security.

Family Service Coordinator case notes are another very important part of the EI record that should include:

• Documentation of compliance related steps following referral and through eligibility determination (including attempts to contact the family, scheduling intake, providing Parental Rights, notification of eligibility, scheduling IFSP meetings)
• Documentation of conversations with all IFSP team members
• Documentation of the occurrence IFSP meetings and the decisions made at them
• Documentation of periodic contacts with the family
• Documentation of compliance related steps toward transition
• Documentation of progress and services provided

Documentation within First Steps is very important and is one of the best ways to insure that services are being provided and that we are remaining compliant!