What Exactly is a Primary Service Provider?

1. What Exactly is a Primary Service Provider? One professional provides weekly support to the family, backed up by a team of other professionals who provide services to the child and family through joint home visits with the primary service provider. The intensity of joint home visits depends on child, family, and primary-service-provider needs. McWilliam, 2010

2. The Purpose of the PSP • Enable families to establish and maintain an ongoing working relationship with a lead team member with needed expertise who then becomes an expert on the whole child and family • PSP teaming requires an interconnectedness of all team members regarding their role in promoting parent-mediated child learning and development.

3. Primary Service Provider Model • The PSP acts as the principle program resource and point of contact • The PSP mediates the family’s and other care providers’ skills and knowledge in relation to a range of needed or desired resources • The team members use coaching practices to build the capacity of parents and other primary care providers

4. Benefits of a PSP Model • Relationship between practitioner, family members and other care providers enhanced • Efficient use of family and program resources • Reducing both gaps and overlaps in supports and services

5. Misunderstandings about the PSP Model • It limits services • It forces staff to be “generalists” - not “Early Interventionists” • It provides “indirect treatment” • Direct service is better • It restricts family choice • It violates professional ethics

6. Characteristics of a PSP Team • Members include at least an early childhood special educator, OT, PT, SLP and service coordinator(s) with expertise in child development, family support and coaching • May have social work, psychology or other disciplines as needed • Geographically based • Responsible for all referrals within a predetermined area

7. Capacity of a PSP Team • Caseload • Shelden and Rush: 7 FTEs can serve 100-125 families when drive time does not exceed 30 – 45 minutes one way • McWilliam: 16 visits per week

8. Five PSP Implementation Conditions • All team members must be available (and willing) to serve as a PSP. • All team members must attend regular team meetings for the purpose of colleague-to-colleague coaching • The team must use a consistent process to select a PSP according to four factors: parent/family, child, environmental, practitioner. • All team members shall participate in joint home visits as necessary • A PSP should change as infrequently as possible. Sheldon and Rush 2013

9. Critical Issues in a PSP Model • Each team member must • Be an evidence based practitioner in: • his/her own discipline • early intervention • early childhood development • parent education and family support • Be an active participant in all team meetings • Take an active role in professional learning/development • Be willing to share knowledge with rest of team • See parent (rather than child) as focus of intervention

10. Shelden & Rush Critical Issues in a PSP Model • Effective team members • Are agreeable • Are conscientious • Have high general mental ability • Are competent in their area of expertise • Are high in openness to experience and mental stability • Like teamwork • Socialized to the organizational culture Bell, 2004

11. What We Know • Leadership • Administrative support for use of the approach is essential • Program administrators must attend at least some team meetings • Early Intervention Process • Same team should support families from initial referral through transition • Primary coaches do not (and should not) change frequently • Joint Visits • 15-20% of total visits are joint visits • Disciplines other than core, may require more joint visits • Three steps are required for joint visits to be effective

12. What We Know • Team Meetings • All team members must attend all meetings • Meetings average less than 1 ½ hours per week • Meetings need a competent, consistent facilitator • The order in which items occur on the agenda matters • Teams that meet weekly learn and implement practices • Weekly meetings lead to higher accountability among team members • When coaching occurs at team meetings, the practices are implemented • Time • Moving to a primary coach approach takes intensive support over time