Current and Former LEND Trainees Provide Unique EI Services Through the FOCUS Program

April 16, 2021

As the New Mexico LEND cohort liaison to the Emerging Leaders Community, I had the opportunity to interview Una Vicenti and Laura Hawkey of the FOCUS program. Vicenti is an Occupational Therapist and Director of Early Intervention Services and Laura works as a Family Service Coordinator and developmental specialist within the program. Hawkey is a current LEND trainee and Vicenti is a LEND fellow. Vicenti reported that 3 other employees at FOCUS, including the program director, are LEND fellows.

The FOCUS program at the University of New Mexico Center for Development and Disability (UNM CDD) is an Early Intervention (EI) provider. The EI system in New Mexico is called the Family, Infant, and Toddlers (FIT) program, which is housed under the newly developed New Mexico Early Childhood Education and Care Department. The purpose of EI is to identify and support children with developmental delays or those who are at risk of developmental disabilities between the ages of 0-3 due to things such as an established condition, low birth weight, family substance use, prematurity, family violence, or other adverse childhood experiences. FOCUS is located at the CDD in Albuquerque and serves 3 counties in the metro area of New Mexico specifically Bernalillo, Sandoval, and Valencia. This is the most populous area of New Mexico, which has a unique and diverse population.

EI is funded under the IDEA Act and works to support families through therapeutic interventions including physical therapy, occupational therapy, speech language therapy, social work, developmental specialists, and child psychologists. They also work with families to connect them with community resources and legal aid if needed. EI is a freedom of choice system that works to develop an Individualized Family Service Plan (IFSP) to support the child by building up the entire family and guiding the caretakers in early childhood best practices. FOCUS implements this by using a coaching model of practice and by imbedding interventions and strategies into the family's daily routines. FOCUS has a unique niche of supporting families with children at higher risk of developmental delay due to various environmental, economic, and health factors with a focus on attachment and early childhood mental health.

The FOCUS program is unique as an EI provider as they provide an option to receive healthcare services at one of the three corresponding clinics in Albuquerque. These clinics work in collaboration with FOCUS to provide family healthcare services such as well-child check-ups and immunizations, medically assisted treatment for substance use disorder, mental health and behavioral health supports for the family. Vicenti emphasized that the medical and early intervention teams are focused on providing a non-judgmental, trauma informed environment. The families must be accessing EI services through FOCUS in order to receive healthcare services at these clinics, but the healthcare services are optional if the family has a provider in the community that they prefer. The FOCUS program works with the family to plan a smooth and thoughtful transition as the child nears aging out of the EI program at age 3. This includes accessing developmental supports through Part B partners, Headstart programs, or other child development centers and by referring to other healthcare partners in the community. This partnership of a family medical home and early intervention is unique and effective. FOCUS was recently highlighted by the American Academy of Pediatrics as a promising practice for providing wrap around care to high-risk children and families. The program's origins precede the CAPTA legislation that requires EI services and was developed to provide medical care and wrap around services to children that were HIV positive. It initially combined healthcare and case management to support families and has gradually developed into the full EI support and medical home care known as the FOCUS program.

The FOCUS program has begun to work to access grants and other funding to expand services to 5 years old so that families can be provided with support through Kindergarten when the child can access services through the school programs. Given the unique population and landscape of New Mexico, this extension of services would benefit many families. EI is a research-based intervention and FOCUS is doing an exemplary job of implementing it in the Metro Area of New Mexico with culturally competent, wrap around, family focused, and patient centered care provided in a non-judgmental, supportive environment. Vicenti and Hawkey spoke with pride about their program and hope to see the services expanded to reach more families for a longer period of time.

By: Laurel Christensen, NM LEND Trainee Liaison