First Steps, Inc.
1900 Graybar Lane
Nashville TN 37215
Mission Statement
The mission of First Steps, Inc. is to care for children with special needs and medical conditions alongside their typically developing peers in an inclusive environment and support their families. The vision of First Steps is to: Enhance the quality of life for children and their families, eliminate barriers to services for children with special needs, empower families as they seek to meet the needs of their children, celebrate each child's unique potential, and improve the community as a whole; child by child, family by family.
Leadership
CEO/Executive Director Ms. Heather Higgins
Board Chair Mr. Wil Caldwell
Board Chair Company Affiliation HCA
History & Background
Year of Incorporation 1957
Former Names
Outlook Nashville
Duncanwood School for Retarded Children
Organization's type of tax exempt status 501-C3
Financial Summary
Graph: Expense Breakdown Graph - All Years
 
 
Projected Expenses $2,617,776.00
Projected Annual Revenue $2,650,455.00 (2018)
Statements
Mission The mission of First Steps, Inc. is to care for children with special needs and medical conditions alongside their typically developing peers in an inclusive environment and support their families. The vision of First Steps is to: Enhance the quality of life for children and their families, eliminate barriers to services for children with special needs, empower families as they seek to meet the needs of their children, celebrate each child's unique potential, and improve the community as a whole; child by child, family by family.
Background First Steps has been serving children with special needs from the Nashville community for sixty years. In July of 2007, Outlook Nashville and First Steps, Inc. merged to become one of the largest providers of early interventions services in Middle Tennessee. The Agency operates a Child Development Center providing early intervention and education services for children with developmental delays, who are medically fragile or are typically developing. Approximately 65 are served in the Center at one time. First Steps Community Outreach Program and the Ayudando Ninos (Helping Children) program support families in providing learning opportunities for their child with disabilities within the activities, routines, and events of everyday life. Teachers take early intervention services to the child in their home, their community day-care, their hospital room or any other setting that is natural for the child. This program serves approximately 300 children at one time, and 700 children total each year. Our newest program, Pediatric Therapy, provides physical, occupational, speech/language, feeding, and aquatic therapies to children ages birth to twelve. Accepting most insurance plans, our experienced therapy team works with families to find a treatment plan that allows each child to set individual, achievable goals. We served over 900 children in 2017.
Impact

As we closed the fiscal year of 2017 on June 30th, we saw great growth. We served 939 children in our three programs. The community outreach program continued to thrive, serving 690 children in three counties in Middle Tennessee, the majority of which are low income and many are from other countries. Our pediatric therapy program worked with 213 children in the disciplines of speech/language, physical, aquatic, feeding, and occupational therapies. The child development center served 100 children with one third of those being children with developmental disabilities or special needs.

 

The child development center served 77 children with one third of those being children with developmental disabilities or special needs. Our Literacy program also celebrated a successful year, with 100% of typically developing Pre-K students meeting all Read to Succeed assessment benchmarks, and when you include all students in Pre-K class with IEPS, that number is 82%.

 

The Board, staff, and stakeholders adopted a new Strategic Plan in 2016. The three pillars of the new plan include: Improving Program Quality, Securing Financial Stability, and Being an Employer of Choice.

Supporting action for these three pillars include 14 initiatives. Since adopting the Strategic Plan, we have worked diligently on executing many of the initiatives.  It is through this new strategic focus that First Steps will best serve its mission and drive changes forward.  

Needs

Although we continue to grow and serve more families, we feel our greatest challenge is still awareness. Each year First Steps works to ensure that we serve as many children as our programs can reach, but we know that they are not all aware of the opportunities. In addition to assistance with marketing and outreach, we have also prioritized the following needs.

1. Financial support for equipment and supplies for use in therapy sessions, classrooms and homes. 2. Board members with IT, healthcare, or fundraising expertise. 3. Volunteers for classrooms with early childhood or special education skills. 4. Volunteers for special events.   

 

Other ways to donate, support, or volunteer

We make it easy to donate online at www.firststepsnashville.org.  You can also donate by sending a check to 1900 Graybar Lane, Nashville TN 37215 or by calling with credit card information 615-690-3091.

We also encourage volunteers to be active in the Child Development Center, with Administrative duties and on the grounds.  Please contact 615-690-3091 with inquiries.
 

Service Categories
Primary Organization Category Human Services / Developmentally Disabled Services/Centers
Secondary Organization Category Education / Preschools
Tertiary Organization Category Human Services / Child Day Care
Areas of Service
Areas Served
TN - Davidson
TN - Robertson
TN - Williamson
TN - Wilson
TN - Cheatham
TN - Wilson
The Community Outreach program focus on assisting those living in the community who are at or below poverty level and includes a very high immigrant population.
CEO Statement

First Steps, Inc. believes you should never underestimate a child. Our programs touch the lives of children and families throughout the greater Nashville area. The more than 700 children we serve each year come from very diverse backgrounds, all benefiting from our commitment to enhancing each child’s potential to learn and grow. Our Child Development Center represents a unique opportunity for children of all levels of ability to come together to work toward their educational goals. Our staff is specially trained through the support of a Nurse to work with diverse populations, including children with feeding tubes, seizure disorders and special mobility and seating equipment. We strive to be a model environment for quality childcare programs through individualized curriculum and a focus on early literacy skills. Our Community Outreach Program sends skilled Developmental Therapists to work with children with special needs in five Middle Tennessee Counties and to support their families. We are fortunate to have bilingual therapists supporting the Hispanic community. Our newest program offers Physical, Occupational and Speech/Language Therapy to children age birth to 12 in our easily accessible and child friendly therapy space in the McWhorter Family Children’s Center. Through our variety of programming options, we are able to provide support in many ways in order to meet the challenges our special families face.  

Programs
Description
The First Steps Community Outreach Program consists of 16 developmental therapists that travel to a child's home, childcare center or other natural setting to spend time each week in play based interventions geared towards the child's goals. Coaching with parents and other caregivers in these natural settings and preparing them to work with tools to continue these techniques is an important part of this program. The Ayundando Ninos (Helping Children) program is a part of the Community Outreach Program that works with children from multi-cultural families, offering interpreters to assist in communication and other cultural barriers. Last year, the Community Outreach program served 690 children aged birth to three years old in the Middle Tennessee area. 
Budget 935548
Category Education, General/Other Special Education
Population Served Infants to Preschool (under age 5), Immigrant, Newcomers, Refugees, Families
Short Term Success  In all of our programs, the children have individualized goals.  We expect that at least 85% will make progress on their individualized program goals. We also expect to see family surveys reporting that at least half have achieved a better quality of life while participating in the programs.
Long term Success

The long-term goals for therapy include a better quality of life for the child and family, the ability to function well in a school setting and decreased need for long-term care. After nearly 50 years of research, there is evidence--both quantitative and qualitative--that early intervention increases the developmental and educational gains for the child, improves the functioning of the family, and reaps long-term benefits for society. Early intervention has been shown to result in the child: needing fewer special education and other services later in life; being retained in grades less often; and in some cases being indistinguishable from typically developing classmates years after intervention. Early intervention can result in parents having improved attitudes about themselves and their child, improved information and skills for teaching their child, and more time for leisure and employment.

 
Description Our inclusive McWhorter Family Children's Center offers full-time care and education to children with special needs alongside their typically developing peers ages six weeks to five years. In 2017, 100 children were served in the McWhorter Family Children's Center. First Steps serves children who are often turned away from other programs due to the severity of their health issues, medical needs or limited resources. Our staff is highly trained and provides each child the individual attention they need, recognizing that each child has a distinct set of strengths and challenges. Our staff reports daily to parents and caregivers via Teaching Strategies Gold on their child's progress, while providing tools to continue these techniques in their home environment. First Steps provides our children with a curriculum rich in literacy and developmental skills while encouraging healthy lifestyles. Our on-site nurse works with staff to ensure each child receives ample exercise and nutritional snack options, and creates lessons around healthy eating using tools like our vegetable garden to encourage participation in healthy choices. We also provide parents with healthy lunch-packing options. Keeping our children healthy both nutritionally and developmentally is a priority. 
Budget 886326
Category Education, General/Other Early Childhood Education
Population Served People/Families with of People with Disabilities, People/Families with People of Developmental Disabilities, People/Families with of People with Physical Disabilities
Short Term Success  

First Steps provides education and care throughout the year, and progress toward goals is monitored on a monthly basis. We anticipate that 60 of 75 (80%) of children tested this year will meet at least 80% of their developmental goals.

Long term Success First Steps prides itself on being an inclusive care provider. We believe that inclusive environments are beneficial for both children with special needs and typically developing children, allowing each child to learn acceptance of people of all levels of ability from an early age. The long-term goal of First Steps is to provide the highest quality of expert care, education and therapy services to children with special needs and medical conditions alongside their typically developing peers that result in quantifiable improvement toward their developmental goals in the areas of motor, cognitive, social, adaptive, and language skills.
Program Success Monitored By

Children will participate in group-based activities in classrooms that incorporate research based curricula like Frog Street and DLM.that are designed to build developmental and social skills. Enrichment programs will be provided in the arts that engage and expand the knowledge and experiences for the children.

Teaching Strategies Gold will continue to be utilized to track each child's progress in all developmental areas including motor, cognitive, social, adaptive, and language skills. This program has been a successful tool to monitor goals and report to parents and therapists.

Examples of Program Success
 
Description

Our Pediatric Therapy Program offers occupational, speech/language, physical, feeding, and aquatic therapies to children up to age 12 in our McWhorter Family Children's Center. Over the past year, over 5,600 therapy sessions were provided to 213 clients. With a growing staff, we are able to serve more children than ever before. Pediatric therapies are one of the top fields for growth because the needs continue to expand. According to the Bureau of Labor Statistics the various pediatric therapy fields will see growth at a rate of between 29% and 38% over the next 5 years.  

Budget 440222
Category Diseases, Disorders & Medical Disciplines, General/Other Birth Defects, Genetic Disorders & Developmental Disorders
Population Served People/Families with of People with Disabilities, Infants to Preschool (under age 5), Children and Youth (0 - 19 years)
Short Term Success

Over the next year, six different therapists will see patients in five different types of therapy – feeding, aquatic, physical, speech, and occupational. In all, they will see over 175 clients totaling over 5,600 sessions. Total sessions for each specialty are expected to be: Aquatic 350, Feeding 450, Physical Therapy 1,075, Occupational Therapy 1,660, and Speech 2,065.   

 

Long term Success

It is the goal of the Therapy Program to specifically help each child reach their individual goals and their full potential.  Goals individualized and different for each child.  Goals include, but are not limited to: weight gain, willingness to accept a varied diet, fewer food refusals, increased core strength, ability to jump, increased mobility, ability to keep head in midline and appropriate developmental placements, willingness to make eye contact, ability to follow two-step directions, demonstration of decreased tactile defensiveness, and many more.

The long-term goals for therapy include a better quality of life for the child and family, the ability to function well in a school setting, and decreased need for long-term care.

Program Success Monitored By

First Steps uses a variety of accepted tools to assess children with special needs in our programs. Specifically, for pediatric therapy, the Peabody Development Motor Scale (Peabody) and Sensory Profile are the most accepted measures for children with special needs.

The Peabody is one of the most reliable testing instruments used by many professionals, including both occupational and physical pediatric therapists. It was designed to assess gross and fine motor skills in children from birth through five years of age. For feeding therapy, the therapists directly evaluate many critical assessments including: weight gain, choosing items from at least 5 food textures, decreasing refusals to no more than 5, appropriate positioning 100% of the time, demonstration of active tongue cupping and/or bilabial closure, and demonstration of appropriate vertical munch. The Sensory Profile contributes to a comprehensive picture of a child's performance. This tool connects performance strengths and barriers with the child’s sensory processing patterns. It also evaluates the possible contributions of sensory processing to the child’s daily performance patterns.

Additionally, Parent Surveys are completed every six month, or upon exiting the program.
Examples of Program Success  Aiden is a little one who came to us in August of last year at 2 ½. The family had been to another facility earlier in the year but did not see the progress they were hoping for and discontinued therapy for a time before resuming services here with us. At the time he started was eating only purees and did not have functional chewing skills. In 6 months of weekly therapy with family involvement, Aiden is now eating a variety of crunchy foods (crackers, cookies, freeze dried fruits and vegetables), soft cooked fruits and vegetables, and is beginning to eat some meats! We are currently working on expanding his variety, but his chewing skills are nearing age appropriate levels. 
CEO Comments

All children enrolled in our programs are working toward individualized goals designed to enhance their development whether they are a child with developmental disabilities or one who is developing typically. We work with families, on an on-going basis, to ensure we address their needs and concerns as they relate to the health and development of their child. Over 700 children and their families are served annually. 72% of the families are at or below the poverty level and 96% of the children have a disability or delay of some type. 90% of children enrolled make measurable progress toward their goals in the areas of communication, cognition, motor, adaptive and social development. First Steps Child Development Center serves children with disabilities in an inclusive environment. Inclusion means that the education and care of all children, with and without disabilities, takes place within the routines and activities of everyday life. All children benefit from this approach. Children with disabilities are provided with realistic life experiences that prepare them to live in the community. They are also able to interact with peers, thereby learning social or communicative skills. Typically developing children benefit from this environment as well. They are provided with models of people who achieve despite challenges and develop healthy and positive attitudes about the uniqueness of others. Our Community Outreach Program is able to meet the needs of children with disabilities by serving those who are too medically fragile to enroll in a childcare center, those whose parents choose the home environment and those who are enrolled in another community childcare center but need some educational support. Our Pediatric Therapy Program offers a wide range of services for children age birth to 12, including occupational, speech /language, physical, feeding and aquatic therapies. Pediatric therapy is part of our integrated, team approach to offering children and families the best options to support their needs.

Board Chair
Board Chair Mr. Wil Caldwell
Company Affiliation HCA
Term July 2017 to June 2018
Email Wil.Caldwell@hcahealthcare.com
Board Members
NameAffiliationStatus
Ms. Bahar Azhdari BrookdaleVoting
Mr. Stuart Burkhalter Riley, Warnock, & JacobsonVoting
Mr. Wil Caldwell HCAVoting
Mr. Jay Davis Vector Disease ControlVoting
Mr. Matt Eskind HCAVoting
Mrs. Kristy Frazier HealthTrustVoting
Mr. Phil Groves LBMCVoting
Mr. Jon Harris Ogletree DeakinsVoting
Ms. Amy Hobbs Accurate HealthcareVoting
Ms. Ruthie Huggins LEAD Public SchoolsVoting
Ms. Kathy Medlin Counsel on CallVoting
Ms. Holly Poff Meridian Surgical PartnersVoting
Ms. Marcy Rehse TACT Autism ConsultingVoting
Mrs Emily Runzo Harpeth HallVoting
Mr. Harlow Sumerford Tennessee State Attorney GeneralVoting
Dr. Travis Walters Green Hills PediatricsVoting
Mr. David Wedemeyer HCAVoting
Board Demographics - Ethnicity
African American/Black 0
Asian American/Pacific Islander 0
Caucasian 16
Hispanic/Latino 0
Native American/American Indian 0
Other 1 0
Board Demographics - Gender
Male 9
Female 8
Unspecified 0
Governance
Board Term Lengths 3
Board Term Limits 2
Board Meeting Attendance % 85%
Does the organization have written Board Selection Criteria? Yes
Does the organization have a written Conflict of Interest Policy? Yes
Percentage of Board Members making Monetary Contributions 100%
Percentage of Board Members making In-Kind Contributions 100%
Does the Board include Client Representation? Yes
Number of Full Board Meetings Annually 6
Standing Committees
Board Development
Development / Fund Raising
Executive
Finance
Human Resources / Personnel
Risk Management Provisions
Accident & Injury Coverage
Automobile Insurance
Commercial General Liability
Crime Coverage
Day Care Center/Nursery School
Directors & Officers Policy
General Property Coverage
Improper Sexual Conduct/Sexual Abuse
Life Insurance
Medical Health Insurance
Professional Liability
Special Event Liability
Umbrella or Excess Insurance
Workers Compensation & Employers' Liability
CEO Comments

I am honored to be serving First Steps, Inc. in the role of Executive Director. Having been involved with the agency for 16 years as a service provider, a parent, and an administrator I am closely connected to the services we provide and the children and families we are privileged to serve. My goal is to continue the standard of excellence we have set for ourselves and establish relationships that will allow us to continue our work for many years to come.

Executive Director/CEO
Executive Director Ms. Heather Higgins
Term Start Mar 2005
Email hhiggins@firststepsnashville.org
Experience Bachelor of Arts in Psychology from University of Kentucky, Master of Arts Program in Psychology at University of Tennessee, Knoxville. First Steps, Inc. Community Outreach Program Director, Early Intervention Classroom and Outreach Teacher, University of Tennessee Graduate Research Assistant in Industrial Organizational Psychology. Co-authored a publication in APA Journal on work teams. Eight plus years experience in management, early intervention programming, advocating for families of children with special needs. Has expertise in programs and community awareness, while serving on committees for Local Interagency Coordinating Council, Caring for Children Council and Early Intervention Providers Network.
Co-CEO
Experience  

Bachelor of Arts in Psychology from University of Kentucky, Master of Arts Program in Psychology at University of Tennessee, Knoxville. First Steps, Inc. Community Outreach Program Director, Early Intervention Classroom and Outreach Teacher, University of Tennessee Graduate Research Assistant in Industrial Organizational Psychology. Co-authored a publication in APA Journal on work teams. Eight plus years experience in management, early intervention programming, advocating for families of children with special needs. Has expertise in programs and community awareness, while serving on committees for Local Interagency Coordinating Council, Caring for Children Council and Early Intervention Providers Network.

Former CEOs
NameTerm
Ms. Leah L. Smith Nov 1999 - July 2004
Mr. Reggie Tiller Sept 2004 - Feb 2005
Staff
Full Time Staff 39
Part Time Staff 5
Volunteers 75
Contractors 1
Retention Rate 75%
Plans & Policies
Does the organization have a documented Fundraising Plan? Yes
Does the organization have an approved Strategic Plan? Yes
Number of years Strategic Plan Considers 5
When was Strategic Plan adopted? June 2016
In case of a change in leadership, is a Management Succession plan in place? Under Development
Does the organization have a Policies and Procedures Plan? Yes
Does the organization have a Nondiscrimination Policy? Yes
Affiliations
AffiliationYear
AFP (Association of Fundraising Professionals)2006
Center for Nonprofit Management Excellence Network2003
Nashville Chamber of Commerce2005
Nashville Area Association for Young Children (NAAYC)2006
National Association for the Education of Young Children (NAEYC)2006
Center for Nonprofit Management CEO Network2015
Nashville Area Association for Young Children (NAAYC)2012
Williamson County Chamber of Commerce2015
Awards
Award/RecognitionOrganizationYear
Three Star Quality Child CareTennessee Dept. of Human Services2005
Marvin Runyon Leadership AwardCenter for Nonprofit Management2002
Making A DifferenceFrist Foundation2003
Nonprofit Innovation AwardPeter F. Drucker School of Management2004
Access to Care FinalistBaptist Healing Trust2011
Innovation in Action Award FinalistFrist Foundation2013
Senior Staff
Title Director of Operations
Experience/Biography Master in Early Childhood Special Ed., MTSU - over ten years of experience working with families and children with special needs. Parent Advisor and liaison for Davidson and surrounding counties.
Title Outreach Program Director
Experience/Biography
Title Center Director
Experience/Biography
Title Therapy Program Director
Experience/Biography
Title Director of Finance
Experience/Biography
CEO Comments

I am honored to be serving First Steps, Inc. in the role of Executive Director. Having been involved with the agency for 15 years as a service provider, a parent, and an administrator I am closely connected to the services we provide and the children and families we are privileged to serve. My goal is to continue the standard of excellence we have set for ourselves and establish relationships that will allow us to continue our work for many years to come.

 
 
Fiscal Year
Fiscal Year Start July 01 2017
Fiscal Year End June 30 2018
Projected Revenue $2,650,455.00
Projected Expenses $2,617,776.00
Endowment Spending Policy N/A
Endowment Spending Percentage (if selected) 0%
Detailed Financials
Revenue and ExpensesHelpFinancial data for prior years is entered by foundation staff based on the documents submitted by nonprofit organizations.Foundation staff members enter this information to assure consistency in the presentation of financial data across all organizations.
Fiscal Year201620152014
Total Revenue$2,404,600$2,294,503$2,220,490
Total Expenses$2,441,777$2,412,595$2,310,496
Revenue Less Expenses($37,177)($118,092)($90,006)
Revenue SourcesHelpThe financial analysis involves a comparison of the IRS Form 990 and the audit report (when available) and revenue sources may not sum to total based on reconciliation differences. Revenue from foundations and corporations may include individual contributions when not itemized separately.
Fiscal Year201620152014
Foundation and
Corporation Contributions
$0$0$0
Government Contributions$918,537$919,345$946,146
Federal$0$0$0
State$0$0$0
Local$0$0$0
Unspecified$918,537$919,345$946,146
Individual Contributions$378,766$304,218$420,294
$0$0$0
$1,076,863$988,684$786,692
Investment Income, Net of Losses$5,698$34,051$30,228
Membership Dues$0$0$0
Special Events$11,572$20,939$22,700
Revenue In-Kind$0$0$0
Other$13,164$27,266$14,430
Expense Allocation
Fiscal Year201620152014
Program Expense$2,279,237$2,160,476$2,062,370
Administration Expense$103,940$168,953$172,727
Fundraising Expense$58,600$83,166$75,399
Payments to Affiliates$0$0$0
Total Revenue/Total Expenses0.980.950.96
Program Expense/Total Expenses93%90%89%
Fundraising Expense/Contributed Revenue4%7%5%
Assets and Liabilities
Fiscal Year201620152014
Total Assets$3,432,446$3,478,462$3,671,346
Current Assets$476,366$414,111$582,805
Long-Term Liabilities$551,636$588,417$623,496
Current Liabilities$149,897$107,200$101,950
Total Net Assets$2,730,913$2,782,845$2,945,900
Short Term Solvency
Fiscal Year201620152014
Current Ratio: Current Assets/Current Liabilities3.183.865.72
Long Term Solvency
Fiscal Year201620152014
Long-Term Liabilities/Total Assets16%17%17%
Top Funding Sources
Fiscal Year201620152014
Top Funding Source & Dollar AmountProgram Revenue $1,076,863Program Revenue $988,684Government Grants $946,146
Second Highest Funding Source & Dollar AmountGovernment Grants $918,537Government Grants $919,345Program Service Revenue $786,692
Third Highest Funding Source & Dollar AmountContributions, Gifts and Grants $378,766Contributions, Gifts & Grants $304,218Contributions, Gifts & Grants $420,294
IRS Letter of Exemption
Capital Campaign
Is the organization currently conducting a Capital Campaign for an endowment or the purchase of a major asset? No
Capital Campaign Anticipated in Next 5 Years? No
State Charitable Solicitations Permit
TN Charitable Solicitations Registration Yes - Expires Dec 2017
Solicitations Permit
Charitable Solicitations
Organization Comments First Steps has evolved over its long history from an almost fully governmentally funded entity to a nonprofit with a mission. The financial basis of the organization has shifted from government funding to a need to raise funds through special events, grants, foundations, and private/corporate contributions. The Board and staff have worked diligently to position the Agency so that current as well as potential funders understand the impact of their dollars that go directly to the quality programs they support.
GivingMatters.com Financial Comments
Financial figures taken from Form 990. The endowment is housed at The Community Foundation of Middle Tennessee.
Financials completed by Frasier, Dean & Howard.
Comment provided by Kathryn Bennett 11/18/16.
Nonprofit First Steps, Inc.
Address 1900 Graybar Lane
Nashville, TN 37215
Primary Phone (615) 690-3091
CEO/Executive Director Ms. Heather Higgins
Board Chair Mr. Wil Caldwell
Board Chair Company Affiliation HCA
Year of Incorporation 1957
Former Names
Outlook Nashville
Duncanwood School for Retarded Children

Related Information

Childcare & After-School Programs

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