Loading...
HomeMy WebLinkAboutEI Provider Meeting Minutes 1-17-14Early Intervention Provider Meeting Friday, January 17, 2014 Staff: Jennifer Johnson, Ashley McCartney, Ed Franchi, Trish Elliott, Steve Nevada Providers: Holly Whiteside, Natasha Kara, Matt Yingling & Linda Hess (SAM, Inc.), Jenn Hawbecker & Cynthia Bosserman (UCP), Adam Roland (Advanta Therapy) Conference Call: Megan Lesko (Building Blocks), Theresa Miller & Gloria Branca (Invo HealthCare), Gina Eckert (UCP), Barbara Manning (Western PA School for the Deaf) MEETING MINUTES Welcome & Introductions Fiscal/Budget Discussion We have talked in prior meetings in terms of projection sheets. Ed wanted to go into more details and explain the importance of the projection sheets and answer any questions that the providers have now that they’ve been doing them for a couple months. We need to be more proactive in monitoring our allocation and make sure services provided are within our allocation. Last year EI spent 100% of their allocation. We need to be on top of funding and closely monitor where we are going to be throughout the fiscal year. If EI needs more dollars, we need to request additional dollars from the State. We are in the process now of completing contract amendments to make payments to providers who needed additional dollars in FY 12-13, we had been waiting for our final re-budget from the State to do so. Hopefully we will be receiving information from the state on submitting our first budget request for FY 13-14. Everyone should have received a projection sheet from Ashley, as it relates to each provider and their contract. Ed reviewed the sample projection sheet during the meeting so providers have an understanding of the flow and intent of it: - Each projection sheet contains the provider’s name. - In the upper right-hand side of the spreadsheet is an estimated monthly billing. This is for informational purposes only. - Column A lists the months of the fiscal year. - Column B includes the original contract amount and allows for any amendments to be added in the month it was completed. - Column C and D is for actual billing expenses. Column C is for Franklin billing and Column D is for Fulton billing. This should be updated as each monthly billing is completed. - Column E and F is for projected billing. Column E is for Franklin and Column F for Fulton. We know providers cannot project exact amounts but may have a better idea of what they expect to bill and/or any changes that may arise. - The bottom of the spreadsheet will show if you are projecting to be over or under your contract. Examples of things we should or may see on the projection sheets: - If one month there is a claim that has not been billed for yet, enter the amount in the projection column along with the actual billing in the designated column. This shows us that you are still waiting to bill for additional services. The amount should remain in the projection column until the issue is resolved. - Each month enter your actual billings in the Franklin and Fulton columns then remove the numbers in the projection columns (unless there are still services not billed for) then complete the rest of the fiscal year’s projections.  The most frequently missed step that Ashley is seeing is when the actual billings are entered the projected billings have not been removed for that month. Also, please make the change to previous month’s actual billing columns if they need to be updated. It is very important that we receive these projection sheets on a monthly basis; ideally when providers submit their billings, they should submit the projection sheet as well. We will be taking an even closer look at the projection sheets now that we are over six months into the fiscal year. If you have any questions, please contact Ed or Ashley. We are in the process of updating procedure statements. The procedure statements have been updated as they relate to the projection sheets and the Franklin/Fulton split. Once the procedure statements are finalized, you will receive an email stating that they have been posted to the County website. You will be receiving an acknowledgement form stating that you have reviewed and comply with the procedure statements. Please sign this acknowledgement form and return it to the County. Questions/Comments: Jenn (UCP) ~ we do not always know funding sources. If a child has been adopted that we have been billing for, most likely the funding source will remain the same but it is possible that it might be changed. Children’s funding can go from MA, to the County then back to MA. Do you want us to put these projections in as a holder and put a note at the bottom of the projection sheet stating what is taking place? - Ed: Yes. Use the best information that you have at the time. You can put a note for the projection stating “the child is going through adoption”. That will give us an understanding of the projection inserted. Steve Nevada ~ we are trying to get all (MH/ID/EI) providers to give projections. If you find areas where we could become more efficient, let us know. If you know of things we can remove as tasks, let us know. We understand we are adding more work and not removing any work. There are providers who submit the projection sheets regularly and some do not. The contracts for FY 14-15 will state that the projection sheets must be submitted. Audits Procedure Statement MHIDEI-2014-412 was reviewed. Our procedure statement mirrors the state and federal guidelines. The procedure statement has not really changed as it relates to the audit. Provider/sub-recipients that expends $500,000 or more is required to provide an A133 audit. The audit is not specific to what the provider has been paid by Franklin/Fulton; it is if the provider’s whole organization has received $500,000 or more in federal and state dollars. Provider/sub-recipient that expends at least $300,000 but less than $500,000 will be required to conduct what is typically terms a “yellow book” audit. Outside of this federal/state requirement, the county may request any provider to provide an audit. As per the procedure statement, we must notify you and tell you we are expecting that. One change that has been made to the procedure statement is #6. This addition states “to clarify, if a provider/sub-recipient is providing a service that is paid at a state-set rate but the organization is still conducting an independent audit, the county would like to receive a copy of the audit. However, if the provider/sub-recipient is not required to have an audit performed and the service(s) they provide are paid at a state-set rate, they are not required to submit an audit.” If a provider’s fiscal year-end is other than June 30 and they already conducts an annual audit and all the services provided are paid at a state-set rate, we do not need the provider to do a separate June 30 fiscal year-end audit, as long as you provide the county with the audit that was conducted. We need to make sure that things are going okay and that the auditors did not see anything within their audit that we should be aware of. If you are a smaller provider and not required to do an audit, such as A133, yellow book audit, financial audit, or an outside agency comes in to review your books, we may not require one to be done, if all the services provided are paid at a state-set rate. However, you must still maintain auditable records because the county may still conduct their own audit. New Eligibility Announcement Guidelines Trish sent out a copy of the Office of Child Development and Early Learning (OCDEL) ANNOUNCEMENT: EI 13-#08 Effective Date: 12/13/13 and an attachment titled Guidance on Evaluation Practices. The purpose of the announcement is to clarify practices, provide guidance and ensure consistency in the process of determining when an infant, toddler or preschool age child is eligible for the early intervention program. The Evaluators will be required to have information extremely well documented when they use Informed Clinical Opinion as their basis for eligibility. If you have any ideas/tips on documenting Informed Clinical Opinion please send those ideas to Trish. Battelle Development Inventory 2nd Edition A timeline handout was provided for initial/annual evaluations. We would like to be fully up and operating with the Battelle 2 Inventory by May 1st. This has taken a lot of collaboration between Trish, Holly, the SCs and the evaluation team (Building Blocks and Keystone). Holly has evaluations that will be coming up in the next few months that we will be using the Battelle 2 on, as well as annuals. We hope to have all these together by the deadline. Everyone needs to review the timeline going forward as there is a lot to process. We want to clarify that we would like the therapists to have progress monitoring to the SCs two weeks prior to the annual evaluations. Trish has talked to Val Postal and Beth Fairchild (who are guiding us through this new process). They have stated that it gives therapists the opportunity to have a voice in whether they believe the child should keep having services, are they making progress, etc. The progress monitoring is going to be become a very important tool for the evaluation team. Comments/Questions/Further Discussion on Topic: Holly (SAM) ~ Some therapists have been doing progress monitoring at the annuals and some have not. It has never been a requirement but has been accepted. However, this is new that everyone is expected to do since they will not be doing testing. We have started scheduling independent annuals in March and are working on ones for April. This will depend on when the Battelle arrives; whether it is here or people are comfortable doing it, independent annuals will occur. The reason we are asking for the progress monitoring two weeks in advance is to give the independent an opportunity to look at the results and have time to review it. We want to make sure they have the ample time and be able to ask therapists questions if needed. We are looking for PMOS data. We are going to develop a “who is responsible for what” document to define everyone’s roles. If the annual is scheduled, the last day the therapist can go out to the families home is the Friday before. They should not be going out the day after. The SC will schedule the annual, inform the current therapist of the date and after the annual the SC will inform the provider instead of the therapist if the child continues to qualify and what services are expected. Trish is looking at developing a sign off. We are expecting therapists to review the annual and read the IFSP since they will not be at the meeting and will need to know what is going on. If you have any feedback or think of something helpful, let Trish or Holly know. Cynthia & Jenn (UCP) ~ UCP is having difficulties knowing when evaluations are due and when appointments are scheduled. Not all therapists are at the meetings and are not being informed. Holly (SAM) ~ We try to schedule the appointments at the nine month meetings. If you have any questions, please let Holly know. Megan (Building Blocks) ~ It is going to be a work in progress on all sides. We want to hear what treating therapists have to say, as it is an important piece. It will be a big help to have forms ahead of time. Ed ~ How does the Battelle system affect the units (or services being provided)? Should we expect an increase in units for SC and/or therapists? Trish believes the units are going to increase for both SCs and the evaluators. Ideally the Battelle takes between 60 and 90 minutes to administer. Since it is new and a work in progress it may take longer initially to administer. We have discussed how we cannot take up so much time in a families’ home. Holly (SAM) ~ Keystone and Building Blocks are currently the only providers doing initial evaluations. Providers are currently testing children for the annual during a therapy session(s). Now the provider will not be completing the annual testing during a therapy session. Keystone or Building Blocks will be going back in to the families’ homes and it will be a separate bill. If we ask therapists to stop the Friday before to have therapy, this may help the budget. There is potential to have an increase in units. Keystone and Building Blocks are going to increase their billing. The process for an independent annual is very similar to the initial evaluation in that the SCs would go to the families’ home, the testing would be done and everything will be completed at the annual meeting. SCs now will not know if a child is eligible prior to the meeting so they will have to go out for the meeting and update the IFSP again. The SC will be going out with the therapist during the evaluation, just like they do at the initial evaluation. The SCs did not go out during the annual testing but will have to now. Steve ~ was under the impression that changing from the DAYC2 to the Battelle would not change much. Holly (SAM) ~ it is doing the independent that is the change not switching from the DAYC2 to the Battelle. Due to the independent, two agencies that were doing initials before are going back out to the families’ home to do the annual. The ongoing therapist did the annual testing before. Steve ~ we will need to do a dialogue regarding this. We as a system need to look at this and how we are going to do it. We have been looking into other counties to see the most beneficial way to utilize resources. Trish ~ Our surrounding counties are making the move to the Battelle. Holly (SAM) ~ until the change is implemented there is no idea of what will occur. It could save money or break even. Trish ~ Beth Fairchild and Val Postal will be coming to evaluations and meetings with us. We are going to be collaborating and talking to see how we can make this happen. Holly (SAM) ~ it’s definitely a positive thing. It will relieve pressure of the SCs and ongoing therapists. Trish ~ this is direction we have been given from OCDEL. We need to follow what the test was devised for. DAYC2 is standard deviation and we were using age equivalency. The best thing we felt we could do was switch to the Battelle. The SCs are anxious to start this process. We want the children to get their outcomes and move forward and be positive. We are very focused on this. Holly (SAM) ~ in regards to the informed clinical opinion, we are looking for providers to give us other tools to provide to Keystone and Building Blocks. We are looking for other tests instead of informed clinical opinion to show why we feel this child needs services. Natasha (SAM) ~ Are therapists in the habit of doing other assessments? Jenn (UCP) ~ Therapists use sensory profile. Other testing that would be done at the annual would be additional. Theresa (Invo) ~ we use PLS5, sensory profile and TABS. We would look at it to see if there is a supporting tool to give us additional data. Megan (Building Blocks) ~ as far as using other tests, it may be a good thing to see on quarterly progress forms. Sensory profile may be needed for this child that way we can have everything we need at the annual. Jen Johnson ~ is this test going to catch more children? We need to take this into account as the funder. Trish ~ It will definitely standardize the testing and children we have in our system will definitely qualify for EI services. There has been question about testing being used the way it was meant to be used. Jenn (UCP) ~ DAYC2 is subjective. Anyone can say the child did it. The Battelle is standardized and gives specifics. Holly (SAM) ~ we are not trying to use informed clinical opinion to say a child needs services. That is why we are asking for other tools. We can measure and look at the Battelle to see what was done instead of saying “in my opinion”. We have been complimented by the state that we rarely used informed clinical opinion, which is a good thing. We encourage families to call in 3-4 months if they still have concerns. Miscellaneous There is a PATTAN training on Mobile Technology Tools on February 26th. You can access the training calendar at www.pattan.net. Trish is asking that you share this with speech pathologists. Steve discussed that we are looking for creative ideas to access services in the Fulton County area. There are barriers for funding and travel. However, this does not mean that we should not provide services there. We need to develop strategies collaboratively. We have meetings with Fulton representatives to see what ideas they have. This announcement is just as a heads up that we are looking into this. If there is something that you would like added to the agenda for an Early Intervention Provider Meeting, please let Trish know beforehand. 2014 Provider Meeting Dates All provider meetings are on Fridays at 10:00 a.m. in the Human Services Building at 425 Franklin Farm Lane in Chambersburg. April 25th July 18th October 17th The meeting was adjourned. Minutes by Erin Nye