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HomeMy WebLinkAboutEI Provider Meeting Minutes 1-18-13Early Intervention Provider Meeting Minutes Friday, January 18, 2013 Staff: Trish Elliott, Ed Franchi, Holly Divelbliss, Linda Hess Providers: Debbie Reuvenny – Keystone, Jenn Hawbecker, Jenn Byers & Cynthia Bosserman- UCP, Megan Lesko-Building Blocks, Isabel Stennett & Jack Jones-BOPIC, Inc., Adam Rowland-Advanta Therapy Conference Call: Jody Bering & Cheryl Gazan-LIU, Shelley Tobin-Invo Absent: Claire Hornberger Meeting Minutes  Welcomes & Introductions  Announcements o Trish passed out a communique from OCDEL regarding teaming codes. Her thoughts are that EI/providers are going to have to look at each case when doing teaming codes. The service cannot happen unless there is prior authorization from the EI Supervisor to use certain teaming codes. Trish and Holly previously sent out an email with information about the teaming codes. Jen Hawbecker from UCP said that the hand out explained the teaming codes and what is needed on session note perfectly. o There is a new Provider Quick Tips website: http://www.dpw.state.ps.us/publications/forproviders/QuickTips/index.htm.  Contracts o It is coming up on that time of year where Trish is going to be sending out the part of the contract that providers fill out about outcomes and goals. Those contracts under $50,000 are not required to complete outcomes, goal settings or financial audit. This is from a County perspective; it is recommended that providers check with their auditors for regarding State and Federal requirements.  Budget o There is a concern that the state allocation will not cover the cost of services until the end of the year. Trish stated that EI recently talked to Steve Gauvry, EI Advisor, about EI’s deficit. EI staff prepared information regarding the budget and where we stand, then sent that information to the State substantiating our need for additional money. The State replied back that there is no additional money. Using current projections, EI will have spent their entire allocation by the middle of May (six weeks before the fiscal year ends). EI has not received a correct allocation letter for FY 12-13. The letter was expected to be received shortly after the Thanksgiving holiday but it has yet to arrive. Trish asked all providers attending the meeting to present any of their ideas on reducing spending. The following bullet points are suggestions on reducing budgets and comments regarding the budget:  At Regional Meeting, Trish mentioned schools have breaks and questioned if EI, as a program, can do this. It is either that families take some breaks in services (which would result in the IFSP needing revised) or in May they will not have any services for the rest of the fiscal year.  Holly reviewed the changes that Service Coordinators have done to help reduce spending. SCs started writing initial IFSPs that limit services to three times a month for most services. This is starting to make a difference. There have been some complaints from families; no one wants to have their services reduced. The SC’s have been talking with families about the frequency and duration of a service. If your child no longer needs it then that service will be ended. The discussion about frequency and duration are covered at every visit. In other counties (Holly is looking into this for ours), the therapists conduct an annual review three weeks in advance and if the child no longer qualifies for services, that is when the services end. There may have to be one more session to wrap up ECOs. Holly and SCs are trying to think of ways to reduce spending that is not going to harm the child.  Cynthia from UCP - We need to get back to what EI used to be. It used to be a teaching model not a medical model. Some children have therapists in their homes 3-4 times a week. We need to get things back on track. If the therapist is doing their job and the parent is doing theirs, then there is no reason why the therapist should be in the home more than twice a month.  Jen from UCP - If a child has PT and OT, instead of having both in the home at one time; look at what the families’ biggest concern is at that moment. If it is decided OT is the biggest concern, have that therapist working with the family on those concerns then later bring PT in to talk to the family. There are families on their second or third child who are used to the services we provide and may be reluctant to the changes.  Jody from LIU - We are not the only pot of money. There are a lot of other services out there. We can direct families to other providers. Early Intervention is not for every child. There are specific cases where EI is not the solution.  Holly talked about writing IFSPs for a six month time period instead of yearly. Once those units run out, the therapist can no longer go out to see that family. This allows the therapist to be more flexible. It takes into consideration a break for the therapists or perhaps the case of a canceled appointment. At one point, therapist case notes were showing that 50% of cancellations were made because of the therapists not the families.  Jen from UCP – If a therapist goes to a home and works intensely with the family, they might not need the amount of services they are given. The child might need every week at the beginning of the month but then as time goes on, it might be necessary to cut back services. o Ed Franchi and Linda Hess have tried to keep close tabs on the EI budget/allocation. Some providers are sending back the form they were asked to fill out regarding their budget and projections through the end of the fiscal year. Trish will resend this form out to all providers so that all will participate. o Ed Franchi suggested that each provider project where they are going to be at the end of the fiscal year on each monthly invoice they send to Linda Hess. By doing this, we can incorporate that amount into our reports. It will give a better estimate of where each provider will be at the end of the year. o Ed let providers know that the increase in spending is directly related to services. The administration piece in the budget has not increased over the last few fiscal years. The number of children we are providing services to has. o EI is trying to get someone to clarify that when we are out of money, are we to stop services for base funded children or for all children (waiver and MA). Financially, it is only base that is running out of funds. But Holly questioned is it fair to continue to provide services to all other children and not base. We anticipate families filing due process. If they do file for due process, we have to continue to provide services at the same rate of when we notified them.  Eligibility o Debbie Reuvenny from Keystone discussed a meeting held between Franklin/Fulton, Cumberland/Perry, Dauphin and York/Adams counties regarding DAYC 2. It was to discuss and take a serious look at Early Intervention scoring. There was concern with the use of Age Equivalency and that it is not an appropriate measure to determine eligibility for most children. There was also a discussion of standard scores for determination of eligibility. In order for standard scores to be entered in Pelican, that score must be transferred into a standard deviation score. There will be a formal training on this procedure. This process is for initial and annual assessments and evaluations. Debbie proceeded to explain standard deviation and provided a hand out for all who attended the meeting. The standard scores method added percentiles into the scoring. The percentiles are the easiest way for a parent to understand where their child is. The scoring is going to be consistent across the board due to standard deviation. Talking Points was created to help with explaining the evaluation. The change in scoring highlights the skills a child has versus their age. It is expected that less children will be eligible for Early Intervention services based on standard deviation. Informed clinical opinion was also discussed. Franklin County does support the use of informed clinical opinion with documentation explaining this choice. Holly stated that EI is thinking about utilizing a 6 month IFSP instead of a yearly IFSP. After 6 months, the child would then be reevaluated. Cumberland/Perry County uses a flow chart regarding re-evaluations. Holly will see if she is able to access this chart. o Dauphin County and Cumberland/Perry County are transitioning to standard deviation by March 4th. York County has already instituted the new method. Keystone will have training on January 30th. Franklin County will also join the training on January 30th. This training will be for initial evaluators. All initial evaluators will use standard deviation scores as of February 1st. All other providers will have training by the end of February. There will be training for annual evaluators as well. The goal right now is to start with new individuals then get all others up to speed. o Trish is hoping this is going to address our new eligibility announcement that has yet to be seen. She feels that after we begin using standard deviation scores service coordinators should reassess the talking points regarding the way we do eligibility and find out from the families if they understand the change and how it impacts services.  Service Access & Management, Inc. (SAM) o Early Intervention Service Coordination will no longer be working for the county as of February 28th. SAM may be attending Provider Meetings after that time.  Comments o Debbie Reuvenny from Keystone stated that evaluators at Keystone are happy coming down to Franklin County and working with the service coordinators. They feel the SCs are so on top of the things they do. They enjoy working with Franklin/Fulton Counties. o Jen Hawbecker from UCP asked that when there is a more concrete idea on procedures, forms, etc. regarding the move with SAM, to let providers know about any changes. Trish answered that after the transition date, we will be inviting SAM to future provider meetings. o Trish will send out the report that Debbie Reuvenney discussed regarding standard deviation. If you have any comments on the report, send them to Trish and she will share them. o Trish sent out an email to evaluators regarding the standard deviation training on January 30th. She has heard from one evaluator but is still waiting to hear from others.  2013 Provider Meeting Dates All provider meetings are on Fridays at 10:00 a.m. in the Human Services Building on 425 Franklin Farm Lane in Chambersburg. April 19th July 19th October 18th The meeting was adjourned. Minutes by Erin Nye