HomeMy WebLinkAboutEI Provider Meeting Minutes 4-15-16Early Intervention Provider Meeting
Friday, April 15, 2016
EI Provider Meeting 1 4/15/16
Staff Present: Trish Elliott, Ashley McCartney, Erin Nye
Providers: Holly Whiteside (Service Access & Management, Inc.), Krista Miracle (Pediatric
Therapy Specialists of South Central PA), Shelley Tobin, Faith Blee & Theresa Miller (Invo
HealthCare Associates), Adam Rowland (Advanta Therapy), Jenn Hawbecker & Michael
Wagner (UCP of South Central PA), Stephanie White (Fulton County Medical Center),
Megan Lesko (Building Blocks Therapy – present by phone)
Providers Absent: Lincoln Intermediate Unit #12, BOPIC, Inc., Keystone Autism Services,
Tuscarora Intermediate Unit #11
MEETING MINUTES
1. Welcome & Introductions
Everyone introduced themselves and their agency affiliation.
2. Quality Enhancement Plan
Overall, Franklin/Fulton EI had a very good verification. The following are a few
things noted during the verification:
1. Ensure initial IFSPs and annual IFSPs are developed within required time
frames.
2. Ensure IFSP includes procedures for measuring progress to include how data
will be collected.
3. Ensure children receive IFSP services in a timely manner.
4. Transition: services coordinators and preschool program. Conferences should
be held according to timelines and transition part of the IFSPs should be
developed according to timelines.
Discussion was held during the provider meeting on the above mentioned points:
1. IFSPs have to be completed within 45 days of initial referral date; annuals
have to be completed within 364 days of initial evaluation. There were nine
(9) children who appeared as deadline not met in the data but were actually
due to family reasons. This was causing an issue with data. The state gave
partial credit and full credit will be given when Holly sends the state
information along with screen shots to show the data was correct.
2. Emily Hackleman met with Trish and Holly to discuss measurable activities.
IFSPs were stating such things as, track the number of words a child says.
Emily questioned at what point that child is considered to have accomplished
their goal. SCs are looking to therapists on how these goals should be written.
What is being turned into the SCs has to correspond with what is written on
the IFSPs. If the team decides another goal needs to be worked on or if the
goal is changed slightly to be more specific, the SC needs to be notified so it
can be changed in the IFSP. The IFSP is a working document; therefore,
things can change at any time the team agrees that a change is needed.
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3. Missing the fourteen (14) day deadline will pull the verification score down.
Therapist must make contact with the family within fourteen (14) days. If the
therapist is unable to attend due to illness or whatever reason, another
therapist of the same discipline should be sent in to make that initial contact.
Therapists need to keep in mind when agreeing to take on services for a child
that there is availability in their schedules to see that child within fourteen
(14) days. So far this year, the fourteen (14) day deadline has been missed four
(4) times. This will result in missing 100% compliance, which is the
expectation set by the state.
› SCs will work with therapists in communicating what the last date is
to meet the fourteen (14) day deadline when they accept a referral.
4. Emily provided information on how to move forward with transitions. Even
if families choose not to transition their child to preschool, recommendations
for their children should still be given. During verification, points were taken
off the overall transition score because a transition plan was to be developed
between 2/3 and 2/9; the SC went to the home a week early and completed
the plan. This was counted as untimely. Holly has since checked and all
transitions are in good standing.
3. Fiscal Year 16-17 Contract Changes (handout)
Fiscal year 2016-2017 contracts are going to reflect the changes to Uniform
Guidance. Please review the handout for highlights for Sub recipient information.
Uniform Guidance requires that the federal funds the County pays providers be
printed on the checks with the amount and the Catalog of Federal Domestic
Assistance (CFDA) number. Funds are going to be drawn down proportionally
among providers who meet the requirements. The addition to the FY 16-17 contracts
is Appendix G and Attachment X. These documents will be filled out by the County;
providers will not have to complete them. Federal funds (Appendix G) will
determine whether or not a provider will need an audit. Previously, the threshold
was $500,000; it is now $750,000. This amount is not just referring to federal funds
from Franklin/Fulton but from all sources. Providers will now see the Federal funds
received from Franklin/Fulton. They will be able to track the exact amount received.
There are still more details that need worked out regarding the new requirements.
The changes affect fiscal staff at the County more than they do the providers. If
anyone has questions, please contact Ashley (almccartney@franklincountypa.gov).
4. Good Decision Making/Holding Children (When is this restraint?) (handouts)
Please review the announcements on Natural Environments and Positive Behavior
Supports. The federal government still looks for children to receive services in their
natural environment.
Several therapists are using the coaching model. These therapists go into the home
and use items that are part of a child’s natural environment. They look at those items
around the house and incorporate them into the families’ natural routines. They
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Friday, April 15, 2016
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create activities using these familiar items for play, routine, therapies, etc. This does
not always work because some children may need brushing, pressure vests, or other
therapeutic equipment. These activities need to be based on what is going on in the
home and what is best for the child. The state would like everyone to adopt the
coaching model in their interactions with families. Another webinar will be held
May 13th from 9:00 a.m. to 11:00 a.m. at the Agriculture Building on Franklin Farm
Lane around the coaching model and how families are praising the results. SCs have
stated that they can tell when a therapist uses strategies from the coaching model.
Along with the Positive Behavior Supports announcement there was a discussion
concerning restraints. When a therapist goes into a family’s home, at what point is it
okay for them to put their hands on a child? Do parents really know that what
therapists are doing is really therapy or do they take it the wrong way? How do
providers talk to their therapists about this? How often are therapists left alone with a
child? Do the parents stay during sessions or do they walk out of the room? How do
therapists share with the parents what is taking place so they are all on board? The
physical therapy for torticollis was given as an example. In many cases, the only way
an infant has of displaying their unhappiness with someone putting pressure on their
neck is crying. Do families understand fully that this is what has to happen? Do they
understand the therapy or do they think the therapist is abusing their child? Some
therapists are more hands on than other; while some are completely hands off.
Therapists should be communicating with the families what is going on and what
that particular therapy session is going to look like. We do not want to see therapists
put in a questionable situation. Therapists also need to be aware of the liability piece
involved. Is there a way to get a child’s interest other than being hands on? Not all
therapy styles are the same. Some therapists are more physically involved than
others. It is a good practice for therapists to explain to families what exactly they do.
Various provider comments/suggestions were made:
› Invo HealthCare has an appointment guideline document that includes
information about a parent needing to be part of the session for the entire time
of the session. This document sets the conversation for the first visit. Parents
then sign the document. Invo therapists discuss positive behavior supports
with the family. One suggestion was to show the family the therapy by using a
doll then do the therapy together before using it on the child.
› Advanta Therapy lets the families know within five (5) minutes of being in the
home that they will always be in the line of sight of the parent and that the
therapist will not be left alone with the child. Advanta will also not put their
hands on the child unless that child is about to fall. A suggestion was made to
document when a parent agrees/disagrees if a therapist is able to touch their
child.
› Pediatric Therapy Specialists follows an “I do, you do, we do” process.
Sometimes the “I do” part can take some time until the therapist and family
figures out what works for the child. Therapists ask to touch the child before
doing so and explain what they are about to do.
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› Fulton County Medical Center discussed creating a document for open
dialogue that states what the session will look like. That way if there is
something on the list that the family is not comfortable with it will be known
from the beginning. This will also provide documented evidence on what was
reviewed with the family.
Other counties are also struggling with how to update families who have children in
day care and/or receiving therapy while in the care of grandparents. They question
how the therapists connect with the parents so they are up-to-date, know that the
plan is being followed, the goal of the sessions and how things are going. Therapists
leave a session note but should make calls to the parents. Communication with the
families is very important; whether it be text, email, call, etc. Suggestions/comments
made on this were:
› Pediatric Therapy Specialists uses a communication book. The therapists
write in the book, leaves it for the parent then the parent writes in the book
and leaves it for the therapist. Therapists all try to do at least one session a
month with the parent involved.
› Another county suggested scheduling the session while the parent has a break
during their day at work. The therapist can then call the parent like a
conference call to have them involved.
5. Miscellaneous
Holly (Service Access & Management) discussed the following:
› Fulton County Local Interagency Coordinating Council (LICC) is developing
a seasonal calendar. The calendar contains activities for each season, toddler
recipes, crafts, library schedule, milestones, etc. The LICC is looking for
donations to sponsor the project. It is in hopes to have the calendars ordered
by the end of June to utilize FY 15-16 funds. Those who donate to the project
will have their logo and information for their agency on the back of the
calendar. If you are interested in making a donation, you can contact Trish
(telliott@franklincountypa.gov). Checks for donations should be written out
to: Fulton Co. LICC/TIU #11 and mailed to Tuscarora Intermediate Unit #11,
2527 U.S. Highway 522 South, McVeytown, PA 17051. The next meeting for
the Fulton LICC is May 11th.
› Holly is asking providers to think about the ECO process between now and
the next EI Provider Meeting. Emily Hackleman showed Holly and Trish
data reports to be shared at the next provider meeting. Current data indicates
that 54% of children who received services “did not improve.” This number is
inaccurate. Holly will be reviewing the ECO data and provide more about the
ECO scores after the ECO training has been completed.
Provider comment:
› Providers discussed initial paperwork and getting permission from the family
to speak to a therapist from another agency who may be providing therapy in
the same home. Most providers stated that they currently do this. Providers
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agreed that releases should be obtained to allow dissemination of information
regarding the child that is receiving therapies from multiple therapists working
for different agencies but are all providing those therapies in the same home.
› Fulton County Medical Center (FCMC) has developed a Disability
Awareness Program. It is a one hour session in which Lauren Everetts reads a
book about a kitten with a disability. There are also dolls that use wheelchairs
for mobility and other items to make children aware. If anyone is interested in
having Lauren present the program to their agency or have any ideas for
where else she could present her program, please contact Lauren at the Fulton
County Medical Center. She has already read the book at some head starts
and day cares.
Next Meeting: Friday, July 15, 2016 starting at 10:00 a.m.
Located at the Human Services Building (425 Franklin Farm Lane)
Remaining 2016 Meeting Schedule
October 14th
Minutes by Erin Nye