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HomeMy WebLinkAboutEI Provider Meeting Minutes 07-15-20Early Intervention Provider Meeting Wednesday, July 15, 2020 Staff Present: Jenn Hawbecker, Ashley McCartney, Dan Rhodes Providers Present: Adam Rowland (Advanta Therapy), Megan Lesko (Building Blocks Therapy), Lauren Everetts (Fulton County Medical Center), Deborah Marsilio (Inspire Health and Education), Faith Blee & Stefany Messina (Invo HealthCare Associates), Keith Parker (My Therapy Tree), Krista & Phillip Miracle (Pediatric Therapy Specialists), Cynthia Bosserman (PennCares Support Services), Holly Whiteside & Matt Yingling (Service Access & Management), Marci Walborn (UCP of Central PA), Rachel Bechtel (Aspirations) MEETING MINUTES 1. Welcome & Introductions – Introduction of New Providers This meeting was held via Google Meet. All providers present were introduced and gave a brief description of their services including the following new providers: Inspire Health and Education, My Therapy Tree, and UCP of Central PA. 2. OCDEL Updates – Tele-intervention Jenn Hawbecker presented and explained documents that OCDEL has sent out in regard to tele-intervention. She recently participated in a small group discussion between EI Coordinators from surrounding counties and OCDEL staff including Emily Hackleman. The discussion offered an opportunity for EI Coordinators to ask questions and get additional information about new health and safety procedures. Decision Tree: Tele-intervention or In-person This graphic organizer contains examples of questions that providers should ask during each color phase of reopening to guide them in deciding between tele-intervention or in- person services. OCDEL has previously stated that a county entering the green phase does not mean “go” with respect to in-person services. Tele-intervention continues to be the preferred method of service delivery and should be used as much as possible. COVID-19 Screening Tool OCDEL has provided a COVID-19 screening tool with examples of questions that should be asked before every in-person visit. Providers must contact families in advance of the scheduled in-person visit to ask these questions. They may add more details and other questions to their own screening tools. Providers should also document in their session notes that the screening questions were asked prior to the visit. Personal Protective Equipment (PPE) Providers are responsible for making PPE available to their staff. EI has been able to reimburse providers for some PPE purchases since the beginning of the COVID-19 pandemic. Jenn will be looking into whether there is available funding and an additional need to do this again during the 2020-2021 fiscal year. Early Intervention Provider Meeting Wednesday, July 15, 2020 Masks for Providers/Children & Families Both providers and families must wear masks during in-home visits as per directives from the Governor and Department of Health. Families have the option of either wearing a mask or accepting tele-intervention services if they choose not to wear one. Providers and families are required to wear masks even when they meet face-to-face in outdoor settings. Certain families may be willing to wear masks but do not have access to them. In these situations, EI could potentially utilize training funds to purchase extra masks for providers to hand out to families. Jenn will check with Ashley McCartney about utilizing training funds for this purpose and will give providers an update when she has more information. Holly Whiteside confirmed that service coordinators are telling all families that they need to wear masks during in-home visits. It is possible that providers may have to reinforce the mask requirement when they actually go out to meet with families. Holly acknowledged the difficulty of requiring families to do something while in their own house. She will be meeting with service coordinators to discuss how to go about having these conversations with families. Ultimately, if the family refuses to wear masks and declines the tele- intervention option, their child’s EI services will have to be closed. Jenn explained that OCDEL has supported the mask requirement by considering the family’s home to be the provider’s place of business at the time a visit is taking place. Furthermore, families can be told that the government guidelines must be followed because EI services are paid for with state and federal funds. Jenn confirmed that face shields are an acceptable substitute for masks as per the Department of Health’s latest guidance on universal masking. Although current guidelines require masks for children over two (2) years old, Jenn stated that providers should use their best judgment when serving children who have sensory issues or other medical concerns that would affect their ability to wear a mask. Providers should use coaching techniques while maintaining social distance in order to interact with these children. If a parent or other family member claims that they cannot wear a mask due to a medical condition, tele-intervention should be offered. Marci Walborn asked Jenn if OCDEL was planning any social media messaging to explain the changes in guidance and promote the importance of universal masking to families. Jenn will email EI Advisor Wendy Tucker to inquire about OCDEL’s latest plans for social media messaging and will follow up with providers when she has an answer. Screening If the family answers “yes” to any of the screening tool questions that are asked prior to an in-home visit, tele-intervention will be offered instead. Providers should be having conversations with families about the precautions they are taking while traveling to other states. Through these conversations, providers may decide at their own discretion whether in-home or tele-intervention services are more appropriate given the extent to which families are traveling to particular states. Likewise, similar conversations should occur if a parent or family member is a health care provider who is potentially exposed to COVID-19 on a daily basis. OCDEL does not have formal guidance on Early Intervention Provider Meeting Wednesday, July 15, 2020 either situation other than having conversations with families along with the required screening process. Waivers Providers may ask families to sign their agency’s own waiver of liability. Families should be offered tele-intervention services if they choose not to sign this waiver. If the family will not sign the wavier and also declines tele-intervention, there should then be a discussion with the child’s service coordinator. During the In-Person Session Outside items should not be brought into the home or community setting where the session is taking place. Protocols should be in place to disinfect any items that are used during a session between uses. Providers should be washing and/or sanitizing their hands before entering and after leaving each home. Delivering EI in Child Care Settings As child care centers were initially reopening, providers had been encouraged not to do sessions in these settings so that child care staff could have time to adjust to the new conditions. OCDEL has now stated that providers may proceed with delivering EI services in child care settings. Any discussion about resuming these services must involve an entire team consisting of the provider, service coordinator, family, and child care staff. This will ensure that all team members are in agreement about the precautions for service delivery. Tele-intervention could be an option if the child care center still has restrictions on outside visitors but not every location will have the necessary staffing and technology. Providers are not required to screen children and adults prior to face-to-face visits within these settings because child care centers have already received guidance to conduct their own screenings. They may document in their session notes that the child was screened by child care staff. Department of Health Universal Masking Guidance Jenn shared the following link for the Department of Health’s frequently asked questions (FAQ) about universal masking: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Guidance/Universal- Masking-FAQ.aspx Provider Feedback Jenn asked the providers in attendance for any feedback since resuming face-to-face visits on July 1st. Providers reported that it has been challenging for the children to maintain social distance at all times and that some families do not want to wear masks. Service coordinators have been telling families that current health and safety guidelines are in effect so that services do not return to tele-intervention only. Jenn observed that OCDEL is leaning towards following the lead of other states to make tele- intervention a permanent option in the future. This development will be especially beneficial to families with medically fragile children. Early Intervention Provider Meeting Wednesday, July 15, 2020 3. HIPAA Reminders As per HIPAA’s confidentiality regulations, providers cannot share anything that a family may disclose to them during the screening process related to potential exposure to COVID- 19 or test results. Since this information cannot be shared between providers, it is important that the screening process be completed prior to every in-home visit. 4. Tele-intervention Resources – Google Doc Jenn has shared a link for a Tele-intervention Resources Google Doc with all providers. It contains a listing of resources and fun activities for children that are related to mask wearing, social distancing, and staying healthy. Providers can contact Jenn if they have any issues accessing or viewing the Google Doc. They are also encouraged to add links and descriptions for any other appropriate tele-intervention resources. Megan Lesko informed Jenn that the Google Doc’s privacy settings can be updated so that anyone with the link can make changes without first seeking permission. She will follow up with Jenn after figuring out how to update the privacy settings. 5. Training Logs Jenn reminded providers that training logs are due by July 31st. She had sent out an email with a training log for the 2020-2021 fiscal year. This training log does not include any new required trainings so providers may disregard it if their staff have already completed all current trainings. According to a discussion during the most recent EI Leadership Meeting, there will be an announcement in the near future that coaching is going to be the delivery model for all EI services. Jenn will share more information about the announcement when it is released and will arrange any coaching related trainings or Community of Practice Meetings upon providers’ requests. 6. Interpretation Providers have incurred the cost of interpretation services for several years. After recently receiving new information, the County will now be able to pay for these services. However, providers will not be reimbursed for interpretation services that were previously received through their own contracted agency or individual. EI is now contracted with an interpretation agency called International Corporate Training and Marketing (ICTM). This agency also provides interpretation services to Cumberland/Perry EI and has offices in Hagerstown and Chambersburg. A process will be established through which the service coordinators will send referrals for interpretation services to Lucy Gonzalez at ICTM after the child has been determined eligible for services. Lucy will assign an interpreter to the child and handle the entire billing process. ICTM will process billing for each session after asking the therapist to sign off on a form. At this time, it does not appear the providers will need to send any additional information to them. Early Intervention Provider Meeting Wednesday, July 15, 2020 If a provider has children that are already receiving interpretation services, they should send Jenn an email with a list of all children and their current therapists. Jenn will work with Lucy to set up each child’s interpretation services with ICTM. She will be discussing the initial referral process during the Service Coordinators Meeting on July 16th and will provide additional details to all providers. Jenn confirmed for Cynthia Bosserman that the contract with ICTM has been in effect since July 1st. A provider that was previously using another agency for interpretation may begin to use ICTM as soon as they have given notice to the former agency according to the terms of their contract. Jenn confirmed for Krista Miracle that interpreters who have already been working for an EI provider would have to contact ICTM directly to inquire whether their agency is currently hiring. 7. Referral Process Jenn and Holly will be reviewing the EI referral process in light of tele-intervention and adding new providers. It is not clear whether there will be significant changes to the process. They will be discussing this topic at the Service Coordinators Meeting on July 16th. Jenn will send out an email to notify providers if any changes are made to the process. 8. Provider Updates and Announcements Building Blocks Therapy Jenna Vander Velden, Building Blocks Therapy’s new physical therapist, has been helping out with in-person and telehealth evaluations while COVID-19 restrictions have been in effect. Pediatric Therapy Specialists Krista expressed appreciation for the daily efforts of service coordinators and the entire EI team to reach families during these challenging times. PennCares Support Services PennCares is looking into possibly opening its Child Development and Preschool Groups in September. Recent survey results indicate that there are families who are interested in attending. It is likely that the groups would be held in a diminished capacity with fewer children in attendance on fewer days. Service Access & Management While tele-intervention continues to be encouraged, service coordinators have been trying to meet with families to catch up on months’ worth of paperwork that needs to be signed. Their attempts to mail paperwork to families to be returned with signatures were not very successful. Overall, service coordinators have been balancing caution with accessibility as they navigate face-to-face visits with families. Holly asked the other providers to contact her with questions or concerns at any time. Early Intervention Provider Meeting Wednesday, July 15, 2020 9. Provider Reports Due Prior to the Next Meeting  Progress Report on Outcomes in Appendix A – July 31st  Staff Training Logs – July 31st  Monthly Billing – due 15th of each month o Providers should send Jenn and Ashley an email with the information for any end of fiscal year billing that is being held due to an issue or will be late. They need to know this information as soon as possible in order to process the appropriate contract amendments.  Employee Debarment and Exclusion Check – due 15th of each month Reminders of these reports are sent out 3-4 weeks prior to their due date. You can also review them in procedure statement MHIDDEI-416 Contract Required Reports and Due Dates. Next Meeting: Wednesday, October 21, 2020 starting at 10:00 a.m. Minutes by Dan Rhodes