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HomeMy WebLinkAboutEI Provider Meeting Minutes 07-21-21Early Intervention Provider Meeting Wednesday, July 21, 2021 Staff Present: Jenn Hawbecker, Ashley McCartney, Stacey Brookens, Erin Nye, Dan Rhodes Providers Present: Lauren Everetts, Krista Miracle and Phillip Miracle (Pediatric Therapy Specialists), Cynthia Bosserman and Lori Beam (PennCares Support Services), Shannon Napoli and Holly Whiteside (Service Access & Management, Inc.), Marci Walborn (UCP of Central PA), Shannon Cresswell and Stefany Messina (Invo HealthCare Associates), Sila Alegret-Bartel (ICTM), Adam Rowland (Advanta Therapy), Deborah Marsilio (Inspire Health and Education) MEETING MINUTES 1. Welcome & Introductions This meeting was held via Google Meet. All providers introduced themselves and their agency affiliations. 2. Provider Updates and Announcements Building Blocks Therapy (Jenn Hawbecker provided this update on behalf of Megan Lesko) Building Blocks Therapy will be using the Battelle Developmental Inventory, Third Edition (BDI-3) for in-person evaluations by early fall. Franklin/Fulton EI purchased the BDI-3 last year but it could not be used while most evaluations were occurring virtually due to COVID and had to be done with the Developmental Assessment of Young Children, Second Edition (DAYC-2) instead. Megan Lesko has been working with her staff to get them familiar with the scoring features of this new assessment tool. Invo HealthCare Associates Invo HealthCare Associates recently hired an occupational therapist and a speech therapist. Advanta Therapy Advanta Therapy has contracted with a new occupational therapist who is looking forward to working with pediatric clients after gaining experience in other health care settings. PennCares Support Services PennCares Support Services has received a grant from the Summit Endowment to host a “Care for the Caregiver” training on October 22nd at the LifePoint Church in Chambersburg. This training is specifically for family caregivers of adults and children with disabilities. Jenn will send additional information about the training to all EI providers when it becomes available. Lauren Everetts Lauren Everetts is now independently contracting with Franklin/Fulton EI. She has registered as a limited liability company (LLC) and submitted a Medical Assistance (MA) application in anticipation of future growth. Lauren has been providing physical therapy services full-time. United Cerebral Palsy (UCP) of Central Pennsylvania UCP of Central Pennsylvania will soon be interviewing for speech therapist and occupational therapist positions. Early Intervention Provider Meeting Wednesday, July 21, 2021 3. Service Access & Management (SAM), Inc. Updates Service Coordinators and Scheduling First Session Shannon Napoli provided an overview of the best practices SAM is implementing to ensure that service coordinators are always being notified about the scheduling of each child’s first therapy session appointment. Service coordinators will try to attend the child’s first session whenever possible but there have been recent issues with them not receiving notification from therapists. By the time a child’s first session is scheduled, the service coordinator will have already had multiple appointments with the family for intake, evaluation, and, if necessary, to discuss receiving services in order to make them feel more comfortable. The first session should serve as a “warm handoff” during which the service coordinator and therapist explain their respective roles to the family. These conversations will add to the length of the first session but are intended to eliminate some of the calls therapists receive for questions/concerns (i.e. housing, food, other supply needs) that the service coordinator could handle. While the service coordinator may not able to attend every child’s first session due to a schedule conflicts or cancellations, they will still contact the family to remind them of the session’s date/time and what to expect. In this situation, the service coordinator will also offer to have a follow-up with the family after the first session to check if there are any questions about what their child’s services will look like going forward. Overall, it is important for the service coordinator to be notified about the first session so that they can help address any anxiety/uncertainty that the family may have about receiving services or inviting a therapist into their home. Therapists should communicate any first session schedule changes or cancellations to the service coordinator as soon as possible so that they can plan accordingly. Lauren Everetts suggested that a line for first session date/time could be added to the Fourteen (14) Day Deadline form as a reminder for therapists to notify service coordinators about this information. Progress Monitoring Documentation and Meetings Holly Whiteside explained the importance of submitting progress monitoring documentation to service coordinators in a timely manner. This documentation should be submitted by the first week of the month it is due regardless of when the child’s progress monitoring meeting has been scheduled during the month. Service coordinators have experienced issues preparing for quarterly progress monitoring (QPM) meetings without having received the Progress Monitoring Outcome Summary (PMOS) from therapists. Holly recommended that therapists utilize calendar reminders for each child’s upcoming QPM due dates. For example, if a child is evaluated in July, the first QPM is due in October and the therapist could put a reminder on their calendar to begin working on the PMOS during the last week of September. Service coordinators and therapists also need to coordinate their schedules through clear and consistent communication to allow for both to be present at the child’s QPM meetings. Therapists should be providing the specific date/time that they meet with a child so that service coordinators can check their availability well in advance. Service coordinators will attempt to reschedule in order to accommodate the therapist’s schedule if they are unable Early Intervention Provider Meeting Wednesday, July 21, 2021 to attend the child’s regularly scheduled session. QPM meetings are preferably scheduled to take place at the child’s home with the family present rather than at a child care or Head Start program. Holly emphasized that the therapist’s attendance at QPM meetings is important because it gives them an opportunity to explain what they have been doing to address the child’s outcomes/goals and to discuss any changes that need to be made. If the therapist is unable to attend a scheduled QPM meeting, they should contact the service coordinator prior to informing the family so that the meeting can be rescheduled as soon as possible. At least one (1) QPM must be completed prior to the child’s Six (6) Month Review meeting as per the Office of Child Development and Early Learning’s (OCDEL) requirement. Shannon mentioned that therapists in other counties use an Excel spreadsheet to keep track of children’s QPM due dates. The spreadsheet will pre-populate with each child’s three (3) month, six (6) month, nine (9) month, and Annual Review/Transition Plan due dates based on the date that their Individual Family Service Plan (IFSP) was created. Therapists would only have to input the IFSP creation date and Annual Review dates going forward to pre- populate all QPM due dates for a given year. Shannon will send a blank version of the spreadsheet to Jenn so that it can be shared with therapists. Shannon observed that service coordinators rely on the PMOS and notes from QPM meeting to “give the therapist a voice” and “paint a picture” of the child’s services in case files that are reviewed by OCDEL and the county/Administrative Entity (AE). Marci Walborn and Krista Miracle described the internal systems that their agencies use to track and send reminders about QPM due dates. Holly will meet with service coordinators to discuss making potential changes such as providing a QPM due date reminder during the child’s first therapy session and revising the Fourteen (14) Day Deadline form by adding a line for QPM due dates. 4. Fiscal Updates State Set Rates Contract amendments with revisions to the state set rates have been sent out to all EI providers to be signed. Providers should check with their agency staff that are responsible for signing contracts to confirm that it was received. Staff should receive email reminders to sign their contract but these emails will sometimes go directly to a junk/spam folder instead of an inbox. Providers should let Jenn know if their contract was not received. As per OCDEL’s announcement, the 3% increase to EI’s state set rates came from COVID relief funds and will be in effect through March 2024. OCDEL intends to continue the increase beyond this date if additional funding can be secured; otherwise, rates will return to amounts that were in effect at the end of fiscal year (FY) 2020-2021. A Procedure Code & Fee Schedule with modifiers reflecting the increase is included in this meeting’s PowerPoint presentation slides. End of Fiscal Year Billing All providers should have received an email from Ashley McCartney stating that end of FY billing was due by July 16th. Providers should let Jenn and Ashley know about any remaining Early Intervention Provider Meeting Wednesday, July 21, 2021 FY 2020-2021 billing for children with County funding as soon as possible. Franklin/Fulton EI needs to account for this billing to ensure that reports which will soon be submitted to the state contain accurate numbers. 5. OCDEL Updates: Continuing to Safely Provide EI Post-COVID Jenn reviewed OCDEL updates that were provided during the last EI Statewide Leadership Meeting. While COVID numbers have been down overall, OCDEL still wants to make sure that EI services are being provided safely. OCDEL is not requiring that providers take any specific actions to safely provide services at this time but continues to recommend that they follow existing Centers for Disease Control and Prevention (CDC) guidance and their own workplace guidance pertaining to health and safety measures. For example, child care programs and families should not be asking or requiring providers to show proof of vaccination prior to entering their facility or home. Likewise, providers should respect a child care program or family’s request that they wear a mask while providing services in their facility or home. The decision of individual providers to continue wearing a mask in any setting will also be respected. Providers should continue to practice universal precautions such as hand washing and hand sanitizing in the absence of water. The latest informational updates from OCDEL and a list of relevant CDC guidance links are included in this meeting’s PowerPoint Presentation slides. 6. Tele-Intervention Update Jenn reviewed OCDEL’s most recent update on tele-intervention. OCDEL recognizes tele-intervention as a safe and effective service delivery strategy which the Bureau of Early Intervention Services and Family Supports (BEISFS) and other Department of Human Services (DHS) offices are highly interested in continuing to provide. Governor Wolf had granted the Department of State’s licensing waiver request in March 2020 which allowed for health care professionals licensed under any of the Department of State’s Bureau of Professional and Occupational Affairs (BPOA) licensing boards to provide services via telemedicine during the coronavirus emergency. The licensing waiver will be in effect until September 30, 2021. Any continuation of telemedicine services after this date will depend on the passage and signing into law of Senate Bill 705 which is currently in committee review. OCDEL supports this legislation because it would allow for EI services to continue being provided via tele-intervention. Senate Bill 705 would apply to providers with a professional license such as occupational therapists, physical therapists, speech therapists, social workers, and registered dieticians. Jenn will provide additional updates on the status of Senate Bill 705 as more information becomes available. 7. Medical Necessity and the Medicaid Screen on Pennsylvania’s Enterprise to Link Information for Children Across Networks (PELICAN) Jenn presented an overview of how to handle four (4) billing scenarios involving the Medicaid Screen on PELICAN. Providers will need to answer questions pertaining to Early Intervention Provider Meeting Wednesday, July 21, 2021 whether the child has MA, Medical Necessity, and a primary care physician that participates in PA’s MA program in order to choose the appropriate action. Child does not have MA: Medicaid Screen will be blank and billing will automatically come to the County for payment. Child has MA but no Medical Necessity: “Have parents approved billing of Medical Assistance?” question will say “Yes” but “Has Medical Necessity been obtained?” questions will say “No.” Please do not bill until all questions say “Yes.” The recording worker’s name and a date stamp will appear at the bottom of the Medicaid Screen whenever changes are made. Child has MA, Medical Necessity, but PCP does not participate in PA MA: This scenario occurs when the child’s PCP is either out-of-state or does not accept MA. “Have parents approved billing of Medical Assistance?” and “Has Medical Necessity been obtained?” questions will say “Yes” but “Is the Referring Medical Provider enrolled in the Medical Assistance (MA) program?” will say “No.” Billing will automatically come to the County for payment. Holly observed that she occasionally encounters children with an out-of-state or non- participating PCP because the family has not yet switched their PCP or does not plan to do so after applying for MA. Child has MA and Medical Necessity: Answers to all questions on Medicaid Screen say “Yes.” Proceed with billing. Lauren asked if the provider information that is entered into the Provider Reimbursement and Operations Management information System (PROMISe) should be left blank if the child has an out-of-state PCP. Cynthia Bosserman and Krista confirmed that it is still necessary to enter provider information in this situation. Marci asked if service coordinators could notify other providers when a child with County funding is in the process of applying for MA or has been determined eligible for MA in order to prevent potential billing issues. Jenn confirmed that families do not always tell service coordinators that they have applied for MA or about their child’s MA eligibility status. SAM and/or County billing will often notify a provider whenever they become aware of a child’s change in MA eligibility status. 8. Provider Registry Training Certificates All service coordinators and EI providers must have their training information including hours and certificates entered into the Provider Registry website (https://www.papdregistry.org) by August 1, 2021. Resource guides should be viewed on the Provider Registry Padlet site (https://padlet.com/manketell/EIProviderRegistry) rather than downloaded because these documents are updated regularly. The Padlet site Early Intervention Provider Meeting Wednesday, July 21, 2021 features a frequently asked questions (FAQ) document and resource guides for agency administrators, provider staff, and county staff. If provider staff did not receive a certificate for a particular training, they may complete an Early Intervention Training Log form or Franklin/Fulton EI’s previously used Training Verification Log form for trainings that occurred during FY 2020-2021. Only the Early Intervention Training Log form should be completed for trainings that took place after the start of FY 2021-2022. Training information should only be entered under the Early Intervention Training Entry section of the Provider Registry profile. Jenn will not be able to see any information that is entered under the Professional Development Outside of the PD Registry section. Jenn will be completing a review of training information on the Provider Registry between August 1st and September 1st. She will reach out to provider staff individually if there are any questions about their training entries. Pre-service Training Pre-service training information is entered into the Education tab of the Provider Registry. An OCDEL advisor recently informed Jenn and other county EI coordinators that, as per regulations, pre-service trainings do not count towards the twenty-four (24) hours of training that are required to be completed within the provider staff’s first calendar year of employment. Jenn will continue to count pre-service training (i.e. an agency’s orientation program) that was completed in FY 2020-2021 towards the provider staff’s annual training requirement. These training hours can be entered into the Provider Registry. Any pre-service training that was completed after the start of FY 2021-2022 cannot be counted towards the annual training requirement. Jenn will also count the Fire Safety, Emergency Evacuation, First Aid, and Cardiopulmonary Resuscitation (CPR) trainings that are due within the provider staff’s first 120 days of employment towards that annual training requirement. Jenn recommended that providers check with other county EI coordinators to determine if they also count these trainings because some counties have different interpretations of OCDEL’s regulations. Jenn confirmed that the annual training requirement applies to both the first calendar year of employment and the fiscal year which results in some overlapping of how the twenty- four (24) hours are counted. Infant, Toddlers, and Families (ITF) Waiver Agreements Special instruction providers can upload their signed ITF Waiver Agreement to the Provider Registry by following instructions from a resource guide on the Padlet. These providers should be uploading the newest version of the ITF Waiver Agreement which is from FY 2020-2021. An ITF Waiver Agreement will remain in effect for five (5) years. 9. Service Delivery: Coaching Across Settings Update Jenn provided updates on OCDEL’s Service Delivery: Coaching Across Settings initiative. Early Intervention Provider Meeting Wednesday, July 21, 2021 It is BEISFS’ expectation that the Service Delivery: Coaching Across Settings Announcement will be reviewed with staff during provider meetings instead of just being sent out to them. BEISFS is currently working on talking points documents for service coordinators and families. These documents will share information about the coaching model and explain how it applies to what EI providers have been doing with families and in the community . Franklin/Fulton EI started the Exploration Phase of the coaching initiative in early 2021. The Core Leadership Team has since attended a series of monthly webinars on coaching prior to completing a needs assessment and drafting an action plan. Franklin and Fulton Counties are now moving into the Installation Phase of the coaching initiative. The movement between phases is expected to follow the stages of implementation science whereby particular phases do not clearly end, often overlap, and may be revisited depending on identified needs. BEISFS will be hosting multiple “Introduction to the Service Delivery Module” webinars for Infant Toddler and Preschool EI Program administrators in August. Jenn will forward an email containing the dates/times and a Zoom link for the webinars to all providers. Jenn provided an overview of the activities/steps, person(s) responsible, and target date for the following goals that the Core Leadership Team has developed for coaching in Franklin and Fulton Counties:  “To establish protocol for initial training opportunities to prepare EI team members in our county to be competent and confident in implementing coaching practices in all settings with fidelity.”  “To establish protocol for on-going training and mentoring opportunities for new and existing EI team members in our county to be competent and confident in practicing coaching in all settings with fidelity.”  “To provide a consistent message about coaching practices in the Franklin/Fulton Early Intervention program to the community, which includes EI providers, families, referral sources, early childhood education (ECE) providers, etc.” An Installation Team has been selected for the current phase of the coaching initiative and will begin training in August. It will consist of Jenn, Lauren Everetts (independent contractor), Heather Mentzer (Invo HealthCare Associates), Cathy Dusman (PennCares Support Services), Norys Lucia Munoz Morales (UCP of Central PA), and Adam Rowland (Advanta Therapy, LLC). 10. Additional Updates and Announcements Autism Conference Jenn recently received an email about a virtual Autism Conference that will be taking place in August. The conference sessions are free to view but providers will have to pay the registration fee for their staff to earn credit for attending. There are available training funds to pay for these registrations. Providers may send the invoice to Jenn in order for their agency to be reimbursed. Family Survey Franklin/Fulton EI exceeded its 25% goal for Family Survey participation in FY 2020-2021 by receiving surveys from 25.83% of families in the program. Jenn thanked the service coordinators for diligently working with families to complete the survey. Early Intervention Provider Meeting Wednesday, July 21, 2021 PMOS Graphs Jenn reached out to EI Advisor Wendy Tucker to ask whether it is necessary to provide a separate graph on the PMOS. After receiving Wendy’s response and discussing this matter, Jenn and Holly have decided that the graph will not be required. However, the written summary on the PMOS must thoroughly describe and explain the child’s progress during the quarter in “family friendly” language. Service coordinators will send the PMOS back to the therapist if more information is needed or if the language used may be difficult for the family to understand. Vision Provider Needed for Franklin and Fulton Counties Franklin/Fulton EI is still seeking a vision provider for Franklin and Fulton Counties. Providers may refer any individuals or agencies that offer vision services directly to Jenn. Update EI Provider Roster Jenn has sent out the current EI Provider Roster. Providers should review the roster and notify Jenn about any changes that are needed. An updated EI Provider Roster will be sent out with this meeting’s minutes. 11. Provider Reports Due Prior to the Next Meeting  Audit Engagement/Extension Letter for FY ending June 30th – July 10th  Progress Report on Outcomes in Appendix A (only for providers with a contract over $50,000) – July 31st  Staff Training Logs entered into the Provider Registry – August 1st  Schedule of Revenues/Expenditures for FY ending June 30th (for non-state set rates) – August 15th  Monthly Billing – due 15th of each month  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 the reports/due dates in procedure statement MHIDDEI-416 Contract Required Reports and Due Dates. Next Meeting: Wednesday, October 20, 2021 starting at 10:00 a.m. Meeting format (i.e. in-person, virtual, call-in) has yet to be determined. Minutes by Dan Rhodes