1. Pam Treadway, M.Ed. Senior Clinical Consultant September 19, 2013
THURSDAY TARGETED TRAINING: A Comprehensive Look at Quarterly Summary Reports
Pam Treadway, M.Ed.
Senior Clinical Consultant
September 19, 2013

2. Agenda Review of Regulations and BAS Expectations
Monthly Progress Notes to Quarterly Summary Report
Examples
Final Considerations

3. Regulations & Expectations

4. EXPECTATION: ENCOUNTER FORMS
All AAW providers, except for Assistive Technology and Environmental Modification, must complete Encounter Forms each time a service is rendered
SCs are exempt from completing
Providers maintain Encounter Forms in their records

5. REGULATION
“DPW Rules & Regulation, Title 55: Chapter 51.15: Provider Records,” a provider must “document that the [services] for which it claims payment were provided to the participant and that information submitted in support of the payment is true, accurate and complete.”

6. ENCOUNTER FORM PURPOSE
Describe what occurred during service
Remind staff that service activities must relate to
goals and objectives (Summary of Activities)
Verify PROMISe claims (financial accountability)
Serve as a reference for the provider when
compiling the Monthly Progress Note

7. REGULATION: MONTHLY PROGRESS NOTES
“DPW Rules & Regulation, Title 55: Chapter 51.16: Progress Notes,” a provider shall “complete a monthly progress note that substantiates the claim for the provision of a [service] it provides at least monthly. A provider shall maintain [Monthly Progress Notes] in a participant's record.”

8. MONTHLY PROGRESS NOTE PURPOSE
To report to the SC on the participant’s progress
made toward goals and objectives.
To help communicate changes in service needs
To justify the need for change

9. WHY ARE WE DOING ALL THIS PAPERWORK?

10. For the ISP team to……
Evaluate whether progress is being made toward goals and objectives in the ISP that are linked to the service (need to be specific to the objective written)
Example:
Objective- When given the opportunity at work, Matt will respond to a greeting by saying “hello” 100% of the time without job coach prompts for one quarter.
Progress- Based upon the data, this month Matt has responded to a greeting 85% of the time independently with no prompts.
Document that provider activities are aligned with the goals and objectives agreed upon by the ISP team
Ensure that the service is being delivered in the way it is intended per the ISP and the AAW service definition (scope, limitations, staffing, etc.).

11. From monthly progress notes to quarterly summary reports

12. Monthly Progress Note (MPN): Guidelines
All services must submit monthly progress notes, except for SC, Assistive Technology, and Environmental Modification
Services that are not required to have objectives must submit MPN
Service providers should be aware of which objectives are linked to their service
Progress should be reported on each objectives for which the service is responsible
Progress needs to be reported in quantifiable terms (compare to criteria)

13. Monthly Progress Note (MPN): Provider Guidelines
If the service is occurring on a less than monthly frequency, the provider should complete one Monthly Progress Note for each time the service is provided.       
This form must be submitted each month to the participant’s SC no later than the 10th of the following month.
Be sure to keep copies of Monthly Progress Notes in the participant’s file to be referenced during monitoring.

14. Services Exempt from Objectives
Services that are paid by a single unit and/or primarily support caregivers are not required to have objectives:
Assistive Technology*
Behavioral Specialist (Plan Development)
Environmental Modifications*
Family Counseling
Family Training
Job Assessment
Job Finding
Respite
Supports Coordination*
* No MPN required

15. MPNs and QSRs Start with Objectives
Objectives should be aligned with the goals developed by the team
Objectives should be developed asking the following questions:
When will the person practice, learn and use the skill/behavior? (CONDITION)
What exactly is the behavior/skill that will be practiced, learned and used? (BEHAVIOR)
How do we know that mastery was achieved? (CRITERIA)
Supports should be implemented working towards the goals/objectives using best practices
Data should be kept based upon the specifics of the goals/objectives
For example, using a task analysis or collecting information on duration, frequency, etc regarding the skill/behavior
Report the data and anecdotal information to the SC in a consistent manner (using a quarterly report format)

16. Some examples.....

17. Sample MPN without Objectives
Goal
Objective
Monthly Report
Suggested Next Step
Employment: Job Assessment
N/A
(objectives not required for Job Assessment)
The Job Assessment for Chris is in progress. He completed two job tryouts in August (ABC Pet Supply and Martin’s Veterinary Hospital). The final job tryout is scheduled for beginning of September.
Continue

18. Sample MPN without Objectives
Goal
Objective
Monthly Report
Suggested Next Step
Respite
N/A
(objectives not required for Respite)
Mitchell received in-home respite for 5 consecutive days in the month of August while his parents were on a business trip.

19. Incorrect MPN Goal Objective Monthly Report Suggested Next Step
Independent Living Skills
When with CI staff, Erin will demonstrate how to do laundry with assistance.
Erin does her laundry with her CI staff on most Fridays. Sometimes she doesn’t feel like doing it and will ask to postpone doing it until Saturday mornings.
Continue

20. Incorrect MPN Goal Objective Monthly Report Suggested Next Step
Coping Skills
When in the community (e.g. shopping at the mall, eating at a restaurant) and it becomes crowded and noisy, Robin will ask to find somewhere quiet to take a break instead of yelling or hitting staff, 4 out of 5 consecutive visits into the community for two months.
Robin doesn’t like going to the mall. Staff and family report that she has hit them several times while they were on a community outing.
Continue

21. MPN to QSR: ONE service across one quarter

22. Final Considerations
MPNs and QSRs need to reflect progress on all objectives
Keep number of goals and objectives to a reasonable level
If objectives are not written correctly by the provider, then reporting is going to be problematic
Remember – Objectives Cheat Sheet
Follow-up with provider if revisions were requested to objectives

23. Final Considerations
Behavioral Specialist should report progress on the Desired Behavioral Outcomes in the BSP
Providers should be making data-based decisions
Objectives should not continue indefinitely if progress is not indicated – look for decisions to be included in MPN
If changes are not indicated to objectives when there is a lack of progress or regression, this must be brought to the team’s attention

24. Resource Virtual Training Center: http://bastraining.tiu11.org/
Path: Adult Autism Waiver(AAW) Information >
AAW Provider Training and Information >
Communication to Providers >
Guidance on Reporting Requirements