1. CHA-CHA-CHA-CHANGES IN EI SERVICE COORDINATION Implementation Webinar Webinar provided by the Integrated Training Collaborative, with funding support from the Virginia DBHDS, American Recovery and Reinvestment Act (ARRA) August 23 rd at 3:00 pm FOR THIS WEBINAR Please Call 866-842-5779 Enter Code 463 661 9330#

2. WHAT ARE SOME QUESTIONS OR CONCERNS YOU HAVE REGARDING THE CHANGES BASED ON WHAT YOU HAVE HEARD SO FAR? Burning Questions Use Your Chat on The Right Side of Your Screen to Respond

3. Beth Deana Jeff WELCOME! Adele Pam Sharlene

4. List of Handouts for the Webinar  Educational Requirements and KSAs  IFSP Page 4  Physician Certification including Health /Status Indicator Questions  Health Indicator Questions MD Communications  Initial EI SC Plan form  Contact Note Checklist  EI TCM SC Contact Note Samples

5. List of Handouts for the Webinar (con’t)  EI TCM Reimbursement Fact Sheet  July 19 webinar Questions and Answers  EI TCM Fact Sheet  FAQ about Early Intervention TCM  Fact Sheet for Families – ID  Fact Sheet for Families – MH  Fact Sheet for Families – No TCM

6. Phones Are Muted Chat For Communication HOUSEKEEPING

7. Esc. Key to Return to Normal View locate this button on bar below slides click to view slides in full screen VIEW IN FULL SCREEN MODE

8. COMPLETE A SURVEY

9. INTRODUCTION

10. Training Outcomes Participants will understand the new requirements associated with early intervention targeted case management including: Early Intervention Case Manager Certification Service coordinator activities Documentation and reimbursement New and revised forms Participants will know how to transition children and families to the new TCM program

11. WHO CAN PROVIDE EI TARGETED CASE MANAGEMENT?

12. New Requirements for Early Intervention Service Coordinators Education/experience o College Degree in human services field, or o Associates degree in related field such as OT Assistant, PT Assistant or nursing, or o College degree in unrelated field, GED or high school degree PLUS three years experience Training – completion of required module Certification as EI Case Manager

13. Please have this document available for review: Educational/Experience Requirements for service Coordinators and EI TCM Knowledge, Skills, and Abilities Locate Document

14. Current EI Service Coordinators ALREADY MEET THE EDUCATIONAL REQUIREMENTS MUST PASS NEW ONLINE MODULE MUST APPLY FOR CASE MANAGER CERTIFICATION

15. Who will receive EI TCM All children WITH Medicaid or FAMIS coverage Children currently receiving Intellectual Disabilities (ID) or Mental Health (MH) TCM WILL TRANSITION TO EI TCM 10/1/11.

16. Most EI TCM expectations are already required for early intervention service coordination

17. WHAT’S DIFFERENT Initial Early Intervention Service Coordination Plan Communication with child’s physician about health status indicators New short term service coordination goal Referencing SC goals in contact notes

18. COMMUNICATION WITH PHYSICIANS

19. SERVICE COORDINATION OUTCOMES

20. KEEPING FAMILIES IN THE LOOP Frequency- twice a year, every 5-7 months NEW HEALTH QUESTIONS FOR DOCTORS Part C services NOT contingent on family following RECOMMENDED MEDICAL GUIDELINES

21. Health Status Indicator Questions Is this child up to date (per CDC/ACIP guidelines for this year) on immunizations? __ Yes ___ No What is the date of this child’s most recent visit with you? ____/____/____. What is the date of the most recent well child visit? ____/____/____. What month/year should this child see you for the next well-child visit? ____/____. Are there immunizations needed at time of next visit? ___Yes ____No Does the child’s record have any lead testing (either capillary or venous) results? ____ yes ____ no If yes, date service provided ____/____/____ and testing results: ___normal ___elevated 1 2 3 4 5 6

22. DOES ANY ONE STAND OUT? DO YOU HAVE ANY QUESTIONS? Burning Questions? Use Chat to Respond

23. Please have these documents available for review: Combined IFSP Certification/HSI Form Health Status Indicators Locate Documents

24. COMBINED IFSP CERTIFICATION/HSI FORM

25. Health Status Indicators

26. Local Option LOCALITY CAN CREATE THEIR OWN FORM-6 HSI QUESTIONS MUST BE VERBATUM OR Alternate mechanism (e.g., request and review of well-child records) that provides the information necessary to answer all of the health status indicator questions.

27. SC CHECKLIST Request information every six months. Document request Follow up with the physician is best practice, BUT not a requirement.

28. WE’VE GIVEN YOU THREE WAYS TO GATHER THIS INFORMATION. WHAT ARE OTHER STRATEGIES SOME OF YOU USE TO GET INFORMATION ABOUT THE CHILD’S WELL BABY CARE FROM PHYSICIANS? Burning Questions Use Chat to Respond

29. WHAT ABOUT EVERYONE ELSE? ENCOURAGE FOLLOWING THESE PRACTICES WITH ALL CHILDREN - BUT NOT REQUIRED

30. HOW WILL THE DOCTORS KNOW? A memo will be sent from DBHDS to Virginia Pediatricians and Family Practice Physicians in September to alert them to the changes they can expect with implementation of EI TCM.

31. INITIAL EARLY INTERVENTION SERVICE COORDINATION PLAN This plan is available for up to 90 days It does not change the 45 day requirement to develop the initial IFSP This plan is available for up to 90 days It does not change the 45 day requirement to develop the initial IFSP

32. Locate Document Please have the following document available for review: Early Intervention Service Coordination Plan

34. Initial EI Service Coordination Plan Can be used for all children Not required for children who do not have Medicaid/FAMIS In order to bill retroactively for children who receive Medicaid/FAMIS retroactively, the Initial EI Service Coordination Plan must have been discussed with the family and signed at intake

35. Initial EI Service Coordination ends when: when the child is found ineligible for Part C, or when the IFSP is signed, or 90 calendar days from the date of intake, whichever comes first

36. DO YOU HAVE ANY QUESTIONS ABOUT THE INITIAL EARLY INTERVENTION SERVICE COORDINATION PLAN? Burning Questions Use Chat to Respond

37. Please locate the following document: Contact Note checklist Locate Document

38. Contact Note Checklist

39. What do you notice that is different from the current checklist? Record your answers in the chat box. Burning Question Use Chat to Respond

40. WAY TO REFERENCE! Please pull out your “Service Coordination Contact Note – Samples” Handout

41. Contacts with Families Every three calendar months First contact must occur the month following the date the family signs the IFSP Person centered with method of contact selected by family  Face to face  Phone calls  Email (if permitted by LLA)

42. After reviewing the four samples, do you feel comfortable with the EI TCM documentation that is going to be required? How will you incorporate this guidance in your work as a service coordinator? Burning Question Use Chat to Respond

43. REIMBURSEMENT CONSIDERATIONS

44. Billing Limits One Charge per Month / Per Child EI TCM is the case management program for children birth to three Only one case management service can be billed to DMAS per month. o Exception: EI TCM can be billed even if a child is also receiving BabyCare. If a child is receiving therapeutic foster care, EI TCM cannot be billed

45. Please locate the following documents: EI TCM Reimbursement Fact Sheet July 19, 2011 Billing and Reimbursement Webinar Questions and Answers Locate Documents

46. DMAS Requirements for Reimbursement - Overview Face to face contact for initial and annual IFSP Face to face or phone or email contact with families at least every three months Complete, correct documentation Communication to the child’s MD every six months At least one allowable activity documented for each month that is billed

47. Allowable Activities for Billing DMAS Communication with family to address existing or new concerns or goals (face to face, phone, email) Coordinate EI Services – intake, assessment, service planning, transition Link child/ family to supports and services There’s more….

48. Allowable Activities (cont.) Assist child/family with community involvement Make collateral contacts Monitor implementation of IFSP Instruction/counseling to assist with problem solving/decision making Communicate with child’s physician

49. Do you have any questions about requirements for reimbursement, including allowable activities? Burning Question Use Chat to Respond

50. TRANSITIONING TO EARLY INTERVENTION TARGETED CASE MANAGEMENT

51. Transitioning to EI TCM Communication with families o Fact Sheet o Meetings or calls o Letter from Service Coordinator oR System Manager Families must be given ample opportunity to ask questions and discuss the changes.

52. Please have the following documents available for review: Fact Sheet for Families – ID Fact Sheet for Families – MH Fact Sheet for Families – No TCM FAQ about Early Intervention Targeted Case Management Document Review

53. Family Fact Sheets - Contents What changes are occurring? Why are the changes occurring? What will remain the same? What will be different? Who can families contact for more information?

54. CHANGING TO THE NEW IFSP FORM ADD NEW SHORT TERM GOAL All INTIAL/ANNUAL IFSPS WILL BE COMPLETED USING THE NEW FORM

55. IMPLEMENTATION The first FAMILY contact must occur between October 1st and December 31 st, FOR CHILDREN ALREADY ENROLLED IN EI.

56. IMPLEMENTATION The 6 health status indicator questions must be sent to the child’s physician within 6 months of October 1, 2011. April 1, 2012

57. Prior to October 1, 2011  Current processes for implementing and billing 90 day TCM plans may continue;  The (ID) TCM IFSP form can be used through September 30, 2011;  ID and MH TCM can be billed through September 2011;and  BOTH the Initial Early Intervention Service Coordination Plan and the ID or MH TCM 90 day plan CAN BE USED

58. Do you have any questions about IMPLEMENTATION ACTIVITES? Burning Question Use Chat to Respond

59. SCs HOLD THE KEY ITOTS Data Entry --Key requirements for processing EI benefit:  Selection of Medicaid/FAMIS and entry of the 12 digit Medicaid number  Intake date - NEW  Exit date - NEW  Inactive Date  Active date – NEW

60. 10 BUSINESS DAYS The Medicaid/FAMIS NUMBER AND intake date MUST BE ENTERED within 10 business days of the intake visit date. Other “events” must be entered in ITOTS within 10 business days of the event.

61. UNANSWERED Questions ??? Use Chat to Respond

62. THANK YOU! All documents related to the implementation of EI TCM can be found here: http://www.infantva.org/wkg-EI-TCM.htmhttp://www.infantva.org/wkg-EI-TCM.htm.

63. To contact today’s speakers:  Beth Tolley:beth.tolley@dbhds.virginia.govbeth.tolley@dbhds.virginia.gov  Jeff Beard:jeff.beard@dmas.virginia.govjeff.beard@dmas.virginia.gov  Adele Rohner: adele.rohner@mrcsb.state.va.usadele.rohner@mrcsb.state.va.us  Sharlene Stowers: SStowers@grafton.orgSStowers@grafton.org  Pam Park: Pam.Park@fairfaxcounty.govPam.Park@fairfaxcounty.gov  Deana Buck:dmbuck@vcu.edudmbuck@vcu.edu All documents related to the implementation of EI TCM can be found here: http://www.infantva.org/wkg-EI-TCM.htmhttp://www.infantva.org/wkg-EI-TCM.htm.

64. Mark Your Calendar: Q&A Session on 9/12 at 9:00 am Virginia Early Intervention Professional Development Center THANK YOU! www.eipd.vcu.edu