EI/ECSE Contractor Meeting s1

EI/ECSE Contractor Meeting Minutes

December 10, 2009

Present: Nancy Anderson Terri Dickens Janet Dougherty-Smith Nancy Ford Alan Garland

Susan Graham Devora Gramson Nancy Johnson-Dorn Sue Mathieson Pat Moffitt

Judy Newman Kelly Oatman Ann O’Connell Ginna Oliver Jean Orr

Holly Reed Schindler Bruce Sheppard Kristina Sheppard Diane Tipton Ami Muilenburg (VTel) Jim Golden

Guest(s): Debbie Beyer

Recorder: Teckla Buller

Time / Topic / Purpose / Action /
09:00 - 09:15 / General Business
·  Announcements (All)
·  Follow-up from last meeting
Ø  Sending child records (Alan)
Ø  ECSE 60 school days for evaluation (Nancy J-D) / Updates / ­  An information handout about the Oregon Division of Early Childhood (DEC) was distributed by Nancy Anderson.
­  Please send the names of the person(s) who collect, keep and check record lists to Alan Garland at . He is compiling a list and will share it when it is complete.
09:15 – 09:30 / Proposed Budget Reductions (Nancy Johnson-Dorn)
Ø  2% EI/ECSE
Ø  5% OHS PreK / Information / ­  ODE and all state agencies have been asked to provide proposed budget reduction scenarios. Some reductions are a possibility if Oregonians do not pass the measures on the upcoming January ballot.
­  If needed these reductions would be applied to the second year of the 2009-11 biennium, but are calculated on 2% of the full amount budgeted for the biennium. The 2% reduction would bring EI/ECSE reductions down to 7% below EBL. Since OPK started the biennium at EBL, they would be 5% below EBL. Supt. Susan Castillo sent a letter to the Ways & Means committee reiterating the severity of the impact this has had and would continue to have on services to Oregon’s vulnerable children.
09:30 – 09:40 / HS expansion (Nancy Johnson-Dorn) / Information / ­  Oregon received Early Head Start federal expansion funds which will increase the number of children by 471.
­  Head Start expansion dollars will increase those numbers by 138.
09:40 – 09:55 / Expenditure Reports (Debbie Beyer) / Information / ­  Debbie reviewed her handout and explained the changes made to the spreadsheet and how to use it for reporting. Subcontractor funds are included under the 720 code.
­  When testing is completed, Debbie will update and post the report spreadsheet.
­  Contractor information can be found at the links below:
http://www.ode.state.or.us/search/results/?id=252
http://www.ode.state.or.us/search/page/?id=2471
09:55 – 10:00 / ARRA reporting (Nancy Johnson-Dorn) / Information / ­  Nancy reminded everyone that the window is open for the next ARRA reports and closes December 31. Steve Smith and Nancy will review reports as they come in and be available for questions. They will also contact districts and programs whose reports are not in by December 18.
­  OSEP has requested a conference call at the end of December to discuss reporting. There are no known changes at this date.
10:00 – 10:15 / Private School Consultation (Ginna Oliver) / Reminder / ­  If contractors have private preschools in their area, they should be involved in consultations regarding how to provide services to them.
­  Multnomah has a really nice format. It is an ongoing process. It has good resources and is available online.
­  Ginna has work sheets to help contractors calculate proportionate share and will be available to help.
10:15 – 10:30 / Regional Services (Sue Mathisen and Jim Golden) / Update / ­  Sue and Jim reported that Eric Richards chaired a committee of regional contractors, internal and external stakeholders that drafted a core of regional services and how they should look. They reviewed ORS and OARS to determine what is required and looked at services by disability and by hours for high, medium and low level services using a process similar to the proposed EI/ECSE funding model. This committee will continue to meet until the end of January.
­  The goal is to have the service delivery and funding model ready for the 2011-2013 legislative session so that there will time to adequately vet the work.
­  There are concerns about eligibility for regional services, especially for babies, around TBI and hearing impairment. There is a need to make it easier for these children to obtain services. How do we identify and count them now so that they will be included later?
­  There should be TBI forms for both B-3 and 3-21eligibility. Apparently the B-3 form is not posted on the web. ODE will follow up to make this form available.
10:30 – 10:45 / Break
10:45 – 11:15 / ecEval updates and data quality (Bruce) / Information and discussion / ­  Bruce distributed and reviewed a handout.
­  It is important to maintain the quality of these data.
­  Rita has done extensive training and continues to do so.
­  The AEPS Guidance document is currently being updated. When completed, it will be updated on the Child Outcomes web page.
­  Dan Smellow is developing reports that show areas where corrections are needed and that will help programs know how they are doing.
­  These reports can be used as a correction tool as well as to show trends, and may be a way to identify children due, or coming due, for testing.
­  Dan is programming data fields so they not accept incorrect data.
­  ODE is developing a new web page for Child Outcome Information with links to other sites and training information.
­  Summary statements will be included on report cards for 2011. That will also require adequate information so that people can understand what that data means.
­  At the next meeting Bruce will demonstrate how to use the site to run data reports.
11:15 – 11:30 / SICC Update (Nancy F. and Judy) / Information / ­  For 2009-10, the SICC has developed a list of specific topics for each meeting for the council to develop recommendations to ODE.
­  The Governor’s report is finished and distribution is being planned.
11:30 – 12:00 / ODE child find activities (Ginna) / Information and discussion / ­  Ginna distributed copies of ODE’s Child Find Plan and the SICC’s Recommendations. The SICC focused on Child Find during the November meeting and developed a list of recommendation for ODE.
­  Some of the things discussed included:
­  The START program is looking for pediatricians in each region who would be willing to train locally. These trainers are paid by the grant. If anyone knows someone who would be interested, please talk with them and give their name to Ginna or Judy Newman who will pass the information on to Anne Stone. This grant is run thru the Oregon Pediatric Society. Jean Orr asked Judy or Ginna to forward her a copy of the PowerPoint slides. These slides are also posted on the Contractors web page: http://www.ode.state.or.us/search/page/?id=2471
­  There was discussion about the process for referral and eligibility determination for children with hearing disabilities not being referred as they should, or being made eligible. Ginna will send questions to Contractors about their processes for EHDI referrals.
­  ODE’s legal unit is looking at the legality of releasing enrollment information on EHDI referrals to EHDI through giving the program limited access to ecData. Secure email can’t be used for referrals because policies and procedures of various contractors. FAXing is acceptable. If anyone has suggestions to help the communication challenges around the EHDI referral and enrollment processes, please let Ginna know. EHDI is adding another person to do some of this work which should also help.
­  How can contractors ensure that they are effective and consistent in their child find efforts? How do we measure what is actually being done versus what is written in the Service Area Plan?
­ “Branding” may be one option. Some counties have had excellent results using a “relationship” approach. Different approaches work better or differently in different areas, so care has to be taken to ensure that methods work. Time and staffing have a major impact. Methods used to approach parents and talk about their child are critical. People move around so relationships have to be continually nurtured. Relationships with school districts are important as they have joint responsibility for child find with EI/ECSE. Multnomah ESD’s Positive Behavior Support trainer has made a difference by including information about how to make referrals. Devora will send a copy of her PowerPoint training tool share with the minutes and to post on the Contractors’ web page.
­  Connecting with mothers. How can we use technology, (blogging, twittering, etc.) to disseminate information to families?
­  How can Head Start and ECSE partner better? Service providers meet six times a year in Marion County with disability managers from Head Start programs to talk about all of these issues. Multnomah does as well.
­  It is recommended that EI/ECSE programs meet annually, at a minimum, with their Head Start partners to discuss different issues/challenges and also to review interagency agreements as a method for addressing them.
12:00 – 12:30 / Lunch
12:30 – 12:45 / SLP discussion (Susan G. to start the discussion) / Discussion / ­  TSPC has decided to no longer license Speech Language Pathologists. There is apparently one more comment session to be held and then the decision will be finalized. OSHA and ASHA disagreed with TSPC’s approach to granting conditional licensing to candidates who were very close to completing their qualifications, yet not fully licensed. This could have a major impact on EI/ECSE services. For more information, please contact Holly Reed Schindler, at ODE.
12:45-01:00 / ASQ / ­  Referrals arising from parents’ use of ASQ Oregon cannot be tracked back to it unless they result directly from the website.
­  Ginna is ODE’s ASQ Oregon contact. Data indicated that1 or 2 families per year actually referred their child to EI/ECSE programs from the website, however, 2,427 families used the website in 2009 to see if their children were developing typically. Judy felt there was not sufficient rationale to justify staff time for directly handling ASQ Online responses in Lane Co. ASQ Oregon may be the first time parents receive information that their child may not be typically developing. Parents may self refer or be referred by another agency at a later date, but this may not show as a referral from ASQ online in ODE’s referral data.
­  ASQ III has been sold to Brooks. If programs want to operate their own website separately from the University of Oregon, there will be a substantial charge for the materials and the technical support.
01:00 – 01:45 / Medicaid (Linda Williams by phone) / Discussion / Bruce Sheppard had shared contractors’ Medicaid questions with Linda Williams from DHS. The questions and Linda’s email responses (in blue) are listed below, by permission. Linda joined our meeting today by phone, to review the questions and responses, and clarify points as requested. Dan Smellow from ecEval also responded to some of the questions and his comments are noted in red.
Linda stated that nine plan amendments have been submitted to CMS for approval, so there will be no official changes right now.
Q-1. Avoiding duplicate billing: has there been a determination on how to identify who will bill for a child? For example, “Amy” is in EI, but is also seen by Babies First. How do we know who will bill? Or whether someone has already billed?
A-1. In prior discussions with ESDs regarding the provision and reimbursement for EI/ECSE TCM services, Division of Medical Assistance Programs (DMAP) for the Department of Human Services (DHS) understands that EI/ECSE is mandated by legislation to bill Medicaid for covered services provided pursuant to an IFSP. Covered services specified on a child's IEP or IFSP also ties these services to 1903(c) of the Social Security Act where Medicaid is first payor before education. DHS submitted Oregon's State Plan Amendment (SPA) language for each TCM program to The Centers for Medicare and Medicaid Services (CMS) for approval and they are still in the process under review. Until DHS receives CMS' official approval of SPA language for each of the TCM programs we will not be able to adequately respond to your questions regarding these services.
Q-2. Number of programs a family uses: many families don't know the names of all the programs in which they participate. How do we determine whether they are enrolled in another billing program? There was some earlier discussion Linda Williams regarding the development of a statewide database. Has there been any more activity occur on that?
A-2. Not sure how ESDs will know names of other programs the family is involved with because I believe there were problems with EI/ECSE taking part in a statewide database due to FERPA Privacy and consent requirements. However, Service Coordinators providing service coordination to children eligible under EI/ECSE as part of their IFSP should know whether or not the child they are serving is in foster care, is DD, etc., based on services the child is eligible to receive under IDEA pursuant to the IFSP and legal guardian per the provision of and consents required for IFSP services.
Q-3. Care Plan: Is there a final decision on the format that EI/ECSE providers would use to document the care plan? I know we were at first considering the family outcome page and then determined we needed another type of format. What happened with this?