School-Based Medicaid Developmental Disabilities Services Let the - PowerPoint PPT Presentation

School-Based Medicaid Developmental Disabilities Services Let the fun begin… Kelly Hall Shannon Dunstan Southwest Regional Coordinator Idaho State Department of Education Division of Special Education Division of Special Education Early Childhood and Interagency Coordinator

Current Medicaid School Services • Developmental Disabilities Services – Developmental Therapy – Intensive Behavioral Intervention • Psychosocial Rehabilitation • Psychotherapy and Evaluation • OT/PT/Speech • Nursing Services • Personal Care Services (PCS) • Medical Equipment and Supplies • Transportation • Interpretive Services

Clarification on Changes There are 2 Medicaid billable DD services for children that will be impacted by upcoming changes to Medicaid services: 1. Developmental Therapy 2. IBI

What to Expect 2012-2013 School Year

School Year 2013-2014

Replacement Services Available • New: Behavioral Intervention • New: Behavioral Consultation • Personal Care Service

Related Services such as: SLP, OT, PT, and Psychosocial Rehabilitation will stay the same.

Behavioral Intervention/Consultation Definition Behavioral Intervention is used to assist the student to access the educational environment through a consistent, assertive, and continuous intervention process. It includes the development of replacement behaviors with the purpose to prevent or treat behavioral conditions of individuals who exhibit maladaptive behaviors.

Behavioral Intervention/Consultation Who qualifies? • Behavior Intervention is available for children with developmental disabilities, that have been diagnosed with a medically necessary need and exhibit maladaptive behaviors, including but not limited to, frequent disruptive behaviors, aggression, self-injury, criminal, or dangerous behaviors. These maladaptive behaviors impede the learning of themselves or the learning of This service would require Teams to develop others. a FBA and BIP and/or an IEP goal to define delivery of intervention.

Behavioral Intervention Two levels of service delivery – Paraprofessional – Professional

Behavioral Consultation The behavioral consultant assists other service providers by consulting with the IEP team during the assessment process, performing advanced assessment, coordinating the implementation of the Behavior Implementation Plan and provides ongoing training to interventionist and other team members.

Personal Care Services Definition Who Qualifies? • Program that helps with • Those eligible for Medicaid. medically necessary • Those who obtain a doctor’s personal needs. statement that PCS is needed due to medical • Children with physical or conditions. developmental disabilities, • Those who are able to stay in may be eligible. the community safely. http://www.healthandwelfare.idaho.gov

Services under PCS • Grooming • Dressing-Upper Body • Dressing-Lower Body • Toilet Use • Bladder Continence • Bowel Continence • Adaptive Devices • Transferring • Mobility • Eating/Feeding • Medication Assist http://www.healthandwelfare.idaho.gov

PCS Assessment and Plan of Care • Licensed professional nurse (RN) or licensed practical nurse (LPN), licensed by the State of Idaho – District Personnel – Contracted Community PCS Nurse • Develop the Health Plan Idaho Administrative Code IDAPA 16.03.09

PCS Service Delivery • School Nurse • Community Contracted Nurse • Teacher • Paraprofessional

Psychosocial Rehabilitation Services - PSR No identified changes to this program at this time.

What does this all mean? There is going to be a reduction in Medicaid reimbursable in School Based Services. But hold on…

Developmental Therapy IBI PCS PSR

Developmental Behavior Therapy Intervention PCS PSR

Legislative Timeline

Don’t

How to Plan for Change?

www.idahotc.com Training and Technology for Today ’ s Tomorrow • Supported By: – Idaho State • Website to link school Department of professionals and Education (ISDE), parents with special Special Education education training • Project Team: opportunities and resources across the – Cari Murphy state – Shawn Wright

Statewide Special Education Technical Assistance (SESTA ) Center for School Improvement & Policy Studies, BSU Gina Hopper, Katie Bubak, Director Statewide Consultant ginahopper@boisestate.edu katiebubak@boisestate.edu

Contact Information: Shannon Dunstan Early Childhood & Interagency Coordinator Idaho State Department of Education Division of Student Achievement and School Improvement Division of Special Education (208) 332-6908 sdunstan@sde.idaho.gov