, llc parent handbook - interactive kids · attention deficit hyperactivity disorder (adhd),...

Parent Handbook

Revised 11/2019

, LLC

Interactive Kids, LLC Parent Handbook & Policy Manual 2

TABLE OF CONTENTS

Welcome Message to Parents ………………..………………….....……. 3

Contact Information ……………………………...........………….………… 4

Overview …………………………………………………………...........……….. 5

Our Services ………………………………...……………………………….….… 6-8

Policies and Procedures ……………………………….……………………… 8-17

Client Guidelines ………………………………………………… 8

Tree Nut & Peanut Free Policy ……………………………. 8

Pick Up Procedure …………………………..….…………..…. 8

Waiting Room & Parking Lot Policy …………………….. 8

Parent Training Responsibility …………..………………… 9

Parent Observation Policy ……………………….………..… 9

Use of Reinforcers ……………………………...………………. 9-10

Communication Policy …………………….………………….. 10-11

Privacy Policy……………………………………………………….. 11

Photo/Video & Social Media Policy ……….…………….. 11

Policy on Respite and Babysitting ………..………………. 12

Policy on Gift Giving …………………………..…...…..……… 12

Discrimination Policy …………………………………………… 12

Safety Policy ………………………………………..……….……… 12-14

Sick Policy ………………………..……………………...…..……… 14-15

Cancellation and Lateness Policy ….…….…...…..……… 15-16

Financial Policy ………..……………………………...…..……… 16-17

Reporting Child Abuse in New Jersey ……...…..…….…………..… 18

Health Insurance Portability and Accountability Act (HIPAA)

& Confidentiality ……………………………………………….……….……… 19-21

Parent Handbook Acknowledgement …………………………..……. 22


Welcome Message to Parents

Dear Parents,

Thank you for choosing Interactive Kids, LLC. Our Parent handbook and policy manual is intended to inform you about our programs and policies, the team serving your child, and your responsibilities as caregivers. We are committed to maximizing your child’s progress by applying evidence-based strategies rooted in the methods of Applied Behavior Analysis.

The long-term success of our clients is based upon the collaborative approach between Interactive Kids, LLC and their families. Accordingly, this manual outlines the policies and procedures amongst Interactive Kids, LLC our clients and their families. Any questions regarding the information provided in this manual or other aspects of our services should be directed to the office (856) 810-7599.

We look forward to working with you!

Sincerely,

The Staff at Interactive Kids, LLC


Contact Information

Phone (856) 810-7599 Fax (856) 810-7663

Email: [email protected]

Website: www.interactivekids.com

Locations

101 East Gate Drive 2433 Church Road 1515 Shore Road 1305 Kings Hwy N Cherry Hill, NJ 08034 Cherry Hill, NJ 0803 Linwood, NJ 08222 Cherry Hill, NJ 08034

Office contact:

Amber Binder Office Manager- East Gate, Cherry Hill ext. 101 Nancy Connolly Administrative Coordinator- Linwood ext. 108 Kellie King Program Coordinator- Church Rd., Cherry Hill ext. 110

Executive Management:

Melissa Torpey Chief Operating Officer ext. 107 Megann Czekalski Chief Executive Officer ext. 106 Steven Trout Vice President of Clinical Services ext. 103 Jacqueline McCue Director of Clinical Services ext. 103 Rachel Watson Director of Operations ext. 101 Colleen Tessing Director of Educational Services ext. 109 Lynne Farbman Director of Counseling Services ext. 114 Danielle Fiorentini VOICE Program Supervisor ext. 201

Hours of Operation

The office is open from 9 am to 5pm Monday through Friday. Extended hours offered for social skills and individual services, arranged on a case by case basis. Direct care staff and behavior consultants work from 8 am to 8 pm Monday through Friday and some weekends. Any communication outside of these business hours may not be answered until the next business day. Office phone messages are checked daily. Please allow 24 hours to receive a call back from our office staff.


Overview Interactive Kids, LLC is a community resource designed to provide the highest quality consultation and training services for individuals, their families, professionals, and other providers through a collaborative solution-driven relationship.

A wide array of behavioral, educational, and vocational-based services for individuals with disabilities such as autism, developmental disorders, non-verbal learning disorder, brain injury, Attention Deficit Hyperactivity Disorder (ADHD), behavior disorders, and other neurological impairments are offered. In addition, those who may not be diagnosed, but who are experiencing socially challenging behaviors, may also receive services through Interactive Kids, LLC.

Mission Statement

Interactive Kids, LLC strives to provide the highest quality services to the individuals we serve so that they may achieve their greatest potential. Offering ongoing, evidence-based therapeutic treatment rooted in the principles of Applied Behavior Analysis (ABA), as well as training and supervision for families, providers, and the community, comprises the core of our mission.

About Our Professionals

Our expert professional staff include board certified behavior analysts (BCBA/BCaBA), social workers, school psychologists, licensed counselors, guidance counselors, speech-language pathologists and certified special education teachers. All staff members have extensive experience in the field of applied behavior analysis, specifically related to functional behavior assessments, positive behavior supports, verbal behavior, social skills, reinforcement strategies, bullying prevention, vocational training, feeding therapy, toilet training, behavior reduction, functional communication training, direct instruction, differentiated instruction and classroom management, amongst many other skills.

Supervision & Professional Development Supervision for ABA clients and staff is provided by Interactive Kids, LLC consultants who are credentialed by the Behavior Analyst Certification Board (BACB). Every client’s program is assigned a consultant that monitors progress, provides direct supervision to the ABA therapist, conducts assessments as needed and facilitates team meetings with the family/caregiver. Supervision for counselors is provided by Interactive Kids, LLC staff who are credentialed by their state licensing board to provide clinical supervision.


Interactive Kids, LLC wants to help employees succeed and grow in their jobs. Interactive Kids, LLC provides ongoing professional development and training opportunities to maximize an employee’s learning and advancement potential, specifically the most current evidence-based research.

Our Services

In – Home ABA Therapy

Interactive Kids, LLC provides home-based ABA services to our clients. Services may include, but are not limited to, conducting functional behavior assessments, behavior intervention programming, data collection and analysis, creation of treatment materials and treatment planning. In-home services may also include community sessions with the parents to work on skills. Parent training is a component of in-home therapy to ensure the skills and techniques worked on in therapy are generalized to the parents.

Early Learners Interactive Kids, LLC curriculum and therapy strategies are individually developed and applied. A primary goal is to prepare clients to live up to their highest potential and become independent. The family, school personnel, related service providers, consultants, and ABA therapists work cooperatively in order to develop programming, evaluate progress, and problem-solve as necessary to achieve the best outcome for the client.

Early and intensive treatment for children with developmental disabilities using Applied Behavior Analysis (ABA) is proven to yield significant gains. Growth in cognitive, communication, and social skills are crucial for life-long success. The Early Learners Program provides preschool aged children with the educational supports necessary to maximize growth and development, preparing them to enter school with the skills needed to succeed. The individual needs of each child will be met through interventions that include discrete trial instruction, intensive teaching, verbal behavior programming, and natural environment teaching. The development and generalization of social skills, speech and language, gross and fine motor skills, cognition, daily living skills, and school readiness skills are embedded into the program. Staff who support the program include ABA therapists, certified Special Education teachers, and Behavior Analysts (BCBA and BCaBA).

VOICE The Project VOICE program gives teens and young adults, aged 14 and over, a meeting place to improve life skills, build interests, develop talents and discover strengths. The program


welcomes those with Spectrum Disorders, other Social Learning Conditions and Social Communication challenges.

Social Skills The focus of this program is to provide a strong foundation of concepts that are required for social success. Skills are taught through both direct teaching of concepts and real-time practice in activities planned in the group.

Our social skills programs offer kids an opportunity to learn and practice social interactions within a group of peers. With group offerings spanning from Pre-School to High School, the skills targeted vary from basic greetings and responses, unspoken rules, behavioral self-regulation, to independently navigating social situations. A variety of teaching strategies are used including direct teaching and practicing a specific skill to natural environment teaching addressing deficits as they occur.

Speech Comprehensive speech and language evaluations are conducted using a combination of formal assessments, behavioral observations, parental report, and review of records in order to determine if a speech and/or language problem is present.

Speech and language therapies are performed to help your child improve their skills to an age-appropriate level. Therapy is based on the information obtained from a speech and language evaluation. Goals are selected to help achieve success through a carefully designed sequence of activities.

Parental involvement in the therapy is highly encouraged. The speech language pathologist consults with parents/caregivers on an on-going basis in regard to their child’s progress. Parental training of techniques used in therapy can improve a child’s overall success and allow the child to continue practice of skills learned in therapy outside the treatment sessions.

Counseling Cognitive and behavioral counseling services are offered at Interactive Kids, LLC. Eligible clients include children and young adults with emotional and behavioral difficulties associated with Autism Spectrum Disorder, ADHD, Oppositional Defiant Disorder (ODD), Depression/Mood Disorders, and Anxiety Disorders. Services offered may include individual, family, and/or group therapy. Treatment will focus on the individual needs of each client. Common areas of focus in treatment include, but are not limited to treatment planning, social skills, parent training,


cognitive behavior therapy, emotion regulation, development of positive coping skills, executive functioning skills, and sibling support. Family involvement is often critical to achieve maximum success. Parents may be asked to check in at the beginning or end of a session or make other arrangements to share information. Family or joint sessions may be periodically held based on your child’s needs and treatment plan. When appropriate, parents may schedule an appointment time without their child present in order to discuss their child’s needs and treatment more thoroughly.

Policies and Procedures

Client Guidelines

All clients attending programming will complete and maintain current client info, video/picture release, pick up policies/approval, and other center related policies. Any change of address or pick up changes must be updated immediately. Please see your supervising consultant or our administrative coordinator for paperwork.

Tree Nut & Peanut Free Policy

Lunch and snack items to be sent in daily, including drinks. Interactive Kids, LLC is a peanut and tree nut free facility and therefore any food items made with nuts are prohibited. This includes crackers, cereal bars, cookies and candies that are manufactured in a facility with nuts of any kind.

Pick up Procedure

We will release your child only to you or other persons you have identified on your child’s “Authorization for Child Pick Up”. People listed on the Authorization form may be asked to show their identification and if they fail to present identification, your child will not be released to that person. If someone not listed on the “Authorization for Child Pick Up” is coming to pick up your child, you must inform the Director prior to his or her arrival. That person will be expected to pick up your child at the correct dismissal time and show proper identification.

Waiting Room & Parking Lot Policy

It is the parent’s/caregiver’s responsibility to supervise their children at all times. Interactive Kids, LLC is not responsible for children prior to or at the conclusion of social skills classes or any other services. Parents, caregivers and siblings are not permitted to enter the therapy room at any time


and are required to remain in the waiting area. It is imperative that parents safely escort their children in the parking lot. In consideration of the neighboring businesses, we ask that you do not park in parking spots assigned to other businesses.

Parent Training Responsibility

Consistency between you and your child’s therapy team can be accomplished through parent training. You can learn and collaborate on ways to teach your child different skills through parent training, and you can also observe ways in which skills are being taught by your child’s therapy team. Working on skills at home can contribute to your child’s success as it allows for your child to get more practice with those skills in the environment in which he or she will be expected to perform them. The more practice with those skills, the more successful your child will be at developing and using those skills in the future. Insurance requires parent training participation in order for services to be provided. Failure to meet the parent training requirement could result in termination of services. Throughout the consultation process, Consultants will help parents prioritize skills they want their child to learn. Goals will be developed to match those identified skills. Parents are required to implement each goal collaborated on, and as goals master out, future goals may be developed. In addition to implementing a goal, parents are also required to take data on goals to demonstrate generalization of services to their perspective insurance provider. Lack of parental involvement (i.e. refusal to participate in parent training, multiple cancelations in parent training, refusal to practice therapeutic skills independently) can result in decreased service hours or termination of services. Likewise, increased participation may allow for increased therapeutic hours.

Parent Observation

Parents are welcome to come in and observe sessions. Please notify a supervisor or director prior to your observation. All other visitors to the program require written clearance from parent and scheduled visitation.

Use of Reinforcers For parents that are both new and familiar with VB/ABA programming, it is important to know one of the main goals of treatment is to help a child access something we call, “reinforcement.” This means we want to make the child’s day as rewarding as possible to keep them motivated to learn.


First, we request that parents provide an assortment of their child’s favorite items during the sessions. This commonly includes specific snacks and drinks the child likes but can also include special toys from home that we can send back and forth through the child’s backpack. If a parent sends toy(s) with their child, the team will only use these as a possible reward for their child during their learning day. They will not be available to the child at other times. In addition, we work hard to restrict use of your child’s toys by other children in order to prevent possible breakage and loss. However, this does not always go the way we plan, breakage or loss may occur and would be reported to a parent. Interactive Kids, LLC does not replace broken or lost items. When sending toys, we recommend sending gently used toys and toys that do not hold special meaning to the parent or their child.

Second, we ask that parents provide us with a list of the most rewarding items for their child. We will do our best to make these rewards available at all times, and we also ask parents to help replenish basic rewards throughout the year.

This is such an important piece of treatment, and we thank all parents in advance for their support in this area. Without motivation to learn, learning will not take place!

Communication

Interactive Kids, LLC values the expertise of parents and caregivers, and we welcome the opportunity to partner with you in the development of your child’s program. We believe communication is paramount to your child’s success and to a great parent/therapist relationship. All parent – staff communication should be maintained through an assigned supervising consultant. Consultants are available by phone and email during regular business hours. We encourage you to discuss any questions and/ or concerns you may have directly with your child’s therapist first and foremost. If additional support is necessary, your child’s therapist will then arrange for a team meeting with our administrative staff. Notify your child’s supervising consultant and therapist of any unusual circumstances (e.g., allergies, change in medication, new medication, changes in behavior, etc.).

Group Classes

Approximately 5-10 minutes prior to the conclusion of a group class, the facilitator will exit the classroom to meet with the parents/caregivers in the waiting room. An overall summary of the class will be discussed. Should you have a specific question/concern regarding your child, you can contact the facilitator in advance to set up a private meeting (which may incur an additional fee).

For groups that include progress reports, they will be completed after the conclusion of the group session. Clients must attend at least 5 out of 8 classes in order to receive a progress report.


Progress summaries may be written at any time throughout the social skills session for an additional fee.

Individual ABA Services

Approximately 5-10 minutes prior to the conclusion of an individual service, the therapist will invite the parent into the session to discuss progress and recommended strategies to promote generalization at home.

Individual Counseling Services

Parents may be asked to meet with the therapist for the first or last few minutes of the session to provide updates. Reports, letters, or collaboration with other providers can also be provided. Any phone calls, emails, or other requests outside of the session time are unable to be billed out to insurance. Any requests of more than 15 minutes outside of the allotted session time will be billed to the family at the current rate (please inquire with your counselor regarding rates).

Privacy Policy

As per HIPAA regulations, staff must observe confidentially rules when speaking about client’s diagnosis or treatment plan. We ask that parents also respect our client’s privacy and refrain from discussing or inquiring about other client’s cases to parents and/or staff.

Photo/Video & Social Media Policy

We take the privacy and security of our clients and their families seriously. Pictures and/or videos of your child will not be taken unless you have authorized us to do so. There is a permission slip available in the office to accept or decline pictures/video of your child being taken. This policy applies to clients and staff and includes the following guidelines:

• Staff are directed to not accept friend requests from client’s families due to it being a breach of professionalism

• Client’s images or cases will not be shared on any social media, discussion forum or marketing campaign without parental/ guardian consent

• No public discussions or comments regarding Interactive Kids, LLC, staff or clients, that could be deemed inappropriate or offensive

• Any concerns should be immediately reported to your supervising consultant


Policy on Respite and Babysitting

Staff members employed by Interactive Kids, LLC may not provide fee for service childcare to families of children already served by Interactive Kids, LLC.

Policy on Gift Giving

The appropriateness of gift giving to staff within the school context or the feeling that gifts might be expected is sometimes cause for discomfort, especially during holidays or at the end of a year. Some families use gift giving as a means to say “thanks”; but not all families are in a position to do so. Interactive Kids, LLC is ethically bound to ensure that all of our clients are treated equally and that no one has or might be perceived to have special advantages or influence. For those of you who want to give staff members, a token of your appreciation, we recommend a card or letter, or small token such as homemade treat. However, if you are inclined to give any other kind of gift to any staff member it is our policy to restrict gift values to $20.

Discrimination Policy Interactive Kids, LLC does not and shall not discriminate on the basis of race, color, religion, gender, gender expression, age, ancestry, disability, marital status, sexual orientation, military status or any other basis prohibited by law in any of its activities or operations.

Safety Policy The safety and health of clients and employees is a priority. Interactive Kids, LLC makes every effort to comply with all federal and state workplace safety requirements. Interactive Kids, LLC workplace safety rules and regulations are the following:

• No Smoking • No Weapons • No Tolerance for Drugs or Alcohol • Follow HIPAA Regulations • Implement Authorization for Child Pick-up Policy • Follow Severe Weather and Emergency-Related Procedures • Implement Safe Evacuation Procedures

Each employee is expected to obey safety rules and exercise caution and common sense during all work activities. This includes, but is not limited to:

• A therapist in charge of a child or children shall be responsible for their safety. • No child shall be left alone or unsupervised. • An adult over the age of 18 must be present at all times during in-home services.


• A therapist cannot transport a client unless approved by the director and a transportation waiver has been completed and signed by the parent/legal guardian.

• No parent or staff is allowed to smoke in the building or on the premises. • In case of a fire, tornado, bomb threat, or other emergency, instructors will guide the

children through their posted emergency action plan. A parent/legal guardian will be notified as soon as the children are safe.

• A child shall not be released to the parent or caregiver if that person is deemed by the staff to be under the influence of drugs or alcohol.

• Interactive Kids, LLC will immediately notify the Department of Children and Families if there is suspicion of abuse or neglect.

• Interactive Kids, LLC will adhere to all policies outlined in the Parent Handbook Manual

Safety/ Crisis Prevention and Intervention Training

Interactive Kids, LLC staff are trained within a crisis prevention and intervention method. Crisis prevention and intervention consists of increasing positive interactions with client, practice skills geared to preventing behavioral escalation, de-escalation strategies, and personal emergency techniques. Staff are trained to maintain safety during crisis events. Interactive Kids, LLC reserves the right to implement emergency physical techniques in order to maintain the physical safety of both clients and staff. In the event that a client is a danger to themselves or others, physical hold techniques will be utilized to maintain safety. Staff will communicate information regarding crisis events to parents/caregivers for transparency and collaboration purposes.

Solving Disputes/Problems/Issues/Questions/Criticisms

When working as a team, effective communication is key. As professional relationships are built between Interactive Kids, LLC professionals and the families we serve, we strive to maintain open and effective communication.

Please use the following model to address questions/concerns/ problem solve:

- The first line of communication should be to your supervising consultant and your ABA therapy team (Please indicate if a matter is urgent and our consultants will make every effort to respond quickly and appropriately. For everyday items – please allow 24-hour window for return communication)

o Please respect that when a topic/question requires clinical opinion or oversight our ABA therapists may refer you to the supervising consultant

- Communicate openly o Use “I” statements and share information that is key in order for the members

on the team to understand the question, concern, or viewpoint


o Ask for clarification if communication from the Interactive Kids, LLC team member is unclear or not understood

o Verbal abuse, cursing, threats and/or behaviors of this kind are not tolerated within team communication when partnering with Interactive Kids, LLC and will result in damaging the professional collaborative relationship, and may result in termination of services

- Communicate professionally o ABA is a professional service, provided by trained professionals. Communication

expectations are aligned with any other communication modeled by professionals in the medical field

o We recommend providing a short “reflection” period prior to opening a discussion that evokes or has evoked an emotional response

- Communicate information timely in order to allow appropriate members of the team to collaborate/problem solve/respond

- Follow up if further clarification is needed - In the event that there is a communication breakdown:

o Reach out to the supervising consultant to discuss the area of need o If attempts with the supervising consultant do not provide resolution – contact

the appropriate program director/supervisor (Early Learners, Education, Social Skills, Adult Services, Clinical Director, Counseling)

o Any attempts that are not resolved at the director/supervisor level will be immediately forwarded to company management

Sick Policy

If your child becomes ill and exhibits any of the following symptoms below, please notify the office immediately to cancel services:

• Temperature of 100 degrees or higher within the last 24 hours. (Must be fever free for full 24 hours without the use of Tylenol or Motrin). Children should not be sent to therapy if they required Tylenol or Motrin dosages prior to session.

• Diarrhea and/or Vomiting (including occurrences within the last 24 hours both at center and/or home)

• Persistent cough • The beginning of an airway infection (cold/cough/runny nose) • Undetermined rash (requires Dr. note indicating it is not contagious in order to return to

the center) • Sore Throat and/or difficulty swallowing (Must be on antibiotics 24 hours before

returning to school with strep throat)


• If antibiotic treatment is needed, your child should remain home for the first full 24 hours of medication (e.g., if your child has three doses per day ordered, then three doses must be given before the child returns to our office)

• Red, watery, burning, itching eyes or yellowish drainage. (Pink eye must be treated for 24 hours before returning to school)

• Extreme tiredness and/or lack of appetite • Fever • Fever with headache, body aches, earache, sore throat • Any of the above symptoms with fever or chills • Untreated skin conditions such as impetigo, lice, scabies, or similar conditions

We want your child to have a quality session. If you feel they will not be successful due to an illness, please keep them home or cancel the session. If your child exhibits any of the symptoms listed above, you will be contacted immediately to pick your child up from the center-based program or to terminate the therapy session. Be sure to keep your child’s emergency contact form current with name and phone numbers to reach someone who can pick up your child or in case of an emergency. All sick policies will be implemented at the discretion of the program director.

Cancelation & Lateness Emergency and Weather-Related Closings If group classes or individual services provided at Interactive Kids, LLC are canceled due to inclement weather, a message will be left on the Interactive Kids office voicemail (856) 810-7599 and posted on our Facebook page. If a home service is canceled due to inclement weather, Interactive Kids, LLC will make every attempt to provide the family with an alternative day for service. Cancelation/Lateness of Services by Interactive Kids, LLC If a group class is canceled by Interactive Kids, LLC we will make every effort to schedule a make-up class at the end of the session.

If an individual service is canceled by Interactive Kids, LLC we will make every attempt to provide the family with an alternative day for service.

If a home service is canceled by Interactive Kids, LLC we will make every attempt to provide the family with an alternative day for service.


If an Interactive Kids’ therapist is late, he or she will make the time up by staying later that session or during their next appointment.

Cancelation/Lateness of Services by Client If your child/children are unable to attend a group class during the session, please notify the office staff as soon as possible. Make up classes and/or reimbursement/credit for missed classes is not available.

If your child is unable to attend a scheduled appointment, please notify the office staff as soon as possible. Clients are required to provide a minimum of a 48-hour notice for cancelations or changes to scheduled appointments.

If a service is canceled by the client, with less than 48-hour notice, a make-up session will not be available and the client may be subject to a $50.00 cancellation fee. Cancelation fees are not reimbursable by insurance companies or any other third-party funder and the client would be liable for payment.

If a client is late for an appointment, the client will still be charged for the entire scheduled appointment and time will not be made up at the end of the scheduled session/appointment. The therapist is required to wait up to fifteen minutes for a client, after which, they are permitted to leave.

Excessive cancellations may result in termination of services.

Financial Policy

Private Pay

Payment can be made via cash, check, online, or credit card (Visa, Master Card and Discover only). Credit card payments can be processed in the office or via phone. If needed, special payment schedules can be arranged with the approval of the office manager, however if special arrangements are agreed upon between Interactive Kids, LLC and the client, the balance is required to be paid in full on or before the payment due date. Interactive Kids, LLC reserves the right to withhold reports and deny additional services until the balance is paid.

Third Party Payment

If arrangements have been made for a third party (private agency, state agency, school district, insurance company, etc.) to fund the services, it is the responsibility of the parent/guardian to


contact the third party to make the request for payment of services. Once approved, a formal contract will be developed between Interactive Kids, LLC and the third party.

Health Insurance Coverage

We participate with a few behavioral/mental health insurance providers for Applied Behavior Analysis (ABA) services provided to children diagnosed on the autism spectrum. Knowing your insurance benefits is your responsibility. Please contact your behavior/mental health provider with any questions you may have regarding your coverage.

• Proof of Insurance: All clients (excluding counseling services) must complete our client information form before seeing a Board Certified Behavior Analyst. We will need a copy of a script/report indicating a diagnosis of 299.0 and a referral for ABA services from your medical doctor. In addition, a valid insurance card must be provided to ensure proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of the claim.

• Copayments and deductibles: All co-payments and deductibles shall be paid at the time of service. This arrangement is part of your/our contract with your insurance company. It is our policy to collect a co-payment at every visit.

• Claims Submission: We will submit your claims and assist you in any way we reasonable can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that any balance is your responsibility. If your insurance changes, please notify us before your next visit so that we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim within 45 days, the balance will automatically be billed to you. Your insurance benefit is a contract between you and your insurance company; we are not part of that contract.

• Non-covered services: Please be aware that some and perhaps all of the services you receive, may not be covered for whatever reason by your insurance company. If that is the case, you are responsible for payment of services.

• Changes in insurance: All changes related to health insurance, including but not limited to, increases or decreases in co-pays, changes in coverage, if health insurance providers change or if a secondary insurance provider is added or removed, must be communicated immediately. If you fail to provide us with the most current insurance information in a timely manner, you may be responsible for the balance of the claim.


Reporting Child Abuse in New Jersey

All employees of Interactive Kids, LLC are Mandated Reporters under New Jersey state law. If any staff member suspects child neglect and/ or abuse, they are required to report the incident immediately.

How and When to Report Child Abuse/Neglect

In New Jersey, any person having reasonable cause to believe that a child has been subjected to abuse or acts of abuse should immediately report this information to the State Central Registry (SCR). If the child is in immediate danger, call 911, as well as 1-877 NJ ABUSE (1-877-652-2873). A concerned caller does not need proof to report an allegation of child abuse and can make the report anonymously. What information will I be asked to provide to the hotline screener? SCR screeners are trained caseworkers who know how to respond to reports of child abuse/neglect. Whenever possible, a caller should provide all of the following information:

• Who: The child and parent/caregiver’s name, age and address and the name of the alleged perpetrator and that person’s relationship to the child.

• What: Type and frequency of alleged abuse/neglect, current or previous injuries to the child and what caused you to become concerned.

• When: When the alleged abuse/neglect occurred and when you learned of it. • Where: Where the incident occurred, where the child is now and whether the alleged

perpetrator has access to the child. • How: How urgent the need is for intervention and whether there is a likelihood of

imminent danger for the child.

Do callers have immunity from civil or criminal liability? Any person who, in good faith, makes a report of child abuse or neglect or testifies in a child abuse hearing resulting from such a report is immune from any criminal or civil liability as a result of such action. Calls can be placed to the hotline anonymously.

Is it against the laws of New Jersey to fail to report suspected abuse/neglect? Any person who knowingly fails to report suspected abuse or neglect according to the law or to comply with the provisions of the law is a disorderly person.

What happens after I make the call? When a report indicates that a child may be at risk, an investigator from the Division of Child Protection and Permanency (formerly Youth and Family Services) will promptly investigate the allegations of child abuse and/or neglect within 24 hours of receipt of the report.


Health Insurance Portability and Accountability Act (HIPAA) and Confidentiality

HIPAA (Health Insurance Portability and Accountability Act) is a federal law that protects personal medical information. The law allows only certain people to see this information. This means that employers or groups who want this information for their own use cannot have it.

Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your provider, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the provider’s practice, and any other use required by law.

Treatment Confidentiality

We will use and disclose your protected health information to provide, coordinate, or manage your healthcare and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected heath care information, as necessary, to a home health agency that provides care to you.

Payment Confidentiality

Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital admission or stay may require that your relevant protected health information be disclosed to the health plan.

Healthcare Operations Confidentiality

We may use or disclose, as needed, your protected health information in order to support the business activities of your provider’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of ABA students, licensing, and conducting or arranging for other business activities. For example, we may disclose your protected health information to interns that see patients at our office. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.

We may use or disclose your protected health information in the following situations without your authorization. These situations include, as required by law: Public Health and Safety , Heath Oversight, Abuse or Neglect, Food and Drug Administration Requirements, Legal Proceedings, Law Enforcement, Coroners, Funeral Directors, Organ Donation, Research, Criminal Activity,


Military Activity, National Security, Worker’s Compensation, Inmates, and other uses and disclosures required by law. Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of section 164.500.

Other Permitted and Required Uses and Disclosures will be made only with your consent, authorization or opportunity to object unless required by law.

You may revoke this authorization at any time in writing, except to the extent that your physician or the provider’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.

Your Rights

Following is a statement of your rights with respect to your protected health information.

• You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or copy the following records: therapy notes; information compiled in reasonable anticipation of, or used in a civil, criminal, or administrative action or proceeding, information that may not be released to you under applicable law, and protected health information that is subject to law that prohibits access to protected health information.

• You have the right to request a restriction of your protected heath information. This means that you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this notice of privacy practices. Your request must state the specific restrictions requested and to whom you want the restrictions to apply.

Your provider is not required to agree to a requested restriction. If the provider believes it is not in your best interest to restrict use and disclosure of your protected health information, or the requested restriction is prohibited by law, your protected health information will not be restricted. You then have the right to use another healthcare professional.

• You have the right to request confidential communications from us by alternative means or at an alternative location.

• You have the right to obtain a paper copy of this notice.


• You may have the right to have your provider amend your protected health information if we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.

• You have the right to receive an account of certain disclosures we have made, if any, pertaining to your protected health information

You may complain to us or the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint

We are required by law to maintain the privacy of and provide individuals with this notice of our legal duties and privacy practices with respect to protect health information. If you have any objections to this form, please ask to speak with our office manager.

We reserve the right to change the terms of this notice and will inform you by mail of any changes, at which time you have the right to object or withdraw as provided in this notice.


Interactive Kids, LLC Parent Handbook Acknowledgement & Responsibilities Agreement

Please check off and initial:

� _____ Client Guidelines � _____ Tree Nut & Peanut Policy � _____ Pick Up Procedure � _____ Waiting Room & Parking Lot Policy � _____ Parent Training Responsibility � _____ Parent Observation Policy � _____ Use of Reinforcers � _____ Communication Policy � _____ Privacy Policy � _____ Photo/ Video & Social Media Policy � _____ Policy on Respite and Babysitting � _____ Policy on Gift Giving � _____ Discrimination Policy � _____ Safety Policy � _____ Sick Policy � _____ Cancellation and Lateness Policy � _____ Financial Policy � _____ Health Insurance Portability and Accountability Act (HIPPA)

By signing this, I acknowledge that I have received, read, and understand the Interactive Kids, LLC Parent

Handbook and Parent Responsibilities Agreement; and as such, I agree to all requirements within. In

addition, I give consent for my child, ____________________________________________________, to

receive treatment services from Interactive Kids, LLC.

____________________________ __________________________ ____________ Parent/Guardian Name Parent/Guardian Signature Date ______________________________ ____________________________ ____________ Parent/Guardian Name Parent/Guardian Signature Date

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