Putting the Pieces Together

Independent Contractors Working in Schools

At the conclusion the presentation, you will:

Understand options for meeting the legal requirements for working with private agencies who provide developmental or mental health services to students in schools.

Have a framework for implementing practices in your district

Know colleagues you can call for additional assistance

Pieces of the Puzzle

Memo of Understanding is no longer legally permissible.

State Medicaid billed for school based services.

Parents want their agency to work at school.

Federal Medicaid may not cover our costs.

Timelines

Communicate with stakeholders

Board Policy Establish referral

procedures Cost Analysis:

employee costs vs. contract costs

Contract rates

Who will work on the puzzle?

Communications with stakeholders

At the IEP team meeting, communicate to parents your desire to serve students using school based resources

Send a letter to private providers in your area, or meet with them to discuss how you will work with them next year.

Continued . . . Communicate with stakeholders

Plan a way to communicate your plans to principals, teachers, and related service staff. Options might include: written documents,

meetings, host a webinar, principal meetings.

Anticipate conflict due to change in previous practices!

Board Policy

Critical piece of the puzzle!

Study model Board Policies

Policy needs to be read at a Board meeting 3 times before adopting

Policy should be in place before school starts next fall

Board Policy

Reduces contention

With stakeholders

Provides direction

Three readings provide

the public with

opportunities to react

Who are the Independent Contractors?

SLP, OT, PT PSR – Who qualifies for service IBI – Who qualifies for service DT – Who qualifies

Positive Behavior Supports and General Ed. Interventions

PBS should be operating in all schools. Before spending funds to provide 1:1

support, explore multiple options for building a relationship with the student and his/her family.

Implement and document strategies for improving student behavior in general education.

Referral to Placement

A 1:1 aide, provides a very restrictive LRE

Exhaust general ed. interventions. Exhaust special ed. interventions Insure that PSR, IBI, and DT are

available only to students with a significant disability.

PSR Referral Process

Conduct an evaluation to determine whether or not the student has an emotional disturbance

Collect information from multiple sources, including the private agency.

Evaluation must include an in depth Functional Behavior Analysis (FBA) and Social History

Behavior Improvement Plan must be based on the findings of the FBA and include specially designed instruction.

IEP for other funding categories

If the student has an IEP in a different funding category that also accurately describes the disability, then the student must demonstrate: DSM-IV diagnosis AND Obtain a CAFAS score of 80+

Activity Matrix

WHO is providing support

WHAT level of support is needed

WHEN 1:1 is required HOW support is

provided WHERE support is

occurring

Alternative Activities 1 1 7 3 4 5 9 1. Alternative ActivitiesListed by Number 2 2 8 6 1. Practice sight words

2. Phonics3. CVC spelling list

Regular Education 4. Single digit addition

Activities for the 5. Telling time

Student's Assigned 6. Counting coins

Grade 7. Writing first / last name8. Copying sight words9. retelling a read aloud story

10Length of Time for

Activity

SKILL AREAS [ / ] SUPPORTS Make Choices iListening to the teacher d a. Preferential seating Follow Directions a c b. Circle of Friends Expressive Vocabulary e c i c. Peer Buddies Receptive Vocabulary e c d. Spec. Ed. staffAddition d e. Title I TutorTell Time g f. Parent VolunteerPhonemic Awareness e e g. Computer PrograVocabulary Words e e h. Use a model to follow Writing Assignment d i. 1:1 with teacher Ask for HelpIndepent Work @ Centers c Playground Safety Transition Between Activities i Cafeteria c c

Highlight times when additional supports are needed.

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Student: Amanda Smith Grade: 3 Date: January 21, 2007

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Medicaid and PSR

The student must qualify for: Medicaid IEP

If the funding category is E.D., then the school can bill Medicaid for PSR services

If the funding category is any category besides E.D., the student must have a DSM-IV diagnosis and a CAFAS score of 80+.

Options for Providing Services

PSR Qualifications: Must have a B. A. degree in a human service

area IDAPA recommends 21 hours of continuing ed. in

related subjects each year Serves students with a mental health condition

or an emotional disturbance

Hire PSR workers as district employees and bill Medicaid

Contract with an agency

Hiring a District PSR

Hire as non-certified staff

Determine rate of pay for PSR (or IBI) (recommended: $16.00 to $17.00 per hour)

There will be a pool of qualified workers available to work during school hours

District can hire staff of their choice

Work with parents to insure success

Contracting with an Agency

When? The district is not able to provide the service.

How? Look at model contracts: be specific as to the services to be delivered

Considerations for Directors: compare the cost of a contract with employment costs (salary, health benefits, taxes, PERSI, FICA, Workmens Compensation = 33% to 35%) Possible Medicaid reimbursement – 70% of rate

What if it doesn’t work?

What is the District’s obligation?

Complaint procedure How to avoid a sticky

situation. Change is difficult –

some people will complain!

Addressing IBI, PSR, DT on Student’s IEP

How to list services on the Service Page for Medicaid reimbursement.

Be sure to include a statement of need in the P.L.O.P. to justify the related service.

Develop goals and objectives (as required) to match the Social History/Functional Behavior Assessment/Behavior Improvement Plan.

How does it impact Child Count?

Questions and Answers

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