putting the pieces together independent contractors working in schools
TRANSCRIPT
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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