Medicaid Managed Medical Assistance Update

The Statewide Medicaid Managed Care (SMMC) Program has fully transitioned from the fee-for-service model to Managed Care as of February 1, 2019. The continuity of care period was extended for Phase I through February 28, 2019.

The following highlights will discuss the current state and future endeavors regarding Early Steps transition of Medicaid Early Intervention Services and Targeted Case Management into Medicaid Managed Medical Assistance programs:

• A web-page on CMS-Kids.org website has been developed to be a clearinghouse of resources for Local Early Steps programs and external providers at MMA Resource Page. This site contains resources on contracts, credentialing, billing/claims, the IFSP/MDT team meeting, continuity of care and monitoring, and how to submit a complaint to AHCA. Also included are lessons learned from the field on transitions successes.
• The Early Steps State Office (ESSO) combined the Phase I, II, and III conference calls to facilitate cross-program information sharing and to provide intensive technical assistance and support to LESs. The calls will be held bi-weekly on Thursdays from 2:00 – 3:30 pm, starting February 21, 2019.
• The ESSO staff and the Agency for Health Care Administration (AHCA) collaborates weekly to discuss and resolve systems issues identified by LESs.
• A process has been established for LES internal providers to bill MMA Plans for Medicaid EIS and TCM services using UF data system and Change Healthcare. The Department is exploring using Change Healthcare as a clearinghouse for submitting external provider claims to MMA Plans.
• Two webinars were held for internal and external providers on February 5 and 6, 2019. Webinar recordings are available on the MMA Resources Billing/Claims Page at MMA Resources Billing/Claims Page. The following topics were discussed on the webinars:
  • Credentialing and Uploading Providers into MMA Networks
  • The billing and claims survey is designed to collect information on provider loading, claims, acceptance and payment, denials, electronic funds transfer, and related barriers.
  • The IFSP survey is designed to collect information on how the LESs are collaborating with MMA plans on the IFSP process, MMA representatives’ attendance, and MMA representatives’ contribution to the IFSP, and barriers to participation.
• On February 12, 2019, an in-person joint meeting with ESSO, AHCA, LESs, and MMA health plans was held to discuss Early Intervention Services. The meeting focused on the action steps developed by the MMA health plans to rapidly resolve barriers to timely payment of claims.
• The Early Steps State Office continues to:
  • Monitor the fiscal impact of the transition
  • Assess the impact of the transition on the following:
    • Determination of eligibility
    • Timely initiation of services
    • Services in the natural environment and Other components of service provision
  • Monitor for compliance with all state and federal laws

Additional Available MMA Resources:

• A snapshot/overview has been posted on AHCA’ s Website. It serves as an informational document regarding MMA changes and is updated regularly as they occur.
• A Frequently Asked Questions (FAQ) document addresses questions from AHCA’ s training webinars on Medicaid Early Intervention Services. The FAQ can be found here AHCA EI FAQ.
• Please check AHCA’ s website for additional information on prior and upcoming training webinars on Early Intervention Services with a live question and answer session immediately following each webinar.

2017-2018 FAMILY SURVEY RESULTS

The IDEA requires Part C lead agencies to report on family outcomes resulting from families’ participation in early intervention. Specifically, states must report the extent to which families report that early intervention helped them:

• Know their rights;
• Effectively communicate their child’s needs
• Help their children develop and learn

To address this federal reporting requirement, Early Steps implements a process for families to submit a family survey. The results of the survey are reported to many stakeholders, including the Office of Special Education Programs, Local Early Steps, and families.

The Family Survey Results Flyer illustrates how Early Steps has helped families, and most importantly, how Early Steps will use feedback from families to improve the program. This flyer will be posted http://www.floridahealth.gov/programs-and-services/childrens-health/early-steps/index.html and made available to Local Early Steps to share with families, staff, and providers.

NEONATAL ABSTINENCE SYNDROME (NAS) UPDATE

Neonatal Abstinence Syndrome or NAS refers to a group of conditions that occur when a newborn experiences withdrawal symptoms from exposure to certain drugs in the mother’s womb before birth. NAS is most commonly caused by opioids - including heroin, codeine, oxycodone (oxycontin), methadone and buprenorphine (March of Dimes 2017; Florida Department of Health, 2018; CDC, 2018). For a child to receive services, based on an At-Risk condition of NAS, they must have a written diagnosis which includes an ICD 9 code of 779.5, or ICD 10 code of P96.5.

Every year, more than 20,000 children are born to opioid-dependent women in the United States (Association of State and Territorial Health Officials, 2015). Opioid use during pregnancy is associated with an increased risk of poor health outcomes, including neonatal abstinence syndrome (NAS). As of 2012, an average of one infant was born with NAS every 25 minutes in the United States (Children Safety Network, 2018).

Due to the increase in opioid prescription abuse trends and NAS incidence, the Florida Department of Health (the Department) added NAS to the Reportable Disease and Conditions list on June 4, 2014 (Florida Department of Health, 2018). In January 2018, the Early Steps program expanded the eligibility criteria to include children with At-Risk conditions, which includes NAS.

Early Steps NAS Data Collection Projects

The Department of Health collects data from Early Steps as part of a collaborative opioid surveillance project. Recently, the Early Steps State Office provided data, beginning in 2016, to be used for the Opioid Use Dashboard. In January 2017, six children with NAS were served in the Early Steps program. In September 2018, 139 children with NAS were served in the Early Steps program.

The Department of Health’s State Health Improvement Plan (SHIP) includes strategies to develop an infrastructure to support the assessment, referral and appropriate treatment for newborns experiencing NAS. One of the objectives developed to meet this strategy is to increase the percentage of referrals made to the Early Steps program for children diagnosed with NAS from 19.63% to 100% by December 31, 2020. The Early Steps State Office and the Child Protection Team State Office have developed the following list of activities to assist in meeting this objective:

1. Review Early Steps/CPT referral data to identify ways to increase the identification of infants and toddlers with confirmed a diagnosis of NAS, and those with suspected NAS. This will include aggregating data by county to identify areas of success and developing strategies for areas with low referral rates.
2. Engage stakeholders in developing strategies to increase identification of infants and toddlers with NAS or suspected NAS. Identify training opportunities for CPT and Early Steps staff and community providers.
3. Review and make changes to the CPT/ES referral form and screening tool to assist in the referral process. Provide training and TA to LESs and CPT field professionals.
4. Update the ESDS Data System to capture CPT as a referral source and identify a way to track children diagnosed with NAS and those with suspected NAS.

BUREAU OF EXCEPTIONAL EDUCATION AND STUDENT SERVICES

The Bureau of Exceptional Education and Student Services (BEESS) is happy to announce that the BEESS Weekly is now available online for your convenience.

Look for the current issue of the BEESS Weekly to be posted at the end of the day each Friday. Archived issues of the weekly will be placed here as well, so you can reference them as often as needed.

This new web page can be found at http://www.fldoe.org/academics/exceptional-student-edu/beess-resources/presentations-pubs/weekly-memo.stml.

CENTERS FOR DISEASE CONTROL AND PREVENTION

January is National Birth Defects Prevention Month. Join the nationwide effort to raise awareness of birth defects, their causes, and their impact!

Check out the article - Best For You. Best For Baby. 5 Tips for Preventing Birth Defects.

EARLY CHILDHOOD TECHNICAL ASSISTANCE CENTER (ECTA) CENTER ENOTES

The Early Childhood Technical Assistance Center (ECTA Center)is a program of the FPG Child Development Institute of the University of North Carolina at Chapel Hill, funded through a cooperative agreement from the Office of Special Education Programs, U.S. Department of Education.

MILITARY FAMILIES LEARNING NETWORK EARLY INTERVENTION WEBINAR SERIES

The Military Families Learning Network (MFLN) Early Intervention (EI) team is conducting a 2019 series called “Sunrise to Sunset: Supporting Children with Autism Through Their Day.” All MFLN EI webinars carry free continuing education credits from the Early Intervention Training Program. Webinars in this series also carry free BACB CE credits for those attending the LIVE webinar only. The first webinar entitled “What Do We Know: Autism Screening, Diagnosis, & Supporting Young Children & Families” is scheduled for April 10, 2019. For additional information on the webinar visit: What Do We Know: Autism Screening, Diagnosis, & Supporting Young Children & Families.

2019 ONE GOAL SUMMER CONFERENCE

The 2019 One Goal Summer Conference will be held at the Hilton Tampa Downtown in Tampa, Florida, on July 17-19, 2019. The conference will include general sessions, concurrent presentations, and exhibits of appropriate materials.

Early Steps stakeholders are invited to submit conference workshop proposals. An electronic version of the Presenter Proposal Form can be found at http://www.onegoalsummerconference.org. The deadline for proposal submission is April 5, 2019.

To register as a conference participant, click on the following link; http://www.onegoalsummerconference.org/register.htm.

IN FUTURE ISSUES

Bi-annual LES Directors’ Meeting