Medicaid Managed Medical Assistance Update

As per Florida Medicaid, the Early Intervention Services (EIS) and Targeted Case Management (TCM) services transitioned from the fee-for-service model to the Managed Care model. The transition occurred in three phases with the following implementation dates: December 1, 2018, January 1, 2019, and February 1, 2019. After each implementation date, a continuity of care period began for up to sixty days. The continuity of care period was designed to ensure all services continued for all Early Steps recipients while Local Early Step programs negotiate contracts with the Managed Medical Assistance (MMA) plans. Recently, all MMA plans have committed to extending the continuity of care periods for EIS and TCM, until contracts have been executed with Local Early Steps programs, in their coverage areas.

To successfully implement the inclusion of EIS and TCM into Statewide Medicaid Managed Care, the Agency for Health Care Administration (AHCA), MMA plans, Department of Health (Department)/Children’s Medical Services/Early Steps, and Local Early Steps Programs (LESs) are partnering. The Department will continue working with AHCA, and MMA plans to ensure the Department meets IDEA, Part C federal requirements federal and state requirements for EIS.

The Department/Children’s Medical Services/Early Steps State Office and AHCA continues to focus on the following action items:

• Continue to facilitate productive and constant conversations between both the LESs and the MMA plans while providing ongoing education and technical assistance about EIS and TCM.
• Continue to monitor and collect information from LESs and MMA plans on contracting status and improve the current executed contract percentage between the LESs and MMA plans.
• Finalize the newly established process through Change Healthcare (a contracted clearinghouse vendor with the Department), and the Early Steps Data System (ESDS), to allow internal providers to seek reimbursement from MMA plans for EIS and TCM services.
• Identify challenges and a process to allow external providers to submit claims to MMA plans MMA plans for reimbursement of EIS and TCM services through Change Healthcare and ESDS.
• Continue to provide guidance to LESs and MMA plans about the Medicaid provider enrollment process, reimbursement, and service provision.
• Identify and address concerns that may negatively impact an adequate network of providers to serve children in Early Steps.
• Work with LESs to determine efficiencies in administrative tasks and assist, as needed.
• Work with AHCA to identify a timely and efficient claims submission and payment process for LESs and MMA plans, using prior guidance provided by all MMA plans, and updating guidance as needed.
• Monitor the fiscal impact of the transition, by developing a process to track use of funds for Medicaid recipients.
  • DOH will ensure that Early Steps funds are not used to satisfy a financial commitment that would otherwise have been paid for from Medicaid (34 CFR 303.510), and that the program maintains the same level of financial commitment for early intervention services for the subsequent fiscal year [34 CFR 303.225(b)].
  • This requirement applies regardless of the payor.

BI-ANNUAL LES DIRECTORS’ MEETING

The Early Steps State Office (ESSO) will be hosting the 2019 Bi-annual Local Early Step (LES) Directors’ Meeting on July 15th and 16th in Tampa, Florida in conjunction with the 2019 One Goal Summer Conference. The agenda for the meeting will include discussions on Implementation Science, Child Outcomes, and the State Systemic Improvement Plan Professional Development Project

The ESSO is recommending all attendees use the One Goal Summer conference hotel sleeping room block at the Hilton Tampa Downtown location, 211 North Tampa Street Tampa, Florida. Please make your reservations immediately as remaining space is very limited at the Hilton Tampa Downtown. Rates are available from July 14-18, 2019. Reservations may be made online or calling the Hilton Tampa Downtown Reservations Desk at (800) HILTONS (445-8667). If calling, please identify that you are attending the One Goal Summer Conference. Conference rates will be available until the room block sells out or July 6, 2019. For additional information visit http://www.onegoalsummerconference.org/hotel.html

STATE PERFORMANCE PLAN/ANNUAL PERFORMANCE REPORT

The Individuals with Disabilities Education Act (IDEA) requires each State to have a State Performance Plan/Annual Performance Report (SPP/APR). The SPP/APR evaluates the State's efforts in implementing the requirements and purposes of Part C of the IDEA. Subsequently, Florida reports annually to the Office of Special Education Program (OSEP) on its performance under the Part C of the IDEA.

The IDEA requires Early Steps to review the APR each year based on the information provided in Florida’s SPP/APR, and other information obtained, for OSEP to make a determination on Florida; “Meets requirements” and purposes of the IDEA or “Needs Assistance,” “Needs Intervention,” or “Needs Substantial Intervention” in implementing the requirements of the IDEA. Florida’s Determination for 2018 is currently “Needs Assistance”. The 2019 Determination will be provided in June 2019.

The APR not only functions as a progress report for OSEP, but also as a report for Florida’s stakeholders. Florida Part C, which administered by Early Steps, is required to publish the updated SPP/APR on its website. The APR is due each year in February for the previous year's performance. The Early Steps State office is currently working with OSEP staff to clarify and correct the data submitted in its FFY 2017 SPP/APR, prior to issuing the Department’s 2019 determination. OSEP will provide feedback on the State’s FFY 2017 SPP/APR data that OSEP will consider in making the Department’s determination under IDEA section 616(d). In response to OSEP’s feedback, the State must submit to OSEP through any corrected data and clarify any misunderstandings by OSEP about the data submitted on April 18, 2019.

SPACE COAST LOCAL EARLY STEPS PROGRAM SPOTLIGHT

The Early Steps State Office (ESSO) would like to shine a spotlight on the Space Coast Early Steps (SCES) program for receiving a determination of “Meets of Requirements” on the 2018/2019 Quality Assurance report. The SCES program has received determinations of “Meets Requirements” for the past three years and ESSO would like to acknowledge their continuous success.

The SCES believes their established processes and procedures on the coaching model is responsible for the continuous success. It was indicated by SCES, from first contact, the implementation of the coaching model is explained to the families. Every person in the SCES system is trained on the Primary Service Provider/Coaching model prior to providing services. Providers in SCES coach each other and the family through consultation, co-treatments, and larger team meetings.

The SCES program also conducts team meetings to bring providers, coordinators, and families together to discuss difficult situations and share new ideas. The team meetings are allowing providers and families to work together towards unified goals. The team method also taps into the family/child’s every day routines that matter the most, to motivate and empower families.

The service coordinators are trained to support the family in stating exactly what the family wants to work on, how they are going to meet that outcome, and the steps to make it happen. Providers know exactly what needs to be addressed in their sessions with the family/child. Child and family outcomes are measurable and family friendly, so progress can be identified. That translates into scoring higher in domains of testing on the Battelle Developmental Inventory 2 when SCES children exit the program.

The SCES programs would also like to highlight their Family Resource Specialist (FRS), Mary Cancel, who provides families with avenues to connect with other special needs caregivers and children in the community to make and support friendships. Mary hosts support groups, play dates, workshops and sharing relevant events that encourage the social/emotional growth, appropriate behavior modeling and communication opportunities for the children in the Space Coast Early Steps Program and their peers.

Mary also provides families with resource information to get services and supports for their children/family needs. She will go on home visits with the service coordinators and/or providers to support our families and our coaching model. Mary attends IFSP meetings, Transition conferences, Team meetings, and IEP meetings to ensure the family’s success in a personalized, positive and supportive way while supporting the family to be their own advocate.

During the November and December holidays, Mary leads the charge in making big things happen for as many as 50 of our families in need. Everything from gifts (bikes, toys, books, clothes) to food is provided for every member of the family! Staff and volunteers give of their own time the assist in wrapping gifts and make deliveries. The ESSO appreciates SCES efforts and looks forward to their continued success! Contact Luc Toussaint to nominate a program or individual to be featured in a future Early Steps newsletter.

BUREAU OF EXCEPTIONAL EDUCATION AND STUDENT SERVICES

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

RECOMMENDED PRACTICES MONOGRAPH SERIES NO. 6: TEAMING AND COLLABORATION: BUILDING AND SUSTAINING PARTNERSHIPS

The Division for Early Childhood (DEC) has published a new resource in the Recommended Practices Monograph Series, “Teaming and Collaboration: Building and Sustaining Partnerships”. The DEC Recommended Practices provide guidance to families and professionals about the most effective ways to improve learning outcomes and promote development of young children, birth through age 5, who have, or are at-risk for, developmental delays or disabilities. Teaming and Collaboration: Building and Sustaining Partnerships is the sixth edition of the DEC Recommended Practices Monograph Series which offers professionals and families multiple ways to implement the teaming and collaboration practices across the settings in which children grow and learn. For additional information and resources, visit the DEC bookstore at https://www.dec-sped.org/bookstore

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 second webinar of the series entitled “Yuck! I Don’t Eat That! Nutrition & Selective Eating in Young Children with Autism” is scheduled for June 12, 2019 at 11:00 am – 12:30 pm. This webinar will address common concerns of families surrounding dietary preferences and limitations often seen in young children with autism. The presenters will highlight the effects of food preferences, aversions, and special diets on child and family outcomes and discuss ways professionals and families can encourage young children with autism to broaden their diet. They will also provide strategies for ensuring quality nutrition in young children with autism and related disorders. For additional information on the webinar visit: Yuck! I Don’t Eat That! Nutrition & Selective Eating in Young Children with Autism.

THE 21ST ANNUAL FAMILY CAFÉ

The 21st Annual Family Café Conference will be held on June 7-9, 2019, at the Hyatt Regency Orlando, Florida. The conference includes three days of individual breakout sessions, an exhibit hall with public and private resources, keynote speakers, and The Governors’ Summit on Disabilities. The conference provides a forum for networking and family-to-family support. For additional information on the conference and the Family Café Organization, visit www.familycafe.net

In conjunction with the Family Café Conference, the Florida Department of Health, Children’s Medical Services, Early Steps State Office is pleased to announce it will again host the Early Steps, Early Wishes event on Friday, June 7, 2019, at the Hyatt Regency Orlando. This is an opportunity for infants and toddlers served by Early Steps, and their families, to engage with local and state staff while enjoying family-fun activities. For more information on Early Steps, Early Wishes, please contact Kelly Rogers

2019 ONE GOAL SUMMER CONFERENCE

The 2019 One Goal Summer Conference will be held on July 17-19, 2019 at the Hilton Tampa Downtown in Tampa, Florida. The conference will include general sessions, concurrent presentations, and exhibits of appropriate materials. To register as a conference participant, click on the following link; http://www.onegoalsummerconference.org/register.html