Psychologist Professional Development

1. Psychologist Professional Development ACCESS Updates and Pending Changes to Service Documentation Tuesday, September 2, 2014

2. Agenda • Review the requirements for the ACCESS Program • Explain the changes in the Evaluation/Re-Evaluation Claiming • Introduce the template for the new screens under development • Tips for Service Documentation • Review of the Types of Outcome • Review Collateral Service Documentation • Review Progress Note Documentation • Review the Error Reports • Review the EasyTrac History Screen and tracking of Medicaid Parental Consent • Review the 150 day cycle – no more retroactive submissions • Review how claims are submitted and the 15 minute increment • Questions and Answers

3. ACCESS Program Claiming Requirements • The student must be identified as Chapter 14. • The student must be Medicaid Eligible. • The Medicaid Parental Consent must be signed Yes and on file. The One Time Consent form if signed Yes will cover services moving forward. • The service provider must be registered with the ACCESS office and meet the criteria to be credentialed with an ACCESS Provider number. • The services must be provided by the service provider(psychologist) submitting the claim. Absolutely No Intern services are to be claimed. • There must be a psych evaluation or re-evaluation report to support the claim under audit. • Record reviews are not allowable services for claiming. Input into the RR based upon a record review is not a claimable re-evaluation under the ACCESS program. • There must be an IEP in place for the evaluation to be claimable. Re-evaluations are only claimable when there is an ongoing health related service in the IEP. Note: The EasySystem is a Full Electronic Documentation system and all Evaluation/Re-evaluation services should be documented regardless of claiming status.

4. Changes to the Evaluation and Re-evaluation Claiming • The state has removed collateral services from their EasyTrac screens as they are not claimable services. SDP has been removing these service minutes manually from the total time before submitting an eligible claim for processing. We are moving to a method of electronically removing them from the total time when a potential claim is captured for review. • The state screens capture services as a total time for the Evaluation/Re-evaluation up to 20 hours. We are developing a screen to work toward this but that still allows for full electronic documentation of services. • Only psych re-evaluations that have an ongoing health related service in the IEP are claimable when they meet all other eligibility criteria. This change went into effect during the 2013-2014 school year and SDP has been removing the ineligible claims from the claim file before submission. This has created a decrease in claim reimbursements for the psychological services that the district was previously receiving. • The IEP is the claiming date for the Initial Evaluation. There is discussion throughout the state to make the psych re-evaluation date the claiming date. This date would disallow any services provided after the psych re-evaluation date. • All services require Medical Authorization to be claimable. This authorization is obtained by submitting pages from the IEP to a CRNP for sign-off. Psychologists can do their own sign off based upon the services in the IEP.

5. Medical Authorization Form

6. Sample Medical Authorization Tracking Screen

7. Sample Evaluation/Re-evaluation Logging Screen

8. Sample Screen Areas Covered/Assessed

9. Tips for Recording Psychological Services • Make daily entries of the services provided to assure the accuracy of the data. Be sure to be as timely as possible so that the student record is always current. • Pay close attention to the type of service and the time required to perform the activity. Enter accordingly. • Separate services into correct categories. Be careful not to duplicate or overlap services. Do not combine everything into one date if the report was written over the course of several days. Testing should always come before the final written report is documented and the dates should match the test forms. • At the end of the month, review all services to assure your service entries have been recorded correctly. Continue this practice until the evaluation/re-evaluation process is complete. • Maintain a caseload of students for whom you are currently part of the team. Once the IEP meeting has been held and the IEP outcome phrase entered, be sure to remove the student from your caseload and the Psychological Service option from the related service screen. • Utilize the Green Checkmark/Yellow Yield Sign/Red Stop Sign to review actual IEP dates. Use the Event date as the IEP date when recording the outcome phrase in the system. Use the Event date closest to but not prior to completion of your services. Only use the dates that have a final document attached to them. • Do not enter the IEP date more than once. • If you are not sure how to document a particular item, contact the ACCESS team for assistance. • A written report should be available for presentation to an auditor for all psychological evaluations/re-evaluations claimed under ACCESS.

10. Psychological Evaluation/Re-evaluation Outcome Explanations • IEP Meeting Held – Services Recommended This outcome is used when the student receives a ful l psychological evaluation/re-evaluation and is placed in Special Education. It is also used for students who receive a Speech Only or MG IEP. The comment section should be used to notate the Speech Only designation. Note: An evaluation report that can be presented under audit must be readily available. • IEP Meeting Held – Services Not Recommended This outcome is used when the student has been evaluated and is found not to be in need of special education services. Students who are Non-Exceptional receive this outcome. • Student Evaluated – Identified as Chapter 15 This outcome is used when the student has been evaluated and is found Non-Exceptional (not eligible for special education services) but there is an accommodation plan (504 plan) recommended to meet the needs of the student. • Record Review Only This outcome is used when the student does not have a complete psychological evaluation/re-evaluation. It is usually applied when the psychologist reviews records but is not involved directly with the student evaluation. • Eval Process Stopped (Explanation Required) This outcome is used when the evaluation process cannot be completed. It is usually used when a child is retained in Early Intervention Service for an additional year, the child moves out of district before the final Special Education determination is made or for children that are deceased or have some other extenuating circumstance.

11. Changes in Collateral Service Documentation • Collateral services are no longer claimable under the School Based ACCESS Program. • Several services that were formerly collateral services have been reclassified as direct service for the purpose of evaluation/re-evaluation. These include, but are not limited to, classroom observation, consult with medical personnel and writing the evaluation report.

12. What is a Progress Note? • The written record that supplies the details of how the student utilized their treatment plan.

13. Why Do We Use Progress Notes? • Progress notes are vital to good clinical treatment. • Charts the students’ journey through the continuum of care. • Improve and enhance the treatment process by helping the direct service provider track the students’ progress in treatment while staying focused on the treatment plan. • Good progress notes also assist other program staff to participate intelligently in the students’ treatment process. • Review of progress notes is the best way to refresh ones memory when sitting with the IEP team to discuss the students’ progress. • If the primary direct service provider is not available to provide support to the student, the chance that another direct service provider will be able to provide meaningful assistance may be dependent on the quality of documentation in the progress notes

14. How? • Essential that the direct service provider is able to give a complete picture of the student’s progress and/or lack of progress. • Progress note should always include documentation of development with the use of suggested activities or strategies during daily routines. • Notes should explain everything that happened with the student

15. WARNINGS: • A series of notes that only reports the student’s attendance and indicating that they had “good participation” are clinically useless. • Additionally, if notes consistently say that service provider worked on the exact same activity for service after service, it may seem like they are not individualizing services to the student’s needs

16. Error Reports – What Do They Mean? • Duplicated Services - This report advises the service provider that they have already claimed for the service in a previous claiming cycle. • IEP Date Did Not Match – This report notifies the service provider that the IEP date that was entered for the outcome does not match the Event Date of the IEP. This date is the date of the IEP, not the date the final version was finalized. • Multiple IEPs – This report advises the service provider that the IEP date and outcome have been entered multiple times. • No Parental Authorization – This report notifies the service provider that the parent has not given permission for claiming to be submitted. • Missing Parental Authorization – This report notifies the service provider that the parent consent has not been submitted to the ACCESS office for programming in the EasySystem to allow claiming to occur. • Expired Parental Authorization – This report advises the service provider that the Medicaid Parental Consent on file has expired and does not cover the date of service for claiming. The correct version of the Medicaid Parental Consent must be submitted for the error to be corrected. • No IEP Meeting – This report notifies the service provider that the outcome has not been entered to allow the student’s record to be completed and the claiming cycle to begin. • Psych No Service Minutes – This report notifies the service provider that the IEP date entered does not have any services associated with it for claiming.

17. Easy Trac History Screen and Tracking of Medicaid Parental Consent

18. Overview of the Claiming Process Begin Here

19. 15 minute increments • Services eligible for reimbursement under the school based ACCESS program are reimbursed in 15 minute increments. • Services under the 15 minute increment, round down to 0 and are not claimed. • Services over 15 minutes are claimed in 15, 30, 45 or 60 minute intervals. • If a service is over one interval, but under the next, i.e. 40 minutes, the service is rounded down to 30 minutes and the remaining minutes are left unclaimed.

20. Why is the ACCESS team here today? • To update staff on changes to the program. • To advise staff of pending changes that will be effective in the near future. • To make sure everyone is on the same page regarding the logging of services and how it effects claiming. • To reiterate how important timely and accurate documentation is for the student record and the successful claiming of services under the School Based ACCESS Program. • To offer assistance to staff in need of retraining. • To review the types of error reports so that staff understand what needs to be done. • To remind staff that we cannot claim for services without their correct use of the EasySystem.