PublicConsultingGroup.com October 2008 Michigan Staff Pool List Review.

PublicConsultingGroup.com

October 2008

Michigan Staff Pool List Michigan Staff Pool List ReviewReview

MI Staff Pool List Update – October 2008

Agenda

Description of Cost Pools

Case Management Staff Requirements

Case Management Activities

Personal Care Services

Personal Care Service Staff Requirements

Personal Care Service Activities

January – March 2008 Staff Pool List Process

Questions


Cost Pool List Descriptions

AOP – Eligible providers include Administrators Counselors Early Identification/Intervention Personnel Program Specialist Teacher Consultants Speech-Language Pathologist – Non ASHA CCC Psychologist – Non State Licensed and not supervised by a State

Licensed Psychologist Social Worker – Masters Degree – Non State Licensed and not

supervised by a State Licensed Social Worker – Non Master level – All must be in AOP Registered Nurse


Cost Pool List Description (cont.)

Direct Service – Eligible providers include Audiologist Occupational Therapist and Occupational Therapy Assistants Orientation and Mobility Specialist Physical Therapist and Physical Therapy Assistants Physician Psychologist – State Licensed Social Workers – Masters Degree – State Licensed Speech Language Pathologist – ASHA CCC


Case Manager

Case Manager - to qualify the individual needs to meet one of the following criteria: RN with a Michigan license Bachelor Degree with a major in a specific special education area Earned credit in course work equivalent to the above mentioned

degree Minimum of three years personal experience in the direct care of

individuals with special needs


Case Management Activity Examples

Assure that standard re-examination/follow-up of the student are periodically conducted to ensure the student receives needed diagnosis and treatment

Assist families in identifying/choosing appropriate care providers and services

Maintain case records and indicate all contact for student in the same manner as other covered services

Coordinate performance evaluations/assessments, other service needs for student

Prevention of duplicate services Facilitation/participation in development, review and evaluation of the

IEP Supporting activities that link coordinate needed health services for the

student and student progress


Personal Care Services

Personal care services are a range of human assistance services provided to persons with disabilities and chronic conditions, which enables them to accomplish tasks that they would normally do for themselves if they did not have a disability. Assistance may be in the form of hands on assistance or cuing so that the person performs the task by him/her self.

Personal Care Services must be medically necessary and the need for the service documented in the IEP/IFSP. Each Child’s school clinical record must contain a completed, signed and dated monthly activity checklist.

In accordance with 42 CFR 440.167, authorization for Personal Care Services (PCS) may be done by a physician or “other licensed practitioner” operating within the scope of their practice. The state definition of “other licensed practitioner” consisted of Registered Nurse (RN), Registered and Certified Occupational Therapist (OT), Licensed Physical Therapist (LPT), Master of Social Worker (MSW), or ASHA-CCC Speech Language Pathologist (SLP). It is expected that personal care services will be authorized by the appropriate practitioners. (Revised per bulletin MSA 08-36)


Personal Care Service (cont.)

Personal Care Services may be provided when: The service is medically necessary The service categories are documented in the IEP/IFSP. The treatment plan

should contain the details of the service, frequency and duration and can either be part of the IEP/IFSP or an attached document.

The service is authorized at least annually by a Physician, or other licensed practitioner as stated in policy, in accordance with an individual plan of services

Personal Care Services are not covered if they are: Provided by a family member. A family member is described by the Centers for

Medicare & Medicaid services (CMS) to be “legally responsible relatives” ; thus, spouses of beneficiaries and parents of minor beneficiaries (including stepparents who are legally responsible for minor children).

Not documented in the IEP/IFSP Educational in focus, such as tutoring, preparation or educational materials or

Braille interpretation. Performed as a group service; however, one or more students may be served

one at a time sequentially.


Personal Care Service Activity Examples

Eating Feeding

Respiratory Assistance

Toileting

Grooming

Dressing

Transferring

Ambulation

Personal Hygiene

Mobility/Positioning

Meal Preparation

Skin Care

Bathing

Maintenance continence

Assistance with self administered medication

Redirection and intervention for behavior

Health related functions through hands-on assistance, supervision and cuing


Important Changes and Reminders to SPL

Medicaid eligibility of a student should not be a factor in determining if a provider can be part of the staff pool list Provider must be a qualified provider for the service and the service

must be documented in an IEP/IFSP Service must be medically necessary and must be documented in an

IEP/IFSP If a provider is not currently billing due to not having any Medicaid

eligible students on their caseload, they are still eligible to be part of the staff pool list


Important Changes and Reminders to SPL (cont.)

Providers must be in compliance with the Fee-For-Service School Based Services program

Non-Compliant Providers include:o A provider never submits procedure specific claims for their

services. This is intentional on the Providers parto An ISD/LEA or Provider as a standard practice never includes

the service in IEP/IFSP; oro A provider is not appropriately credentialed or supervised; oro A provider is not listed in the Provider Manual as a qualified

provider



Provider Credentials are an essential part of allowing a Provider to be included on the Direct Service staff pool list

Psychologist – Must have State Licensure to be included on the Direct Service staff pool list or be Supervised by a Psychologist who has a State License

Psychologist who do not meet the above criteria may be included on the AOP staff pool list

Social Worker-Masters Degree - Must have State Licensure to be included on the Direct Service staff pool list or be Supervised by a Social Worker who has a State License

Social Worker-Masters Degree - who do not meet the above criteria may be included on the AOP staff pool list



Teacher of the Speech and Language Impairments – Must have their ASHA CCC to be included on the Direct Service staff pool list or be Supervised by an ASHA CCC Speech Language Pathologist

Teacher of the Speech and Language Impairments who do not meet the above criteria may be included on the AOP staff pool list


Going Forward Staff Pool List Process

Starting with this quarter the following changes will be in effect for updating your staff pool list update Changing a provider from one cost pool to another

o Delete provider from current cost poolo Add provider to the new cost poolo Do not state “move to” – If PCG sees this we will delete the

provider from the current cost pool list however we will not add the provider to the new cost pool

Provider placed on the incorrect cost pool listo PCG will remove this provider from the incorrect cost pool listo PCG will not add the provider to the correct cost pool list

Provider information changeso Make the change directly to the documento Document in Add/Delete/Change column exactly what change

was made. EX = LN change from Joneso Never make a replacement by typing over the information of

another provider


Reminders

Do not include any providers who are 100% federally funded in any of the cost pools

Be sure to add email addresses for all of your employees, this helps us with follow-up

If you send a revised updated SPL to PCG please make sure that it is clearly marked as REVISED

Return all staff pool list updates along with the calendar by November 13, 2008


Contacts

Sandy Pillar [email protected] (312)425-0550

Ext. 38

PublicConsultingGroup.com October 2008 Michigan Staff Pool List Review.

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