MaineCare IEP Documentation Training 1 - Shared screen with speaker view
Who can see your viewing activity?
What is SAU and CDS?
School Administrative Unit
Child Development Services
CDS is Child Development Services
For BHDT & RCS - Medical necessity of services and supports is determined by the licensed professionals. How can the IEP team determine BHDT or RCS if there is a clinical professional on at IEP team. This is very common for CDS IEPs to state BHDT and RCS
Thanks, I’m new to school nursing, haven’t learned the whole language yet.
*is not a clinical member on the team
BHDT and RCS is s medical service though.
It will state that in addition to 1:1 adult support
Can the IEP Team put RCS OR BHDT services...since the IEP team may not know under which Maine Care service the child will qualify-and not really appropriate to talk about that at the meeting...
Lindsae and all, we will have a more open Q&A at the end of the presentation portion, so feel free to reach out to ask if your question needs further clarification.
You may be able to see the power point if you change your zoom setting to presenter view instead of gallery view
Can the IEP team put 6.5 hours per day if the school day is 6.5 hours, yet still only bill for 6?
Does putting in Day Treatment assume that a BHP and Clinician will be providing services or do you need to List BHP and Clinician separately
Is it okay to put up to 6 hrs. a week?
Kellie Pelletier OCFS-CBHS R2 Resource Coordinator
@n13r: Up in the upper right hand corner there is a "View" option if you move your cursor toward it. You may need to change view to "Swap Video and Shared Screen"?
A lot of our students in the life skills program tend to fall under section 28
There are 2 categories for RCS. There is base and specialized. How is the IEP team making the determination as to which service is indicated.
BCBA services are listed in section7. However, there are many hours and services that are provided by the BCBA that are not accounted for in section 7. I am just confirming that those BCBA hours/services are captured by putting RCS in section 6.
Typically an IEP will list “BCBA consultation” and that consultation separate from the MaineCare reimbursable service. But if I am reading this correctly, the related service section would need to include all medically necessary service time and not just the consultation time. For example – BCBA services as part of Section 28 include the following: data collection and analysis, coordination of care with providers, participate in team meetings, update and maintain master treatment plan, parent training, Functional Behavior Assessment and developing/maintaining treatment plans and positive behavior support plans. All of the categories are billable categories. To align with this MaineCare guidance document it seems as though the related services would need to read BCBA services and then the monthly allotted time for each activity. Example: ITP and BSP Development and Updates 1 x 60 minutes per month, Summary and Analysis of Data 2 x 30 minutes per month, Conduct Evidence-Based Practices 4 x 30 minutes per month,
Are you saying that the IEP must say either day treatment OR RCS and not the bottom section where it says ed tech/BHP? Writing only the bottom section will not be reimbursable?
What if a student is day treatment and receiving 28 do you still list both
I have a day treatment student that receives BCBA services aslo, can I identify both in section 6?
they are non-concurrent services
When you say sometimes transportation, how do schools know when the sometimes is?
Some people put the ESY services/dates directly under the school-year services in the related services section. Are you saying ALL ESY services must be on the top of the grid?
Does a student in a SPPS need a BCBA listed, or is it inferred?
Where would social work services be identified since that is part of Day Treatment
Will day treatment and RCS continue to not be listed on related services?
If you are providing special transportation do you need to have a bus aide listed if the student has a need?
So those are all reimbursable?
Transportation, aides? Etc?
Is this where I would ask....BCBA services are listed in section 7. However, there are many hours and services that are provided by BCBA that are not accounted for in section 7. I am just confirming that those BCBA hours/services are captured by putting RCS in section 6.
But do all ESY services have to go on the top of the grid...??or can they be placed under the related service which is listed at the bottom of the grid...
BCBA services. For the frequency and duration of services. Does each activity type need be broken down with a duration?
I thought social work services for a Section 65 student are reimbursable??
We thought that social work services were reimbursable
So if I am providing BCBA services 2 hours per month for a variety of activities. Do I need to breaka down the frequencies?
jill allen, NFI North
Phew, I almost just had a heart attack Anyone else?
So as long as there is a PCP referral for additional services (for example services accessed during a CDS shut down week), Mainecare can be billed for treatment.
So you can have a private duty nurse but not have it on the IEP and it is billable for the provider?
In order to bill for OT, PT, ST services to Mainecare, it has to be medically necessary. How can an educational service be medical?
For students receiving services through CDS, the referrals for BHDT and RCS are not always being made with a clinical person at the table to lead the discussion. How do we handle those referrals?
For Section 28 is it required that a licensed provider write the ITP and CA or can the SPED teacher write these?
jill allen, NFI North
I think it would be helpful for the powerpoint and instructions to be more clear regarding clinical/social work services. We enter how much the students needs per week knowing we have to provide that and that it is billable. Does that make sense?
Thanks Jill. That is some good feedback for us to consider.
Hello! The Morrison center is accepting case management referrals - specializing in kids with autism / chronic medical needs. No waitlists for southern Maine and Bangor. We can support families with understanding the IEP process as well. **we are also taking outpatient referrals in Scarborough
sorry...going back a little...just need to clarify...ALL ESY services go on the top of the service grid...none go on the bottom (related services) part of the grid even for related services, such as OT. Is that correct?
Thanks for getting the ESY clarification, Erin. I look forward to hearing what the Fed Team has to say.
Base 28 does not require a BCBA - is my understanding
will you be sending the ESY and to Jacqueline, I would appreciate that information as well
I am talking base section 28 in a school based setting.
I have the policy too but it is not clear in the policy that I can see.
How much “MaineCare” language needs to be/ or should be included in the Written Notice? Naturally, one would include the rationale for related services and an LRE statement but I wonder about the “medically necessary” statement of old ( remember there once was a “medical necessity decision tree” and associated language).
You mentioned there would be an additional training for further documentation that supports the IEP requirement. Do you know when that will be?
Brittany Look RN CCM MaineGeneral
I have the same question as Lesa Kenney.
If the 16th will include information that was not covered today please let us know so we can plan to attend.
What language should be on the IEP for special transportation?
Will you be emailing the powerpoint or just posting them?
The training on the 16th will be the same slide deck and information presented. That said, it is possible someone may ask a question in the next session that was not asked today.
Thank you for your time!
will you email the answer to the esy service