ICC MEETING - Kentucky Cabinet for Health and Family ...
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ICC MEETING
Kentucky Early Intervention Services (KEIS) Interagency Coordination Council (ICC)
Virtual Zoom Meeting
April 8, 2021
ICC Members Present: Liz Schumacher (Norton/UofL), Judy Theriot (Medicaid), Scott
Tomchek (UofL), Holly LaFavers (parent representative), Catherine Lowe (parent
representative), Andrea Bartholomew (KDE IDEA and Preschool), Melissa Ferrell (KDE
Homeless), Christa Bell (DCBS), Ann Raispis (Provider), Beth Jordan (BHDID), Elizabeth
McLaren (IHE Morehead), Alaine Owens (Ft Knox)
SLA Staff: Paula Goff, Tammie Isenberg, Melissa Hardison, Casey Turner, Donna
Montgomery, Lisa Dorman, Paul Carlisle, Matt Krupp, Colleen Meszaros, Savannah Propst,
Donty Lear, Kimberly Deakins, Shawn Bailey, Karen McCracken,
POE: Allison Clark, Amy Meadows, Christina Christian, Rebecca Alley, Jessica Wood,
Melissa Robinson, Christy Jones, Gina Otterson, Hope Rice, Nancy Combs, Barbara Sweeney,
Clorissa McConnell, Mitzi Helton, Lisa Connor, Zach Bennett, Theresa Wicklund
Guests: Steve Brown, Becky Brown, Kathy Mullen, Mary Kennedy, Caroline Gooden, Teresa
Ryan, Renea Sageser, Amy Martin, Jaime Grove, Serena Wheeler (UofL), Cybil Cheek
(UOFL), Michele Magness (UofL), Julie Leezer (UofL), Denise Insley (UofL)
SLA=State Lead Agency, POE=Point of Entry, UofL=University of Louisville
I. Call to Order
• Start time was 10:00 am.
• Paula Goff facilitated introductions of attendees.
• Liz Schumacher, chair, welcomed everyone and called the meeting to order.
• Liz Schumacher asked the group to review the minutes from the January ICC meeting.
There was a question about whether ASHA had approved 20 college hours as indicated
in the January minutes. It should have been 20 continuing education hours, not college
hours. Scott Tomchek motioned to approve; motion seconded by Anne Raispis.
January minutes were approved with correction regarding continuing education rather
than college hours.
• Liz Schumacher opened the floor for public comment. No comments were made.
• Paula Goff reminded attendees to mute their microphones and raise hands if they had a
question or comment. Paula also pointed out that Tammie Isenberg had sent meeting
handouts through the chat feature.II. Federal Update
• Paula Goff gave an overview of OSEP monitoring (DMS) changes, the American Rescue
Act of 2020, SPP/APR and SSIP, Child Count, and possible review/revision to SSIP
FFY21-FFY26.
o DMS has been suspended while OSEP addresses COVID-19 issues (re-opening
public schools and reviewing state plans/budgets). DMS is expected to restart in
fall or early 2022. SLA has completed single line of authority.
o The American Rescue Act of 2020 has provided money for Part C, anticipated to
arrive July 1. We are estimated to receive $2.8 million, which will be one-time
money. OSEP is writing guidance on this money and determining if we’ll have to
amend our budget that was already submitted or if it will be included in a new
period. This money is intended to help defray costs associated with the pandemic
and may be used to help infants and toddlers (e.g. could be used to pay for 3 year
olds still receiving services rather than using agency money). The SLA has made
an internal wish list including upgrading our Adobe Connect system, but will have
to wait for guidance on how to spend. Money cannot be used for any salary or
personnel costs because it isn’t sustained dollars.
o Our SSIP was submitted March 29 (due April 1). An informal review was done by
our project officer at OSEP with minor constructive suggestions, but overall it
looked good. The review period for SPP/APR and SSIP will be April 13-27. This
will be a time for OSEP to ask questions and for us to make corrections if needed
(no new data can be added). We will resubmit as needed and should get a final
determination in late June. After clarifications, both plans will be posted on the
SLA website. The entire reporting period for this year was impacted by COVID-19
restrictions and decreases in active families and providers.
o Child Count was submitted in March. This is a one-day in time snapshot of
children with an active IFSP as of December 1, 2020. At this time we had many
families electing not to receive services due to the pandemic, so our enrollment
was down (does not affect funding).
o Paula asked for input on review/revision to SSIP FFY21-FFY26. The stakeholder
group will be working on answering the following questions this summer:
▪ Is the current Theory of Action still valid or should it be revised? Will it
lead to the desired outcome?
▪ Is the State Identified Measurable Result (SIM-R) appropriate?
▪ Who wants to be involved in the stakeholder group? Are there any missing
representatives? Are there enough parents and early intervention providers
to provide input? The stakeholder group currently has about 30 members.
▪ What is the next step with Coherent Strategies?• Comments/Questions
o Q: Is the current SSIP expiring?
A: We are on a new budget cycle for the next reporting period so it’s a natural
time to make changes, and more of a revision period than creation of a new plan.
o Q: If we don’t makes changes, will we have to explain why?
A: Yes
o Q: What have other states done for their SSIP?
A: Training on social emotional domain, family outcomes, and coaching. We
were probably the only state that created our own system, which has been
received very well nationally. Other states have also been interested and OSEP
seems to like our plan.
o Q: The coaching cohort requires ongoing expense, so is there money in the
budget to support a new idea?
A: It depends on the idea. We have federal money so as long as we don’t do
something that isn’t sustainable over time we could probably make it work.
III. First Steps Operations
• Donna Montgomery introduced new staff Savannah Propst (Administrative Specialist III)
and Donty Lear (Health Program Administrator). First Steps is now fully staffed.
• Casey Turner gave an overview of the resumption of in-person services, compensatory
services, compliance monitoring, and Child Find/referrals.
o In-person services were allowed to resume effective March 1, 2021. POEs
needed time to get safety protocols in place and contact families, so they weren’t
required to be ready for in-person services until April 1, 2021. Families and
providers could choose to do tele-intervention only, in-person only, or a hybrid.
Appropriate PPE and safety protocols are required for in-person services.
o All compensatory services offered last year due to COVID-19 expire by June 1,
2021. Children who began receiving these services by tele-intervention may have
their own expiration date for services. Three year olds were given no more than
12 weeks beyond their birthday to complete these services. First Steps
technically does not have the authority to serve three year olds.
o The SLA received one formal complaint regarding confidentiality while working
remotely. Corrective action included a breach letter, retraining on confidentiality,
and a change to less remote work. We also had many informal complaints
regarding services at age 3; several parents wanted to extend these services past
June. Billing audits revealed no issues for two providers. One provider did not
follow frequency of services per IFSP. A Corrective Action Plan is pending for
this provider.
o In January 2021 we had 823 referrals vs. 1,142 in 2020). In February 2021 we
had 766 referrals vs. 959 in 2020, and in March 2021 we had 1,255 referrals vs.
702 in 2020 and 1,079 in 2019. POEs continue to work hard to get the message
out that First Steps is open and accepting referrals.• Tammie Isenberg gave an overview of new provider enrollment, which remains on hold
unless there is an emergent need at a POE. In May, surveys will be sent to potential
providers who have expressed interest since the hold started. New provider enrollment
will open in June.
• Paula provided data on provider payments through 3/31/21. We are barely above half of
what we would normally be paying due to the decrease in the number of children being
served. Right now only 40% of kids served are covered by Medicaid. Paula explained
that First Steps regulations expire in October 2021 and are required to be reviewed by
state law.
o We can accept the regulations as currently written or request changes. If changes
are requested, there is a formal process required by state law and we would need
approval by OSEP. Public comment and an opportunity for a hearing would also
be required. Changes must to be approved by the legislature.
o Paula believes we’ll have to change our regulations to include tele-intervention.
o We will need to consider how any changes could affect catchment areas (i.e. will
tele-intervention be available only if no one in that area is available?) Paula asked
ICC members to email ideas on how it could work.
• Comments/Questions
o Q: Do you have data on the percentage of families who have elected to have visits
in-person?
A: Not yet.
o Q: Can you give more details about hybrid model?
o A: A family can choose week-to-week whether they want in-person or tele-
intervention, and this choice does not have to be connected to COVID-19.
Families were encouraged to include hybrid as an option just in case something
happened and to provide more flexibility.
o Q: Has there been discussion of increasing the hourly rate listed in regulation
and/or using a tiered payment model?
A: We are conducting a rate study. Once that is done, we will create a workgroup
to make recommendations for a tiered reimbursement rate system that aligns with
quality. These changes would have to be approved by DPH and CHFS before they
could be suggested as regulation changes. We could still have a max KEIS rate
but include more specifics about levels in our implementation. This change is
probably a couple of years away at minimum.
IV. Record Review Report for FY 2021
• Scott Tomchek provided a record review report.
o The majority of record reviews are for eligibility purposes or requests for ILEs
(intensive level evaluations) for kids with autism spectrum disorder.
o The record review team recently put together guidance on when to request ILEs.o There is a low volume of requests for kids who already have IFSPs but Scott
anticipates we may see an increase in this type of review.
o Despite the pandemic, we are only 5% down from the previous fiscal year.
o Discussed number of record reviews per district
V. Old Business
• Liz mentioned that by July we’ll start thinking about new appointments and possibly a
new chair if someone is interested.
• Liz reviewed the questions Paula gave to the group regarding possible review/revision to
SSIP: Is the current Theory of Action still valid or should it be revised? Is the State
Identified Measurable Result (SIM-R) appropriate? Who wants to be involved in the
stakeholder group/are there any missing representatives?
• Comments/Questions
o Q: Is anyone keeping data on providers who are leaving First Steps?
A: Providers let us know who is leaving and it’s handled through provider
enrollment, and coaches let us know when someone isn’t responding.
o Q: Can we share data points about how many providers join/leave per month and
whether they leaving due to not wanting to do training for coaching?
A: We don’t always know why people are leaving but can try to pull together that
data.
o Comment: One provider mentioned that 90%+ of her staff has decided not to do
training and she can’t keep providers.
VI. Final Business
• The next meeting is scheduled for July 8 and will be held virtually.
• Elizabeth McLaren moved to adjourn the meeting and Holly LaFevers seconded the
motion.You can also read
