Department of Health, Children's Medical Services Early Steps Live ...

1 Department of Health, Childrens Medical Services Early Steps Live Conference Call Provider Enrollment June 30, 2004 Questions and Answers Provider Credentials/Enrollment 1. Question (Orlando) How will the Early Steps State Office know if a provider is re-enrolling or enrolling for the first time? Response The application includes questions about previous enrollment
and requires the identification of the Center where the provider was
previously enrolled and the associated provider code. Verification will be
done by looking at the existing provider records in the Early Steps Data
System. 2. Question (Sarasota) Does a year of experience have to be 100% birth through 5? Response For all providers except service coordinators, one year of
experience in early intervention equals 1600 hours of hands-on
experience with 0 5-year-old children with special needs or their families.
A maximum of 400 hours hands-on work with 0 5-year-old children with
special needs or their families obtained as part of the educational
requirement to obtain a degree can substitute for 25% of the one-year
experience

For service coordinators, one year of experience is defined as
professional work with young children and their families in a teaching,
counseling, or case management role. 3. Question (Gainesville) Are intake staff required to do the online enrollment if they only do intake?

Response If their activity is recorded in the data system as CASE or
TCM, then yes, they must complete the enrollment process. 4. Question (Brevard) Can providers be dually-enrolled as Medicaid Targeted Case Management providers and as therapists or other
providers if they are not employed through Early Steps? Response Yes. In order to enroll in the Medicaid Targeted Case
Management program, providers must be employed with or contracted by
local Early Steps offices as service coordinators. All contracted service 2 coordinators must meet the same requirements as employed service
coordinators (i.e., complete orientation/mentoring and training, participate
in meetings for all service coordination staff, etc.). 5. Question (Miami) Do contractors of local education agencies need to enroll in the Early Steps Provider Enrollment System? Response The Early Steps State Office is working with the Department of
Education to seek clarification to this question and will provide information
as soon as it is available. 6. Question (Broward) The credentials identified for Behavior Analysts are unclear. Response The intent was to identify Certified Behavior Analysts as
appropriate to provide services within the scope of this certification.
Clarification will be pursued with the credentialing body for CBAs and
written response provided at a later time. 7. Question (Broward) Is the issue of an ITDS enrolling in Medicaid still pending approval? Response Yes. The Centers for Medicare and Medicaid Services have
reviewed the amendment to our state plan and requested additional
information before they can render a decision on the request. A formal
response from the State Early Steps Office is due to the Centers for
Medicare and Medicaid Services by August 31, 2004.
8. Question Can a provisionally licensed Speech Language Pathologist enroll in Early Steps? Response Yes. A provisionally licensed Speech Language Pathologist
may enroll in the Early Steps system if the supervising Speech Language
Pathologist is an Early Steps enrolled provider. The Clinical Fellowship
Year (CFY) supervision will constitute the 6-month mentorship required for
individuals without a year of experience.
9. Question Which of the Other Non-Licensed Provider types can now be enrolled?

Response The Certified Behavior Analyst, Hearing Specialist, Orientation
& Mobility Specialist, Special Instruction Consultant, and Vision Specialist
are all active provider types with defined credential requirements. The
other types listed in the Personnel Development and Training Guide are
new specializations being developed.
3 ITDS 10. Question (Miami) Where do you get an ITDS Certificate if you have endorsement for birth to 5? Response You can currently earn an ITDS Certificate by completing the
university certificate programs at Florida State University and the
University of Central Florida. Other universities are currently in the
process of exploring the option of offering the ITDS Certificate.

Another option is completion of the ITDS competency modules that will be
offered by the Early Steps State Office beginning this fall. A combination
of university courses and the online Early Steps ITDS Competency
Modules can also be completed to attain the competencies.
11. Question (Brevard) Are LEA teachers able to take an exam of the ITDS competencies to earn the certificate? Response No. Credit for each of the ITDS training modules/courses can
only be earned by completing each module/course work and receiving a
passing score on the exams.
12. Question (St. Pete) If you pass the online exams can you clep out of the ITDS modules/coursework? Response No. You can only receive credit toward the ITDS
competencies by completing the modules and/or university coursework
AND receiving a passing score on the exams.
Additional Requirements 12. Question (Pensacola) What are the terms and conditions that have to be
submitted? Response The Terms and Conditions of Early Steps Provider Enrollment
and Approval Form must be signed and mailed or faxed to the Provider
Enrollment Specialist once an application has been submitted. The form
is found at www.cms-kids.com/ESProviders/providers.htm 13. Question (Pensacola) Can the agency submit the proof of insurance for its employees or does the individual have to? Response Documentation must be provided that the individual applicant
is covered by liability insurance. This documentation can consist of the
face sheet for an individual policy or by the face sheet for a group policy
which is accompanied by a letter on the agency letterhead documenting
the effective date of the individual to be covered by the group policy. 4
14. Question (Orlando) Is there any service a certified behavior analyst
can provide without having to become an ITDS?
Response A CBA does not have to enroll as an ITDS and may enroll in
the Other Non-licensed Provider class. However, a CBA may enroll as an
ITDS if they meet the requirements. 15. Question How can a provider who was enrolled prior to July 1, 2004, be added to service areas beyond where they were previously enrolled?

Response Providers may indicate their availability to provide services in
any part of the state when they complete the re-enrollment process.
Background Screening 16. Question (Broward) Do current providers have to enroll and submit a fingerprint card?

Response Only current providers who are not enrolled in Medicaid and
who cannot document a satisfactory Level 2 Background Screening within
the past 5 years will need to submit a fingerprint card for their 2004 re-
enrollment. 17. Question (St. Pete) If fingerprint cards are already on file for five years are they required to have another finger print card? Response As addressed in Question 16, if providers have a current
Medicaid individual number or documentation verifying a recent (within 5
years) satisfactory Level 2 Background Screening, they will not need to
provide a fingerprint card/payment with the application.
Orientation Modules 18. Question (Gainesville) if individuals take the test for the Orientation Modules and pass without having done the Orientation Modules, will they
receive credit for in-service hours?

Response Yes, they will receive a certificate for the credit hours. 19. Question (Brevard) Are the online Orientation Modules available now?
Response No, that is why we developed the interim timelines. Current
providers will still have until December 31, 2004, to complete the re-
enrollment application process, and then up to six months from the date of
their re-enrollment application to complete the Early Steps Orientation 5 Modules. Current providers will be assigned a temporary approval status
until the training is completed.

New providers will have 90 days from the date the last Early Steps
Orientation Module is made available, to complete the training. New
providers will be granted temporary approval status upon completion of all
other enrollment requirements..
20. Question (Hernando) Will the Orientation Modules count for the licensure for CEU requirements? Response The Early Steps State Office is currently working on becoming
a provider of CEUs for the various disciplines enrolled in the Early Steps
Provider system.
21. Question (West Palm) Do licensed paraprofessionals have to complete the Orientation Modules?

Response Yes. Paraprofessionals are required to complete the Early
Steps Orientation Modules.
22. Question (Miami) When will the online tests for the Orientation Modules be available? Response There will be one cumulative final exam for the Early Steps
Orientation Modules, which may be taken without prior completion of all of
the modules. The final exam will be posted when the seventh module is
developed and posted on-line. It is anticipated that all seven Early Steps
Orientation Modules will be developed and accessible on the web by the
end of October. The individual modules will be posted as they are
completed between now and the end of October. Enrolled providers will
be notified by email as they are available. 23. Question (Miami) Is there consideration for master plan in-service points for teachers in regards to the Early Steps training? Response No. The Early Steps State Office is working with the
Department of Education to provide local school districts information to
include the training in their master in-service plan. However, each local
school district determines what will be included in their master in-service
plans.
Training Requirements 24. Question (Sarasota) An Occupational Therapist license for an existing ES provider expires February 2005. How many CEU/training hours does she
need to have to reenroll with Early Steps? 6 Response Since her MQA license is expiring within nine months of her
initial enrollment with the Early Steps Provider Enrollment system, she
does not need to reenroll with Early Steps or complete any additional
hours for Early Steps in addition to the 24 hours needed to renew her
license with MQA. Early Steps will just verify that her license has been
renewed.
Her first Early Steps renewal date will be two years from the date of the
MQA license renewal date and at that time she will need to document 24
hours of CEUs/inservice hours related to at least one of the Early
Intervention Professional Competency Areas. Those providers whose license expires more than nine months after their
initial enrollment with Early Steps will have to complete the Early Steps
renewal application form at the time of their MQA license renewal. They
also do not need to complete any additional hours for Early Steps in
addition to the 24 hours needed to renew their license with MQA. Again,
their first Early Steps renewal date will be two years from the date of their
first MQA license renewal date after enrolling with Early Steps and at that
time they will need to document 24 hours of CEUs/inservice hours related
to at least on of the Early Intervention Competency Areas. The Early Steps State Office will provide opportunities for providers to
obtain in-service hours, such as the upcoming the Team Training Series,
and other anticipated training opportunities. 25. Question (Sarasota) What is the level two training for Service Coordinators? Response Service Coordinator Level Two training will be comprised of
four days of training, split into two day segments that will be held
regionally on an ongoing schedule for new service coordinators, current
service coordinators and supervisors. Service Coordinator Level Two
training is anticipated to begin in the Spring of 2005 and will be provided
by the Early Steps State Office.
26. Question (Orlando) If a person is tri-enrolled will they need to do all three competencies?

Response New providers must meet the education, experience and
training requirements for each category in which they wish to enroll. 7 27. Question (Orlando) Can you give us examples of mentoring activities for newly hired service coordinators? Response Observations of experienced service coordinators conducting
first contacts, facilitating IFSP meetings, and completing other service
coordination duties are examples of appropriate mentoring activities.
Service Data/Billing 28. Question (Sarasota) If an individual is dually enrolled and providing services as an ITDS and service coordinator, how is the service
reporting/billing done?

Response The provider would record their service coordination time as
CASE and their EI services as EIHF, EIIF, or EIGF, as appropriate.
Medicaid is considering whether this dual role may constitute a conflict of
interest, therefore, they will not pay TCM to dually enrolled individuals
providing both services to the same child until a decision on this is made. 29. Question (Orlando) If a dually enrolled ITDS/service coordinator is in the home providing services, can all of the services be coded as EIHF instead
of CASE in the data system? Response See Question 28. EIHF is a service code which is appropriate
to use for an EI session that is provided in the home, not for case
management. The time they spend doing early intervention is under EIHF
and the case management would be under CASE. 30. Question (Orlando) Is it allowable for the service coordinator to bill TCM to Medicaid and EIHF to Part C for a Medicaid enrolled child? Response The Early Steps State Office will seek clarification from
Medicaid and respond in writing. The question of conflict of interest may
be relevant to this situation.
31. Question (Panama City) Will a provider be able to bill Part C while their Medicaid application is pending approval? Response Providers eligible for Medicaid enrollment cannot be approved
as Early Steps Providers until their Medicaid number is verified. However,
service coordinators may provide services to non-Medicaid children as
soon as they are approved by the Early Steps Provider Enrollment
System. Case Management services provided to Medicaid children prior
to enrollment in Medicaid cannot be reimbursed as fee-for-service with
Part C funds. 8 32. Question (Panama City) When enrolling service coordinators in Medicaid would they have to wait 90 days until their application is turned into
Medicaid? Response No. The Medicaid enrollment process will remain the same.
The applicant submits an online application and submits the Medicaid
application along with the other Early Steps Provider Enrollment
documentation at the same time. The Medicaid application will be
forwarded to Affiliated Computer Services, Incorporated (ACS) as soon as
credentials are verified. 33. Question (Tampa) Do service coordinators have to wait for the Medicaid application to be approved before they can provide services? Response Service coordinators may provide services to non-Medicaid
children as soon as they are approved by the Early Steps Provider
Enrollment System. Case Management services provided to Medicaid
children prior to enrollment in Medicaid cannot be reimbursed as fee-for-
service with Part C funds.
34. Question (Panama City) If enrolling as a new provider, do you have to wait 90 days before you can receive the letter to send to Medicaid with the
enrollment applications? Response The letter which recommends an individual for enrollment as a
Medicaid Early Intervention Provider will be made available as soon as
verification of credentials is complete. The time frame for this verification
will depend on the timeliness of submission for supporting documentation
by the applicant. It need not take 90 days.

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