Temporary Task Force on Preschool Special Education
August 1, 2007 Meeting Minutes
Tom Connoly, Susan Constantino (CP of NY), Mary Garrett (Capital District Beginnings),
Eddie Lee (OMRDD), Tom Hamel (SED), Pamela Madeiros (Alliance for Children
with Special Needs), Harold Matott (SED), Sally McKay (NYC Department of
Education), Donna Noyes (DOH), Nelly Odondi (DOB), Andrea Rieger (Coalition
for Preschool Children with Disabilities), Jane Ryan (JE Ryan & Associates),
Dan Tworek (CP of NY)
Via conference call
Michael Grossfeld (All About Kids), Patsy Yang-Lewis (Westchester County Department
Facilitator Alan Stern (Stage Right)
Note taker Jessica Janeski (OMRDD)
The workgroup agreed on the purpose of the meeting and the following desired
The workgroup discussed SEIT to assure there was a shared understanding of
the issues. The following barriers to adequate SEIT rates were identified:
- Regional differences.
Urban vs. rural. In rural areas teachers may travel
1,000 plus miles a month. In urban areas teachers may work in only
2 buildings. This makes it difficult to determine an adequate
Payment on an enrollment basis may lead to circumstances
where children are not getting the services they need.
- There is no requirement to make up missed sessions.
- Teacher vacations/absences during school year. This is particularly
a problem in NYC when they contract with consultants to provide SEIT
services. They are not bound by “allowed absences” as
some school teachers are.
- Student absences.
In some areas SEIT is being used for unintended purposes. This
is especially true with the increase in autism. Other necessary services
are being provided under the guise of SEIT.
In addition, recommendations should be made for the following SEIT issues:
Agency presentationsVarious state agency representatives provided
a brief overview of the rate setting practices used for their services. The
purpose of the presentations was to provide workgroup members with an understanding
of what different state agencies do to set rates so that the strengths of
each system may be incorporated into the preschool special education rate-setting
OMRDD - Joanne Howard|
Basic Payment System
- OMRDD operates a variety of programs and rates are calculated differently
depending on the service being offered.
- The service system has changed from an institution based system to a
community based system.
- Budget approves a rate methodology. OMRDD can issue prices if within
the negotiated guidelines.
- Providers may appeal budget based rates. There are limitations
outlined in regulation. Appeals must be submitted within 1 year of the
close of the price period. Biggest issue with timeliness of appeals
is providers do not submit adequate documentation (CFR).
- Property costs are separately approved through a ‘prior property
- Services within the approved methodology are generally reimbursed in
a timely manner.
- Depending on the service, rates may be billed on an hourly, daily or
- 80% of services are Medicaid funded.
- OMRDD has very rigid audit/documentation standards.
DOH Early Intervention - Donna Noyes
Basic Payment System
- Providers who deliver EI services must be approved by DOH and under contract
with a municipality.
- Providers bill and are reimbursed by municipalities.
- Municipalities are responsible for seeking reimbursement from Medicaid
and commercial insurers in the first instance, and then submit claims to
the State for the state share (50%).
- Providers are responsible for maintaining adequate documentation to bill
third party payors and for supplying documentation/information needed by
municipalities to seek such reimbursement.
- All EI services (individual and group) are classified and defined in
- Using 16 geographic regions, standardized rates for each service are
- Billing rules for each service category are set forth in regulation.
- When necessary to fulfill a child’s IFSP, the local EI official
can give prior approval to the provider to bill for additional visits above
the billing limits.
OCFS - Dan Zeidman
Basic Payment System
- Cost-based rate methodology for group care and foster family care.
- Model budget approach uses three major cost components for grouping and
limiting reimbursement to cost parameters for direct care, property/maintenance
and administration. Providers can shift money within a cost component
but not between the three.
- CPI is used for non-personal services (food, insurance, shelter, etc.).
- Annual trending.
- Providers are allowed a rate consultation process anytime they receive
- Rate intensification may be approved by OCFS to adjust to changing needs. The
rate intensification may be applied retroactively.
SED Preschool Special Education - Tom Hamel
- Cost reports are submitted to SED.
- The cost reports are reviewed by
- Rate are calculated and sent to DOB for approval.
- DOB approves
rate method. If a rate is within the method it does not need to be
reviewed by DOB. DOB will post-certify the rate.
- The school is notified
of the rate and has 15 days to comment.
- 30 cents per $1 is allotted for
non-direct care costs (property, admin costs, etc).
- There are no property
adjustments for pre-school.
- A rate adjustment will be considered to address
health and safety concerns, non-compliance or programmatic increases.
Ryan of JE Ryan & Associates provided a non-state agency perspective
on the various rate systems. She reviewed the strengths of the various
systems and noted where improvements will assure timeliness and adequacy
of rates. Topics discussed include: property screens; staffing; the
waiver process; 1:1 aides; reserve allowance; and, accountability.
workgroup members provided since last meeting (Dan Tworek)Workgroup
members reviewed the listing of problems/issues as well as the list of
recommendations outlined in the Conceptual Framework - Education Program
Tuition/Rate Methodology Reform (white paper) developed by a provider
Task Force and issued on March 3, 2005. Workgroup members were instructed to consider these lists
when developing recommendations for the Task Force. What does this information
mean to the workgroup? Do the workgroup recommendations address some
of the policy concerns outlined in the paper?
members reached consensus that recommendations should be developed to address
the following areas and were asked to submit other issues for further consideration:
- Regionalization of SEIT rates.
- Develop a set of “blended” parameters
for SEIT services within an enrollment based payment system.
teacher salaries and fringe with public school salaries and fringe.
preschools rates are not in competition with EI rates for professional
- Require increased accountability, programmatic as well as
fiscal (identify methods for such accountability).
- Create incentives for
group related services and group SEIT.
- Streamline the rate approval and
- Create a separate process for the property component of
- Allow for a fund balance (how would it be used?)
By the August 15
workgroup meeting a list of concrete recommendations should be developed
so that they can be discussed and prioritized at the meeting. This
will be facilitated via email.
The next meeting is scheduled for Wednesday,
August 15, 2007 at 44 Holland Avenue, conference room 4A. The meeting
will take place from 11-2.