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Maureen Bradshaw State Coordinator Behavior Consultants

This session will cover the steps involved in the Catastrophic Claim Review Process, including identification of eligible students, providing supportive information, on-site reviews, and accurate submission of funds expended. It will also explain what is considered a catastrophic claim and why it is necessary to review these claims.

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Maureen Bradshaw State Coordinator Behavior Consultants

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  1. Maureen Bradshaw State Coordinator Behavior Consultants mbradshaw@conwaycorp.net Arkansas Catastrophic Occurrences 2010-2011 Review

  2. Documents needed Five PDF’s Catastrophic Process & District Responsibilities (1) Scoring Rubric Behavior/Social (2) Communication Understanding others (3) Communicating with others (4) Structure (5) Two Word Documents ABILITIES Form (1) Student Demographic Forms (2) 2

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  4. Catastrophic Points The act of submitting a claim - does not ensure that it is a “catastrophic claim” which will be reimbursed. The amount of money spent is not the only indicator of whether a student is a catastrophic student. There are other factors involved. Don’t budget based on monies anticipated for catastrophic reimbursement claims. 7

  5. This session will cover 8 88 • What is considered a “catastrophic” claim student, and why is it necessary to review catastrophic claims? • Steps involved in The Catastrophic Claim Review Process. • First Step in the process • Identification of the students who should be submitted • ABILITIES Form • Second Step in the process: Providing Supportive Information • Student demographic form • Third Step: On site reviews • Ensuring catastrophic funds expended are spent to provide FAPE • Student’s Individualized Education Program • Fourth Step: Funding Considerations/Submissions of funds expended.

  6. This session will cover 8 • What is considered a “catastrophic” claim student, and why is it necessary to review catastrophic claims? • The steps in identification of the students who should be registered as a possible catastrophic student • Using the ABIITIES form to identify students to register, how to complete the form and who should be involved in providing the information. • Completion of the student demographic form to describe in detail the services provided by para’s and nurses. • What to expect during the on site review • Accurate submission of funds expended

  7. Why catastrophic claims are reviewed 9 • 1. The state must ensure that reimbursement of Catastrophic claims is for the provision of FAPE in accordance with an IEP, and that only allowable program costs for services provided to eligible students are reimbursed. • 2. Amount of money requested by districts last year far exceeded the amount available for reimbursement. Not all were found to be reimbursable claims. 22 million was requested; 11 million was available to reimburse legitimate claims/costs

  8. First Step Identifying the Student who may be a “Catastrophic Claim”. 10 A catastrophic student is a student who because of his/her multiple &complex needs “requires special education & related services which are unduly expensive, extraordinary, or beyond the normal & routine costs” (associated with special education and related services) A.C.A 6-20-2303

  9. Extraordinary….Beyond normal and routine 11 • Extraordinary: Beyond what is usual, ordinary or regular • Routine: customary, regular, commonplace • Normal: usual, average, standard Which is why you would not pro-rate a 1 to 6 class. It is assumed that a teacher and para are the normal and routine costs for educating those 6 students. The same goes for a 1-10 classroom, etc.

  10. Experiences in Arkansas & Nationally shows 12 • The type of student MOST LIKELY to meet the standard of being a Catastrophic student is a student with severe and profound impairments in a number of functional domains. • We can objectively determine that a student has “severe & profound impairments in a number of domains” by using the ABILITIES Scale.

  11. ABILITIES Scale 13 The ABILITIES scale gives an objective, disability neutral, way for districts to determine if the student has severe impairments in multiple domains ABILITIES Scale: One of the most research-based measurement tools for identifying severe and profound impairments (Bailey & Simeonsson,1988)

  12. ABILITIES Index measures the severity of a student’s disability in each of the following nine areas 14 • 1. audition (A) • 2. behavior and socials skills (B) • 3. intellectual functioning (I) • 4. limbs (L) • 5. intentional communication (I) • 6. tonicity (T) • 7.integrity of physical health (I) • 8. eyes (E) • 9. structural status (S) Refer to rubric to accurately report level of functioning 14

  13. How to Score: ABILITIES 15 • For each variable the student is ranked between 0 and 5 • 0 (meaning normal functioning in that domain) and • 5 (meaning profound disability in that domain) • It is recommended that specific domains be rated by professionals who have knowledge about that specific domain. Ex: OT/PT; SLP; Nurse; SPS, Teacher • Ratings provided by staff must be based on objective, not subjective, information. • During on-site reviews, the reviewer will verify the scores on the ABILITIES form. Discrepancies will be noted.

  14. Objective Data 16 Hearing Impaired Hearing loss must be listed as decibels Nurse completes Or use scores from recent evaluation Interpreters must be qualified: Scores must be provided

  15. 17 Same for Vision List Vision Scores obtained from File or from Vision Consultant Nurse completes OR scores taken from recent evaluation

  16. Integrity of Physical Health 18 Student’s who are rated as a 4 or 5 should have a Health Care Plan Recommend be completed by the Nurse

  17. Intentional Communication 19 Speech-language pathologist should complete

  18. Intentional Communication SLP Rates both Communicating with others 20

  19. And understanding others 21

  20. Intellectual Functioning 22 Scores for cognitive functioning should come from recent evaluation and be rated according to the rubric on the form

  21. 23 Information for Limbs, Tone & Structure should be provided by an OT or PT

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  23. What do the scores mean? 25 According to state and national data The higher the ABILITIES rating, the more cost likely associated with providing FAPE. Cost to educate special education students increases with higher ABILITIES index scores. (exception: Severe Medical or health issues with no impairments in any other domains)

  24. 26 HIGHER SCORES ASSOCIATED WITH HIGH COSTS

  25. Higher ABILITIES Score The More Likely a Catastrophic Student 27

  26. Deciding who to submit into the registry 28 • Review list of students submitted last year • If you received reimbursement on a student then this student should be submitted again this year • If you did not receive reimbursement on a student do not resubmit unless regression/or other factors have changed since last year • For students who are being submitted for the first time the LEA should review the ABILITIES form before deciding to submit. • The following is provided as a measure of the likelihood of the student being determined to be a student with catastrophic needs

  27. Higher scores- likely a Catastrophic Student 28a • An eligible Catastrophic Occurrences student would be expected to score at least 4s or 5s on most of the 9 ABILITIES domains. • Scores of 4 or 5 in two domains: • NOT likely a catastrophic student - Do not submit • Scores of 4 or 5 on three or four domains • MAY BE a Catastrophic Student, but statistically only a small number of students with ABILITIES this low are actually determined to be a catastrophic student given the full definition. • Scores of 4 or 5 on five or more domains • Likely a student who is a catastrophic student.

  28. Multiple Areas of Severe/Profound Impairment 29 Likely -Submit

  29. No multiple areas of severe-profound Not Likely - Should not submit 30

  30. 2008-2009 Reimbursement by disability category 30 a

  31. Question which needs to be answered 31 Is the student a “Catastrophic” student because his/her complex needs require costs above what is considered normal and usual costs for special education? or Is the student a “Catastrophic” student because decisions were made to spend money when other less costly options may have been available?

  32. Second Step: Complete Demographics Data to document services provided by a Para and/or nurse & why services are needed 32 Complete form with Accurate & Student Specific Information

  33. Student Demographic Form: Para & Nurse 33 • Student Demographic form is used to describe: • Services provided by paraprofessionals/nurses; • Paraprofessional (A) • Nurse (B) • Why the student requires these services for FAPE; and • Why the costs to provide FAPE for this student “are unduly expensive and beyond the normal and routine.” (D) • Information needs to be accurate, current, and specific to the student.

  34. Student Demographic Form(C ) Educational Interpreters scores 34 • For services of an Educational Interpreter • Student needs to meet the definition of a “catastrophic student” • Scores need to be provided to show the interpreter is a qualified provider

  35. How and where to submit ABILITIES & Student Demographic Form • Once completed the document need to be saved according to the following format • LEA# (number) name of form (ABILITIES or Student Demographic) then student first name and last initial. • Completed forms are to be emailed to • ADE.catastrophicsupport@arkansas.gov • With the following subject line: • Catastrophic ABILITIES & Student Demographic and LEA# (number) • It is recommended that your get confirmation of delivery. Forms cannot be faxed or mailed

  36. When can forms be submitted 36 • Registry will open on November 19, 2010 & Close on February 1st 2011. • ABILITIES & Student Demographic can be submitted immediately (as soon as a district submits an on site review can be scheduled). All ABILITIES & Student Demographic forms need to be received by 4:00pm on February 1st 2011 • Final submission is May 2nd 2011

  37. On site review 37 • On site Reviews are scheduled once the ABILITIES and Student Demographic Forms are received. • Reviews are conducted by BIC’s & ESO staff • Reviews scheduled with LEA supervisors but only an estimate of when rather than exact date may be given • Reviewers will need the following when they arrive • A copy of the student’s IEP • A copy of the ABILITIES form • A copy of the Student Demographic form

  38. On Site Reviews 38 On site reviews are conducted to: Verify information submitted on the claim. • See if evidence-based educational practices listed on the IEP are evident and implemented in the environment • Verify that staff know, understand, & are able to discuss the evidence base in a child’s particular IEP. • Verify staff demonstrate the required skills and training to implement the IEP as written and provide FAPE.

  39. Review of the IEP - Student’s Program 39 Reviewers do not ‘second guess’ the IEP team. Reviewers take the information provided by the district staff and check to see if it is accurately documented on the IEP and the catastrophic claim form, and the ‘claimed’ services are implemented/observable in the educational environment. IEPs are reviewed according to the standards set forth in IDEA to : determine if the weaknesses identified on the ABILITIES form are reflected in the Present Level of Performance (PLOP) and are addressed in the IEP; ensure that the services outline on the IEP are implemented in the environment and are based on “peer reviewed research.”

  40. Present level of functioning 40 [§300.320 (a)(1)]. The child’s “present levels” statement is, in essence, a comprehensive description of a child’s abilities, performance, strengths, and needs. It is no exaggeration to say that a fully developed, well-written “present levels” statement is the foundation upon which the rest of the IEP can be developed to specify appropriate goals, services, supports, accommodations, and placement for the child.

  41. Appropriateness of the IEP 41 If the statement of present levels of academic and functional performance does not consider the unique needs of the student or establish a baseline to establish goals and monitor progress, then the entire IEP likely will be deficient, since problems with the description of needs at the onset can affect the whole document (LRP) 20USC 1414(d)(1)(A)(i)(I) It is reasonable to expect that a rating of a 4 or 5 on the ABILITIES form would be reflected as an area of weakness on the PLOP. information on the ABILITIES is compared to Present Level of performance on the IEP

  42. 42 Example Behavior rated as severe on the ABILITIES Index/Scale should be documented in the IEP’s PLOP statement and be addressed in the IEP with behavior goals and/or a behavior support plan based on peer reviewed research. Reviewers should see the plan being implemented in the classroom.

  43. The IEP Team needs to make specific considerations regarding behavioral & Social issues for students. 43 IEP team must design appropriate interventions and designate needed supports for a student whose behavior impedes his or her learning or the learning of others.

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