ADMINISTRATION
MISSION
STATEMENT:
The Steuben County Department of Special Children's Services (SCS) administers the Physically Handicapped Children's Program/Children with Special Health Care Needs Program, the Early Intervention Program/Child Find, and the Preschool Special Education Program. The department assures that Steuben County physically, medically, and/or developmentally disabled children and their families are provided with opportunities to access assessment, diagnostic, medical, therapeutic, educational, and financial services. Guided by federal, state, and local laws, the programs provide cost-effective, quality services to assist children in reaching their full potential.
RECOGNITION:
• September 19th our Senior Typist, Darlene Rook, celebrated 10 years of continuous employment with Steuben County. She received a Certificate of Recognition from the legislators.
• The Department contracts with over 75 agencies, individuals, school districts, and transporters to provide early childhood services to hundreds of children under the age of 5. We are fortunate to work with so many exceptional and dedicated people. Each provider contributes to the children’s successes in different ways. Together their contributions make indelible differences in the lives of children.
• This year we said goodbye to five outstanding County Legislators - Gary Swackhamer, Kenneth Isaman, Dr. DeWitt Baker, Ronald Neilson, and Thomas McIntyre. Each one supported and guided Special Children’s Services for many years. Their knowledge, foresight, and advice have always been appreciated.
• After volunteering for 9 years as the County Representative on the Addison School District Committee on Preschool Special Education, Clair Lewis resigned. We thank him for his part in ensuring positive outcomes for many special education children.
• Families are the most important part of a child’s life. It is especially evident in the lives of special needs children. The support and guidance that a child receives in the first years of life remain with them forever. We recognize the contributions and sacrifices that families make for their children. A family’s love, devotion, and perseverance greatly contribute to a child’s success in school and life.
PUBLIC
AWARENESS:
• Copies of the third edition of the Steuben County Children’s Services Directory were distributed throughout the year. The directories contain over 50 government and community agencies and services for children and families in Steuben County. There are tips on child health and safety, as well as sections on developmental milestones from one month of age to 5 years old. Distribution of the directory is ongoing throughout the year.
• Steuben County Special Children’s Services directories and brochures are distributed to government agencies, hospitals, physicians, dentists, libraries, town halls, day cares, schools, and community organizations. Some brochures are available in Chinese, Spanish, Russian, and French.
• Approximately 30 Social Services’ caseworkers attended a meeting on Early Intervention presented by Helen Brutsman, Karen Dgien, R.N., Tammy Norton, R.N., and Deanne Bagley, R.N.
• In January, Helen Brutsman presented an overview of SCS programs to the Corning School District Early Childhood Planning Committee.
• During 2007 Public Awareness activities included distribution of brochures, toys, pens, and pencils at the Special Connections Event in Corning, a local Rotary Club meeting, the Public Health Prevent Team in-service, the Steuben County Fair, and the Atlanta Health Fair.
• Notices about our programs appeared in local papers, Pro Action publications, and the Healthcare Guide booklets.
• In October, informational breakfasts for the health care community were held in three locations –Bath, Corning, and Hornell. They were well attended.
• November 27th, Tammy Norton, R.N. presented an overview of Early Intervention to Alfred University psychology students.
S²AY
- RURAL HEALTH NETWORK:
The S²AY Network is a NYS Department of Health grant-funded rural health network that represents several counties “to integrate, promote and expand appropriate components of the Public Health service delivery system to improve outcomes for all residents of the Network region”. There are 11 counties working together to identify and resolve issues in the early childhood programs administered by the counties. The counties include Allegany, Cayuga, Chemung, Ontario, Schuyler, Seneca, Steuben, Tioga, Tompkins, Wayne, and Yates counties. Betsy Hull is the S²AY’s Early Childhood Coordinator. She keeps the group on task and assists the 11 counties with issues related to early childhood services for children with special health care needs. Meetings are held every month with subcommittees meeting when necessary.
The Finger Lakes Regional Early Childhood Coalition was formed in October 2004 to “create a forum for dialogue among partners that will lead to strengthening the quality of services provided to children in the Early Intervention and Preschool Special Education programs”. It has been expanded to include the Physically Handicapped Children’s Services and the Children with Special Health Care Needs Program. The Coalition includes parents, providers, county personnel, and chairpersons of the Committees on Preschool Special Education (CPSE) from each county.
The Coalition continued working throughout 2007 to assist counties in meeting the state and federal regulations in Early Intervention, Preschool Special Education, and Physically Handicapped Children’s Services programs.
August 13th, Bradley Hutton, the new Director of the NYS Department of Health Bureau of Early Intervention met with our S²AY Early Childhood group. The purpose of the meeting was to convey to Mr. Hutton the difficulties that rural counties face. Adjacent rural counties were invited to the meeting in Penn Yan.
Jane Foley and Patricia Hurld from the NYS Department of Health attended the April meeting to explain the Early Intervention Child Find Program. Each county administers the program differently which is fine with the state.
The S²AY Network sponsored a workshop with Lisa Murphy, also known as the Ooey Gooey Lady. Approximately 150 people attended the workshop held at the Belhurst Castle in Geneva. Lisa gave an entertaining and educational overview of her theory and philosophy for identifying and creating child-centered environments. She combines science, math, and socialization with hands-on play-based learning techniques to prepare young children for Kindergarten.
“Dear Day Care Provider” letters were sent to all licensed and registered day care providers in the 11 counties. Information on normal child development was included with the letter. Day Care Providers were encouraged to discuss child development with families and to make appropriate referrals to Early Intervention on children with suspected developmental delays.
A website, which is a work-in-progress, was developed for parents, providers, school district personnel, and counties. The Early Intervention policy and procedures were reviewed and revised to meet changes identified by IPRO audits.
The group wrote policy and procedures for the Physically Handicapped Children’s Program and the Children with Special Health Care Needs.
The S²AY Finance Committee addressed the transportation of Early Intervention and Preschool children to center-based programs. The counties are responsible for the transportation, which is usually awarded through a bid process. A cost study was completed and each county presented information on how they control transportation costs.
Helen Brutsman, representing the Early Intervention perspective, participated on a special S²AY Network Administration Committee to write administrative policy and procedures.
A subcommittee is meeting to develop an audit tool for Early Intervention child records to be completed in early 2008.
NEW
YORK STATE WESTERN COALITION OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS
(CSHCN) AND PHYSICALLY HANDICAPPED CHILDREN’S PROGRAM (PHCP):
The NYS Western Coalition of CSHCN is a collaboration of 17 counties in western NYS. It meets periodically in Piffard to discuss children's health care issues. Recently the group has been meeting via teleconferences. The coalition works to improve health care for all children in New York State. Helen Brutsman and Linda Griffin attend the meetings. Joyce Stewart attended the meeting in October. It is an opportunity to meet with the people from other counties who are involved in the same activities of providing financial assistance, referring to community agencies, and promoting programs for children.
Since counties continue to have concerns over the lack of Orthodontists, a survey was developed and sent to all licensed Orthodontists. The hope is to determine what barriers discourage orthodontists from participating in the PHCP/Medicaid orthodontic program and then to assist the orthodontists to resolve the issues.
Orthodontists, Anthony Pasquale, DDS and Rahul Renjen, DDS, MS from the Guthrie Medical Clinic approached SCS to offer orthodontic services to PHCP eligible children as well as Medicaid eligible children. Located in Corning, they have accepted several new patients. With local orthodontists opting out of the PHCP and Medicaid programs, most eligible Steuben County children were forced to travel to Rochester for orthodontic care. It is good to have services available within our county.
Data collected through the Children with Special Health Care Needs computer program is felt to be inadequate and give an inaccurate picture of gaps in the state’s health care system. The coalition continues to address the need for better software to record all identified concerns and barriers to health care accurately and consistently across counties.
EARLY
INTERVENTION:
As a provider of Early Intervention Service Coordination, our department was audited by IPRO, the state’s contracted monitoring organization. On November 26th and 27th an administrative audit took place by IPRO. A corrective action plan for service coordination resulted in two minor changes to the department’s EI policy and a corrective action plan which was approved by the Department of Health. The report for the second audit has not been received.
LOCAL
EARLY INTERVENTION COORDINATING COUNCIL (LEICC):
The Coordinating Council held meetings in March, June, September, and November at 12:00 noon with a light lunch served. The meetings were very well attended with an average of 15 people attending each meeting. The purpose of the Council is to advise the Early Intervention Official in the implementation and delivery of a countywide comprehensive, coordinating, multidisciplinary, interagency, cost effective program of early intervention services.
Early Intervention staff report on Early Intervention provider and/or parent surveys, enrollment status, upcoming trainings, state monitoring, S²AY/RECC activities, and proposed legislative changes. They give updates on the Preschool Special Education Program and Physically Handicapped Children’s Program/Children with Special Health Care Needs Program.
LEICC speakers in 2007:
In March, Deputy County Attorney David English was asked to speak on subpoenas and the expectations of appearing in court. Attorney English explained what should and should not be brought to court and what type of questions a prospective witness may be asked. He explained that the Steuben County Law Department is a great resource for employees and providers.
Ryan Peterson, a psychology student working on his dissertation in early childhood, requested that the LEICC send surveys to the Early Intervention families and providers to determine the “Collaboration between parents and service providers in Early Intervention”. He has promised to return to a future meeting with the results of his study.
Lisa Galatio, Program Manager of Healthy Families-Steuben, was the June speaker. She told the group about their national guidelines, referral process, and eligibility. She talked about the new “Parents as Teachers” program and the “Fatherhood Advocacy”.
At the September meeting, Patty Baroody, Caregiver Resource Center Coordinator for the Office for Aging spoke on Grandparents Raising Grandchildren. She stated that grandparent’s greatest concerns are legal issues.
The speaker for November was Jeannie Gallagher, School Social Worker from the Bath Area Family Resource Center. She explained that the Resource Center is part of the Steuben Family Enrichment Collaborative. They work to “strengthen communities through offering parenting education in Steuben County”. The Resource Center is open to Early Intervention and Preschool children and provides fun and educational programs.
At the September meeting, Lisa Galatio was re-appointed as chairperson of the Steuben County Early Intervention Coordinating Council and Deanne Bagley, R.N. was reapproved as vice-chairperson. Linda Griffin was appointed secretary.
PRESCHOOL:
Due to the dramatic growth in services and cost, Governor Spitzer created a Preschool Task Force to examine the Preschool Special Education service delivery system. In November a report was submitted to the Governor recommending changes. To view the final report entitled IMPROVING PRESCHOOL SPECIAL EDUCATION IN NEW YORK STATE access the website online at:
http://www.vesid.nysed.gov/specialed/preschool/taskforce/home.html
In September, Sherry Buhl from James McGuinness Associates came for a day and a half to train Kim on the preschool reimbursement software.
Deanne Bagley, R.N. continues to arrange for a County Representative to attend all of the School District Committees on Preschool Special Education. One of the changes in the committee makeup is that the Early Intervention Service Coordinator has to be formally invited by the parent/guardian to attend the CPSE meeting.
Another legislative change to preschool law is that any adjustment to an existing Individualized Education Program (IEP) may be made by an agreement between the parent/guardian and the CPSE Chairperson. It is no longer necessary to conduct a formal meeting to change an IEP.
Pathways, Inc. opened a new classroom at the Erwin Day Care Center. The new full-day special education classroom was created to accommodate preschool children with disabilities identified and eligible for center-based programming.
TRAINING
AND CONFERENCES:
• In October, Linda Griffin, Karen Dgien, R.N., Tammy Norton, R.N., and Deanne Bagley, R.N., completed an “Introductory Service Coordination” training held in Penn Yan. Tammy Norton, R.N. and Deanne Bagley, R.N. attended a seminar on Obesity in October. In June, Helen Brutsman attended a state sponsored training on “Program Records” in Batavia.
• Joyce Stewart and Helen Brutsman participated in several meetings of the CPSE chairpersons at the Greater Southern Tier BOCES administrative offices in Coopers Plains. The meetings are very beneficial as the CPSE’s and county personnel work together to identify and resolve issues related to Preschool Special Education. Since Kim Gotshall has moved into the Preschool Accounting position, she is now attending the meetings.
• Kim Gotshall and Helen Brutsman attended the Rochester Regional Early Childhood Direction Center (RRECDC) meeting in October. Discussions included changes to state and federal regulations for Early Intervention and Preschool. In April, RRECDC presented two parent workshops for families of children transitioning from Early Intervention to Preschool Special Education. Unfortunately, very few parents attended.
• Due to a Federal audit of NYS’s Medicaid billing practices, Erie#1 BOCES presented a workshop to address the state’s changes in school district and county Medicaid reimbursement claiming. Joyce Stewart, Kim Gotshall, and Helen Brutsman attended the workshop.
• A meeting with the Information Technology Department Director took place to determine SCS’s compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations which cover the security of children and families’ personally identifiable information. It covers information physically contained in our department and that which is electronically maintained. Information contained in children’s charts for the Early Intervention and Preschool Special Education programs’ services is covered under the Family Educational Rights and Privacy Act (FERPA). The federal regulations for HIPAA and FERPA are similar and require written policy plus diligence by staff to ensure the privacy of physical, oral, electronic, and verbal information.
• Healthy Families-Steuben Advisory Council is now alternating meeting locations between Bath and Hornell. Helen Brutsman attends the meetings in Bath and Tammy Norton, R.N. attends the meetings in Hornell. Deanne Bagley, RN is the department’s representative on the Family Network Support committee
• Stepping Stones Learning Center facilitated a workshop on autism for Corning School District personnel, Erwin Day Care teachers, and Steuben County contracted providers.
• Helen Brutsman attended the New York State Association of Counties (NYSAC) conference in September. The Preschool Special Education Program funding is a top priority of NYSAC for 2008. She, also, attended the two-day Early Intervention Conference in Albany in October.
FINANCIAL:
Each SCS program has a different accounting system and one Account Clerk Typist assigned to each program. On August 27th, to cross train employees, the three Accountants moved to different programs. Linda Griffin moved from the Physically Handicapped Children’s Program/Children with Special Health Care Needs to the Early Intervention Program. Joyce Stewart moved from the Preschool Special Education Program to the Physically Handicapped Children’s Program/Children with Special Health Care Needs. Kim Gotshall moved from the Early Intervention Program to the Preschool Special Education Program. It has been a learning curve for everyone. However, cross training is essential to the overall operation of the department and to ensure that reimbursement is maximized.
Financially, 2007 was an especially difficult year for the Preschool Special Education Program. Preschool Special Education center-based program rates are set by the State Education Department. Once a rate has been established, it may be appealed by a program, reviewed by the state, and subsequently result in rate adjustments. In 2006 and 2007 rate adjustments for the eight Steuben County contracted programs exceeded $1,000,000.00, resulting in a shortage of funds appropriated for prior year services. This necessitated a legislative resolution to obtain funds from other sources including the County contingency fund. The methodology of rate setting for center-based preschool programming is complicated, unpredictable, and is lacking in responsible financial practices. Counties and center-based programs are preparing budgets on unreliable data.
In 2006, the NYS Office of the Medicaid Inspector General issued an order to all NYS school districts and counties to stop claiming Medicaid reimbursement for Medicaid eligible special education children receiving speech and transportation services, evaluations by school psychologists, and counseling. Concerns cited by the federal government include the lack of proper documentation of eligible services and the use of unlicensed personnel. In 2008 some of the Medicaid reimbursement for prior years may be claimed subject to strict new state guidelines. Reimbursement for preschool transportation after June 2008 is limited.
MISCELLANEOUS:
During 2007 the Steuben County Legislature passed three resolutions pertaining to Special Children’s Services:
1) Memorializing the Governor and New York State Legislature to amend state law to mandate the prepayment of claims by health insurers for services provided under the Early Intervention Program.
2) Memorializing the Governor and the Legislature to the State of New York to support the removal of counties from the 4410 Preschool Special Education Program.
3) 3) Memorializing the Governor and the Legislature to the State of New York to prohibit the State from retroactive reconciliation of Preschool rates beyond a period of two years.
Helen Brutsman worked with Office for Aging, Public Health and Nursing Services, and Department of Social Services to initiate the NY Connects and Long Term Care single point of entry program. Even though our department traditionally is not involved with long term care issues, there are on occasion children whose care is potentially long term. Therefore, information on our programs must be available for dissemination to families who call for assistance.
During 2007, five new computers were purchased and one desk unit.
