Famspring Client Handbook

Policies and Procedures

Welcome to the Famspring family! This handbook has been prepared with the intent of informing clients of Famspring’s policies and having their questions answered. This handbook will serve as a reference for important topics that clients often have questions or concerns about. Parents are welcome to reach out to the provider at any time regarding their concerns.

Contents

Section 1: General principles…………………………………………………………………………………………………………………………………………………………..2

Mission……………………………………………………………………………………………………………………………………………………………………………………………………..2

Section 2: Service Delivery………………………………………………………………………………………………………………………………………………………………2

Life Cycle…………………………………………………………………………………………………………………………………………………………………………………………………2

Consent to Services…………………………………………………………………………………………………………………………………………………………………………..2

Weekly Schedule…………………………………………………………………………………………………………………………………………………………………………………3

Session Structure………………………………………………………………………………………………………………………………………………………………………………..3

Preparation for sessions…………………………………………………………………………………………………………………………………………………………………4

Parent participation…………………………………………………………………………………………………………………………………………………………………………4

Section 3: Health Insurance………………………………………………………………………………………………………………………………………………………….4

Billing……………………………………………………………………………………………………………………………………………………………………………………………………….4

Service Denials…………………………………………………………………………………………………………………………………………………………………………………….5

Insurance changes…………………………………………………………………………………………………………………………………………………………………………….5

Other expenses…………………………………………………………………………………………………………………………………………………………………………………….5

Section 4: Scheduling & Cancellation Policy…………………………………………………………………………………………………………………………..5

Scheduling………………………………………………………………………………………………………………………………………………………………………………………………5

Office Closures………………………………………………………………………………………………………………………………………………………………………………………5

Cancellations…………………………………………………………………………………………………………………………………………………………………………………………6

Sick Policy…………………………………………………………………………………………………………………………………………………………………………………………………6

Covid-19 Guidelines and Policies…………………………………………………………………………………………………………………………………………………..6

Inclement Weather………………………………………………………………………………………………………………………………………………………………………………6

Staff Cancellations……………………………………………………………………………………………………………………………………………………………………………….6

Section 5: Privacy and Confidentiality…………………………………………………………………………………………………………………………………………6

HIPAA Compliance………………………………………………………………………………………………………………………………………………………………………………..7

Release of Information………………………………………………………………………………………………………………………………………………………………………..7

Audio/Video Consent…………………………………………………………………………………………………………………………………………………………………………..7

Telemedicine……………………………………………………………………………………………………………………………………………………………………………………………7

Section 6: Staff Performance and Relationship……………………………………………………………………………….…………………………………………8

Staff performance…………………………………………………………………………………………………………………..……………………………………………………………….8

Professional Boundaries.………………………………………………………………………………………………………………………….…………………………………………………8

Driving.…………………………………………………………………………………………………………………………………………………………………………………………………………………8

Section 1: General principles

Mission

Famspring is committed to serving children ages 3-17, helping them navigate the world ahead of them. We do this by systematically teaching skills that are required to build independence and social relationships. Famspring is equally committed to supporting the families and solve complex behavioral challenges.

Section 2: Service Delivery

Life Cycle

Famspring delivers Applied Behavior Analysis services that is approved by the Board of Behavior Analysis (BACB). Services are delivered by a Certified Behavior Technician (CBT) who is supervised by a Board Certified Behavior Analyst (BCBA) multiple times a week. The BCBA meets with the parents regularly to review progress, changes and parent training.

The lifecycle of services provided includes

• Intake
• Initial Evaluation
• Treatment/Intervention
• Half-yearly assessments to review/update the treatment plan

Consent to Services

Parents are required to consent to the treatment plan prior to their child receiving treatment. If the child is able make their own decisions, the BCBA will use their discretion to act based on a joint consent from the parent and the child.

The team members and their responsibilities are as follows

	CAN DO	CANNOT  DO
BCBA	Create programs/goalsSupervise CBTsConduct parent trainingsCollaborate with other providers (IEP team, SLP etc)Update treatment plan	Provide services without an autism diagnosisMake recommendations without conducting assessmentsProvide non-evidence based treatment
CBT	Implement programsTake data	Supervise other professionalsMake changes to programsTrain parentsMake recommendations without consulting with supervisorBabysit/nanny/academic tutorTransport clients in their car

Famspring makes every attempt to hire competent behavior technicians who will be a good fit for your family. A lot of effort goes into making this a successful relationship. They undergo regular training and are required to incorporate corrective feedback in order to help the child make progress and for their own professional growth.

Weekly Schedule

Therapy schedule is determined based on the client and provider’s availability, client’s needs and the number of hours authorized by the client’s insurance. The BCBA is required to supervise for at least 10% of the total weekly treatment hours. Parents are required to participate in weekly parent training meetings which includes both formal and informal meetings with the BCBA related to the client’s goals and progress.

Session Structure

The sessions usually start with rapport building during which time the therapist engages in preferred activities with the client. This happens at various times during the session, because building a strong relationship is vital to successful outcomes. During the initial stages of the treatment, this might occur more often. Parents are welcome to join in and recommend activities that the client likes.

Once a successful relationship is built, the therapist starts working on specific goals written by the BCBA. Majority of the goals will be worked on in the natural environment to promote generalization. Some programs may require to be taught in a more structured setting which will be arranged by the therapist. The therapist will be recording data at various times during the session and update session notes during the last 10-15 minutes of the session. Once the therapist has a good understanding of the client’s behaviors, they will start implementing programs in the community such as parks, grocery stores etc.

During supervision, the BCBA reviews data, updates programs, observes and provides feedback to the therapist. The BCBA will model the implementation of programs whenever there is a change. Mastered skills will be assessed intermittently to ensure skills are maintained and generalized.

Parent training meetings can take place during the session or a separate meeting can be scheduled, depending on the availability and convenience of the parents.

Preparation for sessions

At least one parent or an authorized adult should be present in the home during sessions. They are requested to notify the therapist of any important changes and/or health concerns that might affect behaviors, as soon as the therapist arrives. This includes information such as

• Changes in medication
• Lack of sleep
• Dietary needs/changes
• Toileting changes
• Displaying symptoms of an infectious disease
• Exposure to Covid-19
• Major changes in the environment/house

Parent participation

Parent/family participation is key to successful intervention. Parents, grandparents, siblings, other family members and/or caretakers are welcome to attend parent trainings. Expectations from parents include

• Carrying out recommended interventions to help generalize goals outside of therapy
• Be present at meetings on an agreed upon schedule, to discuss goals and progress
• Reply to emails in a timely manner
• Notify Famspring of any schedule changes at least 48 hours in advance
• Insurance companies expect evidence of parental involvement. Non-participation may affect the authorization of services for future treatment periods.

Section 3: Health Insurance

Famspring makes every effort to make ABA services affordable for families. We are in-network with some of the major health insurances in the region and upon request willing to get contracted with other insurances. However, there are costs that the family may incur based on their coverage, which mostly includes the deductible during the beginning of the year. Families are required to take responsibility for such payments that are not paid by insurance.

Billing

In-network rate is the $ rate that the insurance company negotiated with Famspring. We bill your insurance after every session. It takes between one and three weeks for the payment to get processed and the following outcomes can be expected

If the family hasn’t met the deductible or has a copay, both the family and Famspring will get notified by the insurance company. In such cases, Famspring will send an invoice to the family. You can make payment using your HSA (health savings) card / check / personal credit or debit card

If the family has met the deductible and has no copay, your insurance will directly pay Famspring and both parties will get notified

At the end of every month, you will receive an invoice listing all the services billed. Families are expected to make any outstanding payments within 15 days from the invoice date.

Service Denials

Famspring will take care of resolving any payment denials that are due to an error on the provider’s end. If not, families are requested to call their insurance to have the problem resolved.

Insurance changes

Families are requested to notify Famspring as soon as possible if there is any change in the insurance plan or insurance provider, to ensure continued coverage.

Other expenses

We may have to purchase materials for your child’s programming needs. If the materials are going to be of long-term use to you or your child, you are requested to bare the expenses, otherwise, Famspring will pay for them. In order to ease costs, families are advised to make the following arrangements when the client starts doing community outings

• Shopping budget for your child who is learning shopping skills and/or needs to pay for preferred items
• Reduced fare ORCA card for using public transportation, that allows the therapist to accompany the learner for free

Section 4: Scheduling & Cancellation Policy

Scheduling

Famspring will make every attempt to schedule sessions at times that are convenient for the family. We make sure that we schedule sessions with a behavior technician who will be a good fit to work with the family. It is best not to involve BTs in scheduling, and hence parents are requested to send scheduling requests to the BCBA.

The number of hours recommended by the BCBA is based on the client’s needs and the hours authorized by insurance. 

Office Closures

There will be no sessions on these federal holidays:

• New Year’s Day
• MLK Day
• President’s Day
• Memorial Day
• July 4^th
• Labor Day
• Thanksgiving and Black Friday
• Christmas eve and Christmas day

However, it is up to the therapist and family’s discretion to hold sessions on these days. Therapists are encouraged to take these days off to rest and recharge.

Cancellations

Families are requested to notify any pre-planned cancellations at the earliest, so that the therapist can be placed with another client during that time. In case of last-minute cancellations i.e less than 24 hours before a planned session, some part of the hours might be utilized for program development which is billable. Unless absolutely required, last minute and/or frequent cancellations is highly discouraged, as it may affect the progress of treatment for the child.

Sick Policy

If your child is sick or any of the family members have symptoms of a contagious infection, please text or call your BCBA to cancel at the earliest. Sessions will resume once that member is symptom free for 24 hours.

Covid-19 Guidelines and Policies

Famspring staff work with a number of high-risk clients – younger children who are not eligible to get vaccinated, children with comorbid medical conditions and family members with pre-existing conditions. Due to this, we require that all eligible family and staff members are vaccinated, unless documented evidence of exemption due to a medical reason is provided. We will keep a close eye on changing Covid-19 restrictions and follow the guidelines recommended by CDC.

Inclement Weather

In case of inclement weather causing unsafe driving conditions, the session will be cancelled. You will be notified in such cases.

Staff Cancellations

All of the above policies apply to staff members too. Families will be notified of any pre-planned staff cancellations. We will try our best to have minimal cancellations, as we are aware that this can be disruptive to your child’s progress. Please have alternative arrangements made in case of last-minutestaff cancellations due to an emergency, sickness or weather conditions.

Makeup sessions can be arranged for cancellations as long as both the client and BT are available. Please talk to your BCBA to schedule makeup sessions.

Section 5: Privacy and Confidentiality

We have a huge commitment to maintain client’s privacy. All documentation and information collected during assessments are considered Protected Health Information. Famspring will use this information solely to determine treatment goals, consult with other providers working with your child and to provide documentation to the insurance company in case of a medical records audit.

HIPAA Compliance

Famspring is required by law to conform to the Health Insurance and Portability and Accountability Act of 1996 (HIPAA). Your records will be stored securely in HIPAA compliant electronic cloud storage (Google Drive) and BehaviorSoft (ABA Practice Management Software).

Release of Information

Famspring will get parent’s consent to release/share information with other providers, in the interest of the client. Collaborators may include school teacher, SLP, OT and social group coordinator.

However, it is not required to get consent, if required by law in cases such as

• suspicion of abuse and neglect
• release mandated by a judge during legal proceedings
• suspicion that the client poses extreme danger to themselves or others
• for law enforcement purposes

Audio/Video Consent

Famspring staff may need to audio or videotape assessment and/or treatment sessions for supervision purposes. In the event that audio or videotaping is necessary, parents will be informed and asked to give written consent prior to taping. The recorded material will be used only by staff members exclusively for supervision and training. If the assessment or treatment involves formal research that goes beyond normal evaluation or clinical procedures, parents reserve the right to consent or refuse to participate.

Telemedicine

Sometimes supervision and/or parent training may have to be conducted through telemedicine if insurance allows it, for the following reasons

• medical necessity
• extreme weather conditions
• pandemic

Famspring will use HIPAA compliant software for telemedicine and ensure that the meeting takes place in a private location where client confidentiality can be maintained. Telemedicine will not replace in-person visits.

Section 6: Staff Performance and Relationship

Staff performance

The program managers at Famspring will conduct regular supervision to assess staff competency, and provide ongoing feedback. In addition, performance reviews will be held annually. All staff members will undergo clinical training and have opportunities for professional development. If parents have any concerns about staff performance, it is best to notify the BCBA in charge or the owner.

Professional Boundaries

Famspring cannot be used as a tutoring service. Health insurance companies will not reimburse for academic services, unless they are documented in the treatment plan as functional goals.

Famspring staff cannot be used as baby sitters or help with chores. This will constitute as a dual relationship which is against the rules set forth by the Board of Behavior Analysis. Evidence of babysitting constitutes the following

• Adhoc session during the time when session is not scheduled
• Accompanying the child to family gettogethers/parties/classes without a documented goal that is being worked on
• Taking care of siblings, or leaving a young sibling unattended during sessions

Driving

Famspring staff cannot drive your child in their car unless agreed upon by the whole team which includes parents, therapist and BCBA. But the therapist can ride in the client’s vehicle if required.

Family and client satisfaction is of utmost importance to us. We look forward to working with your family, celebrating your child’s progress and having open conversations about your concerns. We are all a team working in the best interest of your child!

I have read and understand the above policies.

________________                                        _________________                            ____________

Parent/Guardian                                             Signature                                                            Date