Secondary Provider

Implementation Guidance

TEAM EI Colorado Vision: Every child and family served by EI Colorado has access to a primary provider in addition to a diverse team of early interventionists that possess expertise to build family capacity to support the child in everyday learning

Definition

Secondary Provider: An additional early interventionist whose expertise has been determined necessary, through the teaming process, in addition to the primary provider, to coach and support the primary provider, family, and other caregivers directly related to the IFSP outcomes

Secondary Provider - Visit Type: Transdisciplinary home or community-based services are delivered by an additional early interventionist with the primary provider as frequently as possible via in-person, telehealth, or hybrid visit. As an infrequent exception, this visit type may need to be scheduled outside of the regularly scheduled primary provider visit. If this occurs, ongoing collaboration and communication between both providers and team discussions are necessary to support the family with this type of visit

Guidance

• Core Functions

  • Used when the team identifies a specific expertise gap that indicates a secondary provider's specific skill set is needed to support the primary provider and family to meet child outcomes

  • Children with complex needs may have a primary and secondary provider identified at the initial IFSP meeting, if needed

  • The primary provider should explain to the family that they are the main point of contact, while the full team collaborates through regular meetings to ensure consistent, high-quality services and access to multiple disciplines

• Requirements

  • Steps Before a Secondary Provider Visit:

    • Adding a secondary provider only occurs after teaming discussions have occurred multiple times, all steps for a joint visit have been completed, AND the joint visit debrief confirms the need for specific expertise to support the primary provider and family to meet the child’s outcomes

    • If a secondary provider is necessary, an IFSP review with Prior Written Notice (PWN) must be completed

      • The provider will discuss the need for a secondary provider with the service coordinator and family

    • The service coordinator will schedule an IFSP meeting and provide PWN to the family

    • The secondary provider checklist must be completed and uploaded into the data system for monitoring purposes

• Best practice

  • The primary and secondary providers schedule simultaneous visits whenever possible (in-person, telehealth, or hybrid)

  • If a simultaneous visit is not possible, ongoing collaboration and communication must occur to support the family and providers and ensure continuity of strategies

• Considerations

  • Ideally, a primary and secondary provider are sufficient, with additional joint visits occurring if specific expertise has been identified and is needed to support the primary or secondary provider

How to Implement Secondary Provider Visits

• When the team identifies an expertise gap and the joint visit result indicates a secondary provider's specific skill set is needed to support the primary provider and family to meet child outcomes, the following must occur:

  • The specific skills and expertise required beyond the primary provider's scope, which cannot be met through teaming or a joint visit, have been identified

  • The primary provider and a team-identified early interventionist with the necessary expertise discuss, schedule, and collaboratively plan a visit to be completed simultaneously with the family

  • The family is educated on why a secondary provider is needed and how they will contribute

  • The role of the secondary provider is clearly defined and communicated

  • Planning before and debriefing after the simultaneous visit is required and considered part of the collaboration process

    • There is no additional reimbursement for planning and debriefing

      • Consider planning and/or debriefing at the conclusion of the team meeting, via email, via phone call, and/or at the conclusion of the simultaneous visit with the family

    • Utilize the secondary provider checklist to plan and document the process

  • The secondary provider supports the primary provider and the family during the simultaneous visit

  • Both providers should be present for the simultaneous visit, which is intended to guide, support, and develop the primary provider

    • The simultaneous visit can be completed in person, via telehealth, or a hybrid method

  • A secondary provider visit may lead to the following outcomes

    • Ongoing secondary provider visits simultaneously with the primary provider to support the family and child to meet functional outcomes at a frequency that works best for the family

    • A shift or change to the primary provider if determined necessary

    • A joint visit for the primary or secondary provider if specific expertise is identified and determined necessary in the future

  • Utilizes evidence-based practices to coach parents on child learning opportunities during everyday routines and activities using toys and materials within the natural environment

Documentation

• *Required Documentation

  • *Individual Child Team Meeting Note

  • *Early Intervention Visit Note

Billing

• The primary and secondary providers bill following the Funding Hierarchy

• If either is not a Medicaid billable service provider, that provider bills the State

• If both the primary and secondary providers bill Medicaid, they need to communicate and collaborate on what they are working on with one another and the family during their overlapping time