Become a First Steps Multidisciplinary Agency

First Steps Multidisciplinary Agencies are the entities that enter into an agreement with the Division of Disability and Rehabilitative Services/Bureau of Child Development Services (BCDS) to manage and provide the following early intervention services to infants, toddlers, and their families within defined service areas:

• Developmental Therapy
• Physical Therapy
• Occupational Therapy
• Speech Therapy

As you consider whether enrollment as a Multidisciplinary Agency is right for your entity, you are encouraged to review the following important information:

• First Steps Mission, Vision, and Values
• First Steps Policies
• Agency Provider Agreement
• First Steps Rate Table
• Individuals with Disabilities Education Act, Code of Federal Regulations

If your entity is interested in applying to enroll as a First Steps Multidisciplinary Agency, or you are an existing Agency wishing to expand your service areas, please see below for more information regarding the requirements to apply, enroll, and demonstrate compliance with minimum standard requirements for Multidisciplinary Agencies.

Requirements for Multidisciplinary Agencies

The following minimum requirements must be demonstrated by a Multidisciplinary Agency to be enrolled in First Steps.

Multidisciplinary agencies must:

• Register the business with the Indiana Secretary of State
• Be in good standing with Department of Workforce Development (DWD) and the Indiana Department of Revenue
• The agency must ensure timely access to services within the entirety of the agreed upon service area(s) (i.e., all geographic locations within a service area must be provided with equitable service coverage)
• Maintain enrollment with a minimum of ten individual First Steps providers within each service area and a minimum number of associated billable hours per discipline. The table below illustrates the minimum provider and billable hour requirements:

• Demonstrate a structure that provides staff support, continued education and mentoring for providers, with a clear line of authority and supervision of compliance of guidelines and quality of work.
• Create and submit a written operations manual that, at a minimum, addresses the following structural and operational requirements:

Documentation

• Ensure service logs completed by all providers meet state requirements.
• Monitor service logs to ensure completeness, appropriate use of ICD-10 codes, and documentation of services provided, and ensure correction of billing errors as necessary.
• Track submission of progress reports to ensure timeliness, use of correct format, and justification of service level provided.
• Maintain billing documentation within the State’s data system.
• Provide necessary additional reporting and documentation to support insurance coverage of early intervention services upon request.

Personnel Standards Management

• Ensure that providers meet all applicable Personnel Standards.
• Manage provider enrollment and disenrollment.
• Oversee provider completion of credentialing requirements.

Training / Education

• Provide mentoring for new and inexperienced early intervention providers.
• Ensure completion of state-directed trainings within a specified time frame.
• Conduct semi-annual trainings related to provision of early intervention services.
• Educate providers regarding Agency/Provider and SPOE/Service Coordinator collaboration expectations and procedures for the respective service area(s).
• Communicate expectations for appropriate individualized service levels, including clear guidelines for reduction and discharge.

Quality Assurance

• Designate a single agency administrator for communication with state employees and contractors regarding complaints and other quality issues.
• Maintain regular communication between a designated Agency and SPOE leadership to discuss and resolve concerns and issues.
• Participate on the Local Planning and Coordinating Council (LPCC).
• Establish plan for measuring family satisfaction with service provision.
• Present a corrective action plan in the event that services are found not to be available in all parts of the service area, including remote and historically underserved areas
• Have written policies and procedures to ensure compliance with all Provider Agency Agreement obligations, including but not limited to compliance with the Individuals with Disabilities Education Act, Part C, Family Educational Rights and Privacy Act (FERPA), and Health Insurance Portability and Accountability Act (HIPAA)
• Implement corrective action plans and subsequent monitoring for providers who are found to be out of compliance with HIPAA, FERPA, or any IDEA Part C laws, rules, and policies, including the First Steps policy manual.
• Participate in all state and/or federal monitoring activities.

Application Process

To be considered for approval to enroll or expand, prospective and existing agencies must submit a complete application packet during the annual open enrollment period of April 1 and April 30. Applications submitted at any other time than the open enrollment period will be considered during the following period.

• New Multidisciplinary Provider Agency Application Packet
• Existing Multidisciplinary Provider Agency Application Packet

The above referenced application packet must be completed in its entirety. Applications must include the following information; however, applicants may submit additional information or documents to assist the BCDS in its review and determination:

• General Information (including contact information, address, and Secretary of State registration identification number)
• Proposed service areas and staffing plans
• Description of prior experience delivering services and alignment with early intervention principles and frameworks
• Description of business management, supervision, and support practices for employees/contractors
• References:
  • One (1) of the professional references must speak to experience in child development, special education, or intellectual and developmental disabilities service provision, and
  • One (1) personal reference.

Applications are to be emailed to FirstStepsWeb@fssa.in.gov.

Applications and references will be reviewed by the BCDS, and if approved, the prospective or existing agency will receive a notification of conditional approval or denial of the application.

Enrollment Process

Approved applicants, depending upon whether they are a newly enrolling or existing agency will complete the following enrollment process.

A newly enrolling agency will be connected with the Provider Enrollment and Management Team (PEM) to initiate the agency enrollment process.

• Agency enrollment must be completed within 90 calendar days of BCDS’s conditional approval notification. If not completed within 90 calendar days, the applicant must reapply during the following application period.
• Agency enrollment must be completed before individual service providers may begin to enroll with the agency.
• If the agency enrollment is completed within the required timeframe and all requirements are met, the newly enrolled agency with be sent notification by the PEM Team.

An existing agency will be connected with the Provider Enrollment and Management Team (PEM) to initiate the process to update enrollment information pertaining to new service areas.

• Updates must be completed within 90 calendar days of BCDS’s conditional approval notification. If not completed within 90 calendar days, the applicant must reapply during the following application period.
• Updates must be completed before individual service providers may begin to update their service areas to the new service areas.
• If the updates are completed within the required timeframe and all requirements are met, the existing agency will be sent notification by the PEM Team.

Conditional Approval

Conditional approval of applications and enrollment will be valid for one year following the date of the approval notification, unless terminated for failure to complete the above-mentioned enrollment/update process within the 90-day timeframe.

During the one-year conditional approval period, the agency is required to demonstrate that it meets or exceeds the full Requirements for Multidisciplinary Agencies, including but not limited to the following:

• Meeting and maintaining enrollment of a minimum of ten (10) First Steps providers within each service area, with at least two being from the following disciplines:
  • Developmental Therapist
  • Occupational Therapist/Certified Occupational Therapy Assistant
  • Physical Therapist/Physical Therapy Assistant
  • Speech Language Pathologist
• Creation and submission of an operations manual that details:
  • Agency structure, including staffing and leadership positions
  • Supervision/Support/Training for Providers and Staff
  • Referral procedures
  • Billing procedures and fiscal controls
  • Quality assurance policies and procedures
• Participating in quarterly business reviews with the BCDS to address implementation matters. Quarterly meetings will include, but is not limited to, the review of the following:
  • Individual provider enrollment numbers
  • Billing activity within the quarter
  • Quality of service log documentation

At the conclusion of the Conditional Approval year, the BCDS will conduct a final review to determine if the agency is in full compliance with the requirements of a multidisciplinary agency. Based upon the provider's compliance status, the BCDS will determine whether to:

• Grant full approval if the provider has come into compliance with all requirements;
• Issue a corrective action plan if the provider has made progress but still needs to make improvements;
• Or, decline to renew the Agency Provider Agreement if the provider has not made sufficient progress or is unable to meet the requirements of a multidisciplinary provider agency.

Inquiries regarding becoming a First Steps Multidisciplinary Agency may be directed to FirstStepsWeb@fssa.in.gov.