A Program Services Summary for Early Intensive Developmental and Behavioral intervention (EIDBI)
What is Early Intensive Developmental and Behavioral Intervention (EIDBI)?
The purpose of EIDBI is to:
- Educate, train and support parents and families of people with Autism Spectrum Disorder and related conditions
- Promote people’s independence and participation in family, school, and community life
- Improve long-term outcomes and quality of life for people and their families
Every EIDBI service must address the person’s goals for treatment deemed medically necessary to develop, enhance or maintain the person’s developmental skills to improve the person’s:
- Functional communication (receptive and expressive)
- Social or interpersonal interaction
- Interfering or complex behaviors
- Cognitive functioning
- Learning and playing
EIDBI people under are designed for people under the age of 21 who are enrolled in Medical Assistance (MA) and living with Autism Spectrum Disorder (ASD) or related conditions. These services must be provided by a qualified EIDBI provider and supervised by a qualified supervising professional (QSP). An individualized treatment plan is developed with the person along with their supporters and meets Medical Assistance requirements as defined by MN Department of Human Services (DHS).
What are the covered services available through EIDBI?
Through EIDBI the person and family supporters will receive:
- A Comprehensive multi-disciplinary evaluation (CMDE) which is also known as a behavior identification assessment and is a required comprehensive evaluation of the person. The information gathered in the CMDE is used to:
- Determine the person’s eligibility and describes the person’s medical need for EIDBI services
- Develop the person’s individual treatment plan (ITP) for services
- An Individual treatment plan (ITP) development and progress: this service covers the development of the person’s ITP and the ongoing monitoring of the person’s progress. This is a person-centered plan of care that:
- Is created using the information gathered in the Comprehensive Multi-Disciplinary Evaluation (CMDE)
- Is developed using input gathered from the person, their supporters, and service providers associated with specific settings important in growth and progress.
- Is specific about the type, intensity, and frequency of services the person will receive so that the person experiences growth and progress in targeted home and community settings.
- Coordinated care conference, also known as a medical team conference: This EIDBI service supports voluntary, face-to-face meetings between the person, his/her family supporters, EIDBI provider(s), other service professionals and/or other individuals the person/family requests to:
- Finalize and approve the comprehensive multi-disciplinary evaluation (CMDE) or individualized treatment plan (ITP)
- Integrate and coordinate services across providers and service-delivery systems to develop the ITP.
- Intervention, also known as adaptive behavior treatment: This is about the delivery of the identified medically necessary, intensive, and individually designed direct treatment. Interventions are designed and delivered specifically to address the identified person’s core skills necessary to grow and make progress on their goal. Interventions may happen in an Individual intervention session which happens in an agreed-upon period of time by a qualified EIDBI provider face-to-face to one person. A Group intervention session happens for an agreed-upon time period by a qualified EIDBI provider face-to-face with at least two, but no more than eight, people receiving EIDBI services, and where a group-based experience offers growth opportunities not possible through individual intervention sessions. All EIDBI intervention sessions must:
- Have a scheduled start and end time
- Only covers EIDBI services
- Follows the person’s ITP
- Intervention observation and direction, also known as adaptive behavior treatment with protocol modification: This EIDBI service is about clinical direction and oversight of intervention services and program modification. Only a qualified EIDBI provider can carry out this service. Intervention observation and direction is provided for the direct benefit of the person based on their needs. The purpose of the service is to ensure treatment fidelity and integrity, as well as to inform any necessary treatment and program modifications. It provides face-to-face, real-time direction to a staff person to maximize the effectiveness of:
- Generalizing new skills
- Activating the Individual treatment plan (ITP)
- Measuring progress
- Training or refining treatment techniques
- Understanding the function of behaviors.
- Family/caregiver training and counseling, also known as family adaptive behavior treatment guidance: This service covers specialized training, education and support for a person’s family supporter or caregiver. The purpose of family/caregiver training and counseling is to:
- Help families and caregivers support the person’s development by learning:
- About the person’s condition
- About other resources available to support the person and his/her family, and how to get them
- About intervention goals, so that families and caregivers can help the person use skills learned in specific settings. This positively impacts progress on treatment outcomes
- How to use techniques and strategies to reduce challenging behaviors and reinforce or increase positive behaviors and skills.
- Build family and caregiver competence and resilience
- Promote the person’s and family’s participation in home, school, and community.
- Telemedicine: Delivery of health care services or consultations while the person is at an originating site and the health care provider is at a distant site. Medical Assistance (MA) covers medically necessary telemedicine services and consultations. The telemedicine services and consultations must be provided with the same service thresholds, authorization requirements and reimbursement rates as services delivered face to face. Because EIDBI is a benefit available under MA, telemedicine is an option for some EIDBI services.
- Travel time An EIDBI service that covers the time it takes for a qualified EIDBI provider to travel to and from a location other than his or her typical place of service to provide face-to-face EIDBI services.
What services are not covered or available through EIDBI?
EIDBI Services does not include the following:
- Provider training activities for staff education and learning
- Transportation for the person
- Group or individual intervention services delivered to one person by two or more EIDBI staff of any level at the same time.
- The EIDBI benefit does not cover services that are:
- Conducted over the telephone, or via mail or email
- For the purpose of reporting, charting or record-keeping (except when this is integral to a covered CMDE or ITP service or a health service record)
- Not documented in the person’s health service record or ITP
- Primarily custodial, such as a day care or respite service
- Primarily recreational and not supervised by a medical professional (e.g., sports activities, craft activities, meal/snack time, trips to community activities tours, etc.) Exception: These activities may be covered if they are primarily for treatment and provided according to the person’s ITP
- The responsibility of a residential or program license holder (e.g., foster care providers) according to a service agreement or administrative licensing rules
- Not approved by the state’s medical review agent (except for services that do not require authorization)
- Including or replacing academic goals that are otherwise included in the person’s Individual Education Plan (IEP) or Individual Family Service Plan (FSP), as required under the Individuals with Disabilities Education Improvement Act (IDEA) of 2004.
- Provided by:
- A parent, legal guardian or another person legally responsible for the person
- A person who does not meet the EIDBI provider qualifications
- Provided in the following circumstances:
- In violation of Medical Assistance (MA) policy as outlined in Minn. R. 9505.0220
- To the general community (e.g., prevention and education programs)
- When the person is sleeping or napping
- Without the required supervision
- Not provided (e.g., appointment no-shows)
- Not provided directly to a person who is present either physically or via interactive video, with the exception of the following services that do not require the person to be present:
- Coordinated care conference
- Family/caregiver training and counseling
- ITP development