Provider Manual

TSS SCHEDULE PROCESS

Attention All BHRS Providers and Prescribers:  Value Behavioral Health of PA, Inc. (VBH-PA) adopted a process to specifically focus prescriptions for Therapeutic Staff Support services to times of the day and week that most effectively address the treatment needs of the child and family.  This process will improve the quality of care by concentrating treatment during times when problematic behaviors occur and when the youth’s significant adults are present to transfer skills. Ultimately, the process will support resiliency and foster independent family functioning.

Through this process any prescription for TSS will include a schedule that will specify the specific times and days when the TSS is to be implemented.  The days and times when TSS will be implemented will coincide with the times when the problematic behaviors frequently occur. The schedule will be developed in collaboration with the parent and other responsible adults. The collaborative nature of the process encourages family engagement in treatment and overall empowerment.

The TSS schedule (TSS Scheduling Form) will become a part of the prescription and will be submitted with the evaluation to be reviewed during the ISPT meeting.  If the ISPT requests changes to the hours recommended, the details are recorded on the ISPT Summary Form, with an attached final TSS Prescription Schedule, to be reviewed, approved and signed off by the evaluator and parent.

The following will be required of all VBH-PA network Independent Prescribers (IP’s) regarding the TSS Scheduling initiative:

  • IP’s will be responsible for collaborating with the member, responsible adult/family, all other involved systems as appropriate (e.g. school, daycare) to determine the time and location of the problem behaviors requiring TSS intervention.
  • IP’s will be responsible for completing the TSS Scheduling Form with the TSS schedule proposed, including the activity and behaviors, symptoms, treatment focus and goal for the TSS.
  • The complete TSS Scheduling Form must be submitted to VBH-PA by the IP, attached to the completed comprehensive evaluation within seven (7) business days in order for the evaluation to be considered for payment.
  • The IP is encouraged to participate in the Interagency Service Planning Team (ISPT) meeting where the TSS Schedule may be “fine-tuned” to meet the member’s needs.
  • If there are any changes to the TSS Schedule at the ISPT, a Final TSS Schedule Form will be submitted by VBH-PA/County to the IP for review for all initial evaluations, and submitted by the BHRS Provider to the IP for review for all concurrent evaluations, and the IP will indicate whether or not they concur with the changes. Should the IP disagree with the proposed changes to the TSS schedule, the schedule will stand as written by the IP. The member will have the opportunity to obtain a second opinion and/or file a complaint.

The following will be required of all VBH-PA Behavioral Health Rehabilitation Services (BHRS) network providers regarding the TSS Scheduling initiative:

  • BHRS Providers are responsible for collaborating with the member, responsible adult/family, Independent Prescriber, all other involved systems, as appropriate (e.g. school, daycare) to determine the time and location of the problem behaviors requiring intervention.
  • If there are any changes to the TSS Schedule at the ISPT, a Final TSS Schedule Form will be submitted by VBH-PA/County to the IP for review for all initial evaluations, and submitted by the BHRS Provider to the IP for review for all concurrent evaluations, and the IP will indicate whether or not they concur with the changes. Should the IP disagree with the proposed changes to the TSS schedule, the schedule will stand as written by the IP. The member will have the opportunity to obtain a second opinion and/or file a complaint.
  • The complete TSS Scheduling Form must also be submitted by the BHRS Provider to VBH-PA as part of a “complete packet”.
  • BHRS Providers will only make changes to the TSS Schedule in accordance with the procedure outlined on the VBH-PA website (vbh-pa.com).
  • VBH-PA will routinely perform chart audits of network BHRS Providers to ensure adherence to the TSS Schedule. TSS services provided outside the agreed upon TSS Schedule are subject to non-payment or reimbursement of payments made.