P3 billing dilemma

miami85

Mon, Nov 07 2011, 7:37 pm

So I took on this P3 case in September. The kid is mandated for 5 hrs of which I service 3. Originally I didn't think it was going to work out with my schedule between work and babysitting. When I told the mother that I couldn't do the full hour and perhaps I should find someone else for her son, she said that she wasn't going to be makpid with the hour because she said her son isn't capable of working for an hour--he has ADHD and some days it is like pulling teeth to get him to work. The mother gives him his work goal for the day and that's what we do. Somedays its like 20 mins, somedays its like 45mins. The mother has said that she'll sign that we did the hour because she doesn't want me to lose out. Now I have to submit my billing, and while I want to do things honestly, I don't want the district to get upset because I'm not servicing the full hour. Does the billing go by the hour? 1/2 hr? The minute? What do you do if you can't do your full session in general?
p.s. Originally I also said I would try to make it work through the chagim, and she asked me if I could continue--I.e. she likes the rapport I have with her son. Anyone with experience in how this works?

B"H

Mon, Nov 07 2011, 7:41 pm

I dont think they mind if you do less, as long as it's not consistently significantly less than the child needs. (I can't say for sure, cuz I always try to do the max, but I work with high school kids, and never had anyone adhd. if they do call you up and give you a hard time- which I highly doubt, then you can just explain the situation.)
and the billing goes by the minute- for each session you write how many minutes you did.

miami85

Mon, Nov 07 2011, 9:18 pm

That's the thing, the mother sets the priorities for him because she knows an hour is too much for her son. We get his homework done and that's what his mother wants. Am I supposed to be doing more than that? When I offered to find someone else, I mentioned that I knew someone who was interested and when I said the name the mother said "no, we tried him already, and he pushed my son too hard." So she doesn't want to do the full hour. More often than not we work 25-35 mins.

seeker

Mon, Nov 07 2011, 10:30 pm

1. You bill by the minute. It says so on the invoice form.

2. If I have a specific time slotted for a student and they come late or leave early due to behavioral junk or whatever, but I was prepared to provide (for example) 45 minutes, I bill it as 45 minutes. The first year I did P3 I actually kept a log of how many minutes I was with the student each time, but then I realized I was not just being honest with the DOE but also ripping myself off. I'm a professional; if we book a 45-minute session and you rush in late or run off early, that is not my problem.

3. If it's consistently too much time, though, I would just shorten the time and bill for that.

4. Possible ways to deal with "an hour is too much:" Spend some of the time on a more active but still productive activity (I don't know your kid. But let's say, put numbers on the floor and jump to the one that answers the math question...). Make a deal like "5 (or 10, depends just how little stamina the kid has) minutes on task, then 5 minutes of a fun game" and repeat.

5. My assumption is that the kid is lacking academic skills, and getting through each night's homework is not going to be enough work to fill them in. Mom is doing the kid a disservice by insisting that you stop at homework. You're the professional here, if you have the time available in your session, you're the one who should decide what will benefit the student. I do understand about parents, though, so if there's nothing you can do... whatever. A shame.

6. The district won't be "upset." First of all, I've never actually seen them keep track that well. Secondly, most kids are down for "x periods per week" and most school periods are 40-50 minutes. I rarely get an hour... You do what you can.

HTH!

miami85

Tue, Nov 08 2011, 6:41 am

With this student a) he's in 3rd grade so I can't make "silly" games. b)In his case he has ADHD and quite possibly dyslexia. He can read the same word 4 times in a paragraph (it can be the word "what") and have difficulty each time. He comes home from school at 4pm and he's tired--probably both physically and mentally. The mother wants the P-3 to help him get through his homework. Then there's also the issue of the mother feels bad that her son can be difficult and she doesnt want me to lose out so she's willing to sign off on the hour. I can't do the hour. Most days thought I did allot 45-50 mins. What do I do?

seeker

Tue, Nov 08 2011, 10:59 am

a) Why no silly games in 3rd grade? He's only 8 or 9, and whatever the age, whatever works...works.

b) If he has "quite possibly dyslexia" then he quite probably needs more support than he'll get in homework. How else will he build the skills that will bring him up to speed?

c) Yeah, the coming home late and tired is the big problem with all after-school therapy. Nothing will actually fix that, all you can do is be compassionate and go a little easy on the poor kids... but not easy enough to let all the work go. Does he have time for some fun between school and you? Any chance of a Sunday session?

d) The way I see it, you're not "losing out" if you're being paid for the amount of work you're doing. If you do x hours, you bill for x hours. If you need to be earning x+3 hours, go look for another 3 hour case and work another 3 hours. There is definitely demand for those few people willing to work evenings. "Losing out" is when you agree to add a kid to a group because the parents tell you he's approved, and then the form doesn't show up until a month later and you don't get paid for the work you did. "Losing out" would also be if you agreed to work with the kid from 5:00-5:40 but he was running around with his sister in the backyard and Mom didn't discipline or insist that he come to you until 5:15, in that case I'd work until 5:40 and bill for the full 40 minutes. Or I'd work until the kid burns out and bill for 5:00 until whenever we ended.

miami85

Tue, Nov 08 2011, 9:08 pm

My student is VERY difficult to motivate especially if an assignment appears daunting--but just as difficult if an assignment is TOO easy or appears to be pointless/busywork. He's fine with sitting and doing nothing if it means doing the assignment at a different time. He is just starting to be able to read for 25-30 mins, but only with very low level books, otherwise he tires very easily.
By losing out I mean--I'm available for working with him, but he can't work the whole time. If I have 45-50 mins to work with him, but he's only able to work for 25-35 mins, then I'm losing out. I can't very easily squeeze in another case within my time constraints. I can't do Sundays--besides he has another P3 provider who comes on Sunday. Originally when I told the mother that I wasn't available on 2 days so can we do a "double session" she said that there's no way her son could handle that.
Also what is proper protocol if the student comes home late?

seeker

Tue, Nov 08 2011, 10:47 pm

Look, I don't know your student, it's your call how much work he can handle. If you sometimes get in a good 50-minute session, then you could justify leaving it at that - I come prepared for 50 minutes, and if the kid doesn't cooperate it's not my problem. But if he never lasts more than 35 minutes I don't see how you can possibly justify billing for 50 minutes per session. If you need a 50-minute case but only have time for one case, then I'd drop this one as soon as I could find another.

It's your personal decision. We finished the discussion of how P3 billing works, now we're heading into ethics, and I hate moralizing...

miami85

Sun, Nov 13 2011, 10:43 am

Follow up:
I received this email from someone I emailed at the NYC DOE:

You should always indicate the length of time you actually provided services and not the recommendation time of 60 minutes. It would be a problem to combine sessions, increase the length of a session or indicate that you provided services the entire session. If you are questioned the parent can confirm that you are providing a decreased session as per their request.
---
Additionally I noticed the exact wording on the bottom of the form is "Total Number of Sessions ___ Rate:____ Total Amount Due:______" SO while you are notating the "length of session", I believe you bill for the # of sessions.

Now for another question: It says "Mail originals to Ms. Lisa Anderson NYC Dept of Education" but there's no address on the form! Does anyone know the address?
Thanks!

amother

Sun, Nov 13 2011, 11:06 am

It's not unusual for a kid to get 45 or 50 minutes for sessions, or get 4 out of five sessions etc. As long as they are getting enough for their needs. As for billing, bill for the time you teach. If you allot 30 minutes and that day it was actually 25, I don't think you need to count each minute each time. Personally if a sessions goes a bit short for any reason, I give the student a few extra minutes the next time so it rounds out for the most part. I don't think you need to calculate a different amount to the minute for each and every session- just talk to the mother about how long the sessions should be and as long as they are a few minutes less or more, just bill for that.

And btw for a kid who can't sit- why not break up the session in the middle (and at the end?) with a game/movement activity/snack/drink so you can get a bit more time in the session?

seeker

Sun, Nov 13 2011, 12:08 pm

miami85 wrote:

Follow up: ....
---
Additionally I noticed the exact wording on the bottom of the form is "Total Number of Sessions ___ Rate:____ Total Amount Due:______" SO while you are notating the "length of session", I believe you bill for the # of sessions.

Now for another question: It says "Mail originals to Ms. Lisa Anderson NYC Dept of Education" but there's no address on the form! Does anyone know the address?
Thanks!

1. OK, so you don't want to trust me. Don't be surprised when your check comes for half the amount you billed for. BTDT.

2. The address for billing is:
Ms. Lisa Anderson
NYC Board of Education
Bureau of Non-Public School Payables
65 Court Street - Room 1503
Brooklyn, NY 11201
(I'm looking at a slightly old form and trying to remember if the room number changed...)
Remember to send a copy of the P-4 approval and a substitute w-9 form!

miami85

Sun, Nov 13 2011, 1:59 pm

Its not that I don't trust you, I'm basing my presumption on the wording of the form along with the email that I received. The mother and I have a mutual agreement. I'm not trying to short shrift him, I'm trying to serve him the best I can given my time constraints as well as the kid's attention span/motivation level.

seeker

Sun, Nov 13 2011, 2:04 pm

Let me know if you turn out to be right, I could be making a small fortune. ALL of my sessions are 40-45 minutes as per the school schedule where I work!

The first year I billed per session under the same assumption as you're making and got paid that way until January. Then suddenly my checks shrank. I called them and they said they're paying by the hour. NASTY SURPRISE! Also, the letter that comes back with the P-4 approval always says "The provider named on the form has been approved blah blah blah at the rate of blah blah hourly."

It sure would be exciting to get paid by the session. This is not the most lucrative job in other ways, considering you're at the mercy of a kid's schedule - a case of flu for him means a week of no work for you, no paid holiday vacations or anything, etc.

Good luck and please do let us know what happens!