TheraTree Pediatric Therapy - TheraTree Blog #tipsTheraTree Pediatric Therapy - TheraTree Blog #tipshttps://www.theratreepeds.com/blogs/tag/tipsWed, 12 Nov 2025 18:53:20 -0800http://zoho.com/sites/<![CDATA[KY Medicaid Annual Renewals]]>https://www.theratreepeds.com/blogs/post/medicaidThe Kentucky Department for Medicaid Services (DMS) is resuming annual Medicaid renewals which may effect your child's coverage. This blog has important information to help prevent patients from losing Medicaid coverage.]]>

Avoid Loss Of Medicaid Coverage

The Kentucky Department for Medicaid Services (DMS) is resuming annual Medicaid renewals which may effect your child's coverage. During the COVID-19 Public Health Emergency, DMS  stopped all annual renewals to facilitate Medicaid beneficiaries keeping their coverage during the Emergency. Because the Public Health Emergency was ended at the federal level, annual renewals have resumed. This blog has important information to help prevent patients from losing Medicaid coverage.


Critical Bottom Lines: 

  1. Medicaid must have your current and up to date information to avoid loss of coverage. If your contact information has changed or is incorrectly listed, you may miss your notification of renewal.  Verify and update your mailing address, phone number, email and other contact information as soon as possible by visiting kynect.ky.gov​​ or calling 855-459-6328.
  2. If your child's benefits are managed by an MCO your child may have a change of coverage during their review whether passive or actively renewed. Currently, MCO's are holding KY Medicaid accountable for coverage during the review period. Therefore if a healthcare service is provided during this review and the provider is unaware of your review, your service may be denied due to no prior authorization. Medicaid has yet to provide a mainstreamed solution for coverage during the renewal process. 

Different Renewal Requests and Actions

Passive Renewals: Members who have up-to-date and verifiable information in the system can be passively renewed. This means that Medicaid has all information necessary to make an automatic renewal determination within their records to ensure they remain eligible. These individuals will receive a Notice of Eligibility and will not need to act. The Notice of Eligibility notifies a member that their coverage has been continued. 


Action Required for Renewals: Members that are missing specific pieces of information will receive a Request for Information (RFI). A RFI requests additional information to support Medicaid in accurately determining a member’s eligibility. Members who receive a RFI must respond to the RFI prior to their renewal due date to ensure their renewal can be accurately and timely processed.


Additional Action Required for Renewals: Members in which Kentucky Medicaid requires more information from the member because they cannot be passively renewed by the system will receive a prepopulated Renewal Packet. A Renewal Packet requests additional information from the member to be updated within kynect. This information must be submitted prior to their renewal due date to ensure their renewal can be accurately and timely processed and coverage can continue.

Different Renewal Requests and Actions

Members renewal and redetermination date, timelines, and status information is available on  kynect in your benefits page.

  • April 2023: Initial notices of renewals sent to individuals enrolled in Medicaid. 
  • May 2023: Renewal process has restarted. 
    • 90 days prior to member’s end date, members will receive an email and SMS communication from the state that their renewal is upcoming.
    • 50-60 days prior to member’s end date:
      • The state will attempt to automatically renew a member’s benefits.
      • In cases where Medicaid cannot automatically renew benefits, 50-60 days prior to member’s end date notices will be sent out. This means that members will receive notices within the first 2 weeks of a month before the month of their end date.
      • If there has been no response from a member by the 15th of the month of their end date, members will receive follow up outreach to request response and information.
    • End Date of Coverage: 
      • It is important for members to provide all requested information before their renewal date to avoid discontinuation of coverage.
      • Coverage will end for members who are determined to be no longer eligible on their posted renewal date. 
      • Members who do not respond to requests for information or submit their renewal packet information may also be determined ineligible based on lack of information. 
  • April 2024: All initial renewals will be complete and additional annual renewals will continue to occur.


Download Instructions for Viewing Your Renewal Date

Important Communication

The most important action is to  update your contact information in kynect (https://kynect.ky.gov/). Submit multiple ways to be contacted by Medicaid within their kynect profile (e.g., home address, email address, phone number). 


All communications will come from the state Cabinet for Family and Health Services (CHFS) and the Department for Medicaid Services. Check your communication preferences on kynect. 

  • Postal Communication: If you have opted in for paper communications, this will come via postal mail. 
  • Digital Communication: If a member is opted in for digital communications, the notice will be shown in their message center and an email and/or SMS will be sent. 
    • Opt in to receive email and SMS messages on your kynect account as well as with your health plan to ensure you receive all information in the most efficient manner. 
    • Other providers or representatives from your health plan may reach out about your upcoming renewal, but any request for information (RFI) or Medicaid renewal packet will only come from the state.
    • Please note that the state is exempt from the Telephone Consumer Protection Act when communicating with members about their benefits.


Ways to get Information:

  • Kentucky PHE website: https://medicaidunwinding.ky.gov
    •  If there are specific questions about the Medicaid renewal process, Medicaid members can access information sheets and guides here.
  • Monthly Stakeholder Meetings: 
    • Every third Thursday at 11:00 EST. 
    • ​You can register for the June 15, 2023 session through this registration link​​.
    • If you have any questions for DMS that you would like for us to speak to during the upcoming monthly meeting, please submit those questions through this survey. 

How to Renew

Information can be submitted in various means. Members will receive a notice that only requests the information necessary, based on their specific situation, to make a determination. The types of documents needed will be clearly communicated to the member.



1. Complete and Return Forms:

  • Fill in all requested information
  • Return by fax to 502-573-2005 or 502-573-2007
  • Return by mail to P.O. Box 2104, Frankfurt, KY 40602



2. Self-Service Portal:



3. Connecting with kynect or DCBS:

  • Kynect
    • Hours: Mon-Fri 8:00 am to 4:30 pm ET
    • Call  (1-855-459-6328) 
    • Find and visit a kynector or agent office HERE. 
  • DCBS
    • Hours: Mon-Fri 8:00 am to 4:30 pm ET and Saturdays from 9:00 am to 12:00 pm ET
    • Call (1-855-306-8959) 
    • Find  and visit a DCBS office HERE.
Download kynect benefits FAQ

Income Verification: If verification of income is requested, Documents are required for proof of income and will need to upload any of the following:

  • Wage stubs
  • Written statement from or a collateral contact to the employee
  • Previous year tax return
  • Award letters for things such as Retirement, Survivors, and Disability Insurance (RSDI) or Unemployment Insurance Benefits (UIB)
  • The state’s various data sources such as eligibility advisor or state wage data for the previous quarter
  • Personal records for those who are self-employed 
  • “No income” status can be verified through client attestation, through collateral contact to a non-household member, a signed written statement from a non-household member, or Form PAFS-702, Proof of No Income.

Social Security Disability Insurance

The Medicaid renewal process will impact members who currently have Medicaid and are on SSDI. Medicaid will attempt to determine individuals on SSDI Medicaid eligible in another category. If Medicaid is unable to make this determination, the member will be determined ineligible and will receive a termination notice (will no longer receive Medicaid benefits).

MCOs

MCO partners will conduct outreach to members who have received a redetermination package or a request for information from the state. MCOs will help members understand what actions they must take and connect them to navigators or kynectors to provide additional support or guidance, as appropriate. MCOs will outreach to individuals administratively terminated for up to 90 days after their end date to encourage they submit information. 


A member submitting required information and determined eligible within the 90 days will have coverage retroactively reinstated to their end date. MCOs will also outreach to members who have been determined to no longer be eligible for Medicaid to support them in identifying alternative health care coverage options such as a Qualified Health Plan on kynect.

Waiver Participants 

Appendix K  Waiver flexibilities will extend 6-months beyond the end of the PHE May 11, 2023  extending waiver flexibilities to November 11, 2023. This extension is to allow 1915(c) HCBS waivers return to normal operation. Appendix K cannot remain in place beyond its approval end date. To make Appendix K updates permanent, changes would need to be incorporated into the current waiver applications and submitted to CMS for approval. Additionally, waiver-related Kentucky Administrative Regulations must be updated and approved.

All waiver participants will go through a redetermination during the 12 months. For detailed information, please see the 1915(c) HCBS COVID-19 and Appendix K FAQ. There is an outreach plan to support waiver members through the PHE unwinding period. Kentucky is actively preparing for the future of our waiver programs to ensure we continue to support waiver participants as well as possible. 

Ineligibility & Disqualifications

If a member is determined to no longer be eligible for Medicaid, they will receive a discontinuance notice that fully explains the reason for no longer being eligible. The discontinuance notice will also indicate the options to appeal the decision. 


All members have a right to appeal if they do not agree with the decision. Members who have been determined ineligible have 90 days from their Medicaid renewal due date to submit all requested information and be determined eligible for Medicaid coverage. Their coverage will be reinstated back to their end date automatically. If a member submits the requested information and application within 90 days from their Medicaid renewal date and is determined to be eligible, they will have their Medicaid reinstated back to their end date automatically. If a renewal is pending for state action at the time of the member’s renewal date, the member’s coverage will be extended until a determination is made. If no longer eligible, the member’s coverage will end on the first day of the following month.

]]>Sat, 03 Jun 2023 11:31:27 -0500<![CDATA[The 4 Functions of Behavior]]>https://www.theratreepeds.com/blogs/post/the-4-functions-of-behaviorImagine this: You are grocery shopping and, in the aisle, next to you, you hear a child arguing with their parents. They won’t stay seated, and they a ]]>

by Lauren Haire, RBT

Imagine this: You are grocery shopping and, in the aisle, next to you, you hear a child arguing with their parents. They won’t stay seated, and they are yelling. It is very common to watch a child “act out” in public with their parents. You sometimes think, “can they just tell them to stop and be quiet?” It is not always as simple as that. 

As a parent and professional that works with children, it’s important for you to understand the 4 functions that drive behaviors that you see in children. Children with Autism can often struggle to communicate and engage in problem behavior to get their point across. 

ABC's of Behavior

Behavior can be broken down into 3 parts to determine the function: 

  • The antecedent is what happened prior to the behavior of concern.
  • The behavior is the behavior of concern.
  • The consequence is what happened after the behavior was demonstrated. 
Example: Lauren saw the toy on the counter and began to cry. Her mom gives her the toy. 

The antecedent is that Lauren saw the toy, the behavior is when she began to cry, and the consequence was her mom giving her the toy. The function here is that Lauren was looking for access to a tangible (to get something.) Her mom gave her the toy which extinguished her crying behavior. 

4 Functions: SEAT

A child's behavior is always functional - they're behaving a certain way for a reason. There are four main functions/reasons for a child's behavior. The easiest way to remember the functions of behavior is with this simple acronym. SEAT. Sensory, Escape, Attention, and Tangibles. 

Sensory

The sensory function provides stimulation from the world to the brain. Sensory information can be in the form of touch, sound, visual, smell, taste, movement, or pressure. 

When does it happen? Children seek out this sensory information because their body can’t get enough of it to use functionally OR they’re overriding a different sensation. In many children with Autism, this shows up as stimming. It can occur at any time, especially when anxious or excited. 

How can I help? Redirect to more appropriate behavior that offers similar sensation. If you notice any behaviors that indicate a sensory deficit, you may benefit from receiving a free screening from one of our occupational therapists to address sensory needs. Occupational Therapy can address deficits related to sensory modulation (I.e. sensory over responsiveness or under responsiveness), sensory discrimination(i.e. attention), and sensory based motor(i.e. motor planning, balance, and postural adjustments.)

Example, a child may exhibit signs of overexcitement. You can relieve that need to release energy by allowing the child to go for a walk or riding a bike. 

Escape

The function of escape removes undesired activities, interactions, or situations. The child is getting out or away from the situation, environment, or task. 

When does it happen? It can occur when the tasks are understimulating, too easy, too hard, boring, or just completely undesired. 

How can I help? Provide a “first, then” prompt, offer choices, or alter the length of task. 

Example: “First clean up, then you may go watch tv.”

Attention

The function of attention provides access or awareness to/from people or interactions. It’s important to consider what kinds of attention the child likes and how much and when they’re currently getting attention.

When does it happen? It occurs when social attention is desired. 

How can I help? You can provide positive reinforcement or attention before the behavior occurs, so they don’t “need” to do the problematic behavior. 

Example: “Great job picking up. I like that you are following my directions.” 

This statement gives positive reinforcement for picking up and following directions while feeding the potential attention seeking behavior. If we reinforce the negative attention seeking behavior, we could risk making the behavior worse. So, it’s important to reinforce only the positive things your child is doing during a difficult situation. 

Tangibles

The function of access to tangibles provides preferred activities/items. This is what we usually think of as a “reward”. Although rewards don’t always need to be tangible to be considered reinforcing. We can use tangible rewards to help each then fade them. 

When does it happen? It occurs when there is a preferred activity or item desired. 

How can I help? There are several different ways you can approach this.


- You may teach the child to verbalize their wants and needs.

- If your child is nonverbal, teach sign language, use pictures to communicate (ABA uses Picture Exchange Communication), or assistive device like an iPad. 

- Contrive teaching situations at home and this goes along with teaching the child to verbalize wants and needs. 

For instance, let’s say your child loves to listen to songs on their iPad/tablet. As you listen to the song, try to pause and play the song. When the song is paused, verbally prompt the child to say ‘Play it.’ Praise the child heavily: ‘Great saying play it.’ And then immediately play the song. Again, this is just an example of how to use a highly preferred item as a teaching moment. 

You can prompt your child to request based on their needs and level of language skills, then gradually fade the prompt. Remember, reinforcement increases the occurrence of behavior whether it is positive or negative. 


We're Here to Help!

Don’t forget that “SEAT” is your go-to acronym when deciphering your child’s function of behavior. By contriving teaching situations in the natural environment, you can help your child practice communication skills, social skills, and give them the ability to communicate their sensory needs. Take ABC Data to keep track of behavior and present data to your pediatrician and/or your Board Certified Behavior Analyst (BCBA.) Your child may benefit from ABA Therapy or Occupational Therapy to assist in these behaviors!

Behavior can be complex! That’s why professionals have specialized in this science and are devoted to educate and help. If your child engages in challenging behaviors, you don’t have to figure it all out on your own!

We want to help. Call or text us at 270-688-8449 or email newpatients@theratreepeds.com to schedule a free screening or comprehensive evaluation. Let’s decrease your overwhelm and increase your relationship with your child together!

Get Started Now
]]>Thu, 13 Jan 2022 11:34:00 -0600<![CDATA[New Year's Resolutions and How to Actually Achieve Them]]>https://www.theratreepeds.com/blogs/post/new-years  The most common resolutions people typically make are to lose weight, to save money, to learn a something new, to become more organized, to stop ]]>

 The most common resolutions people typically make are to lose weight, to save money, to learn a something new, to become more organized, to stop smoking/drinking, and to become overall healthier (eating homecooked meals versus fast food, buying a gym membership, going to bed earlier, finding a new, less stressful job, etc.). One on-line poll in 2020 showed that by about 68% of people give up on their goals after approximately 32 days. The most common reason: lack of discipline. Other factors for abandoning these resolutions included busy schedules, not having “enough time,” and even peer pressure. So the question is: How does one make a New Year’s Resolution and actually follow through with it? Generic answer: Hard work and commitment. 

Don't Think it - ink it!

Every New Year’s Resolution that a person makes is an attempt to fulfill something within their basic needs; To satisfy quality world pictures. Something to make their lives a little bit better. No one ever makes a resolution to make things worse. However, having another commitment to fulfill is often times very stressful and ultimately discarded because one already has “too many irons in the fire.” But these Resolutions should be viewed as a form of self-care and most people tend to put taking care of themselves at the bottom of that list. As this list continues to grow with other obligations, eventually, the resolutions are taken off the list. In order for these resolutions to be achieved, resolutions must become a priority! (Using concepts of Dr. William Glasser’s Reality Therapy and Dr. Robert Wubbolding’s WDEP system, this is where I tell you how!)

By Jacob L. Wright, M.Ed., LPCC-S, NCC

Reviewed and Edited by Michael Fulkerson, LPCC-S and author of Treatment Planning from a Choice Theory Perspective



Well, it’s that time of year again. The Time of year people start thinking about those promises to themselves that they’re not really going to keep. Every year, many people create a New Year’s Resolution with good intentions of keeping them, but soon throw them out along with all the boxes and wrappings of the holidays. In the beginning, these people are very determined and motivated to make changes in their lives. Why? By the end of the year, most people are stressed and overwhelmed and tired of being stuck in a rut. Tired of being broke. Tired of being stressed. Tired of being fat. Tired of being… tired. I know this all too well. I have been one of those people!

Take a few minutes to think about what your resolution would be for the new year. What is something that you feel would improve your outlook on your life? Or improve the quality of your life? Write it down. Don’t’ just think it, INK IT! Chances are, this is something you’ve wanted for a long time. It may also be a resolution you’ve tried to achieve before and didn’t follow through with. Now think about the impact this would have if you were to achieve this. Can you describe it? How would you feel if you could make this happen? Now ask yourself how badly do you want it? Do you just kind of want it? Or do you really want it? There is a big difference in your motivation depending on how you answer this question!

Overcome Past Efforts

Once you know what you want and how badly you want it, think about what you’ve tried in the past to achieve this goal. Write it down! If this is a brand-new want, you may not have tried anything before. And that’s ok! If this is something you’ve wanted before, and did not follow through with, that is okay, too! If this is something you’ve wanted for a long time and have tried many things, how well did it work out? What are some of the things that did work and what are the efforts that did not? Again, write this down. 


By now, you know what you want and how badly you want it. You are also aware of your past efforts, what has worked and what did not. Now ask yourself “What can I do differently and what am I willing to do to make sure this works this time.” This is your plan of action. Be as detailed as possible. If your resolution is to lose weight, write down how you’re going to do this. Example: 

  • I will commit to exercise 3 days a week for 1 hour (Monday, Wednesday and Friday)
  • I will cut down to only having fast food 1 day per week and eat home cooked meals the rest of the week
  • I will drink 72 oz water per day. (Break this down into how many ounces per hour.)
  • I will cut down on sodas to 1 per week and replace with water or unsweet tea.


Dr. Robert Wubbolding, author of Reality Therapy for the 21st Century, attests that for a plan to be effective, it must be “Simple, Attainable, Measurable, Immediate and Controlled by the planner (SAMIC).”


It can be whatever steps you feel you need to take to make this happen. If you find yourself not knowing what steps need to be taken, make a step to include researching or talking to someone who knows more about what it is that you want.  Again, be specific and realistic. Don’t set standards too high. Committing to working out 3 hours a day 7 days a week can be overwhelming and set someone up to fail. If you can do more on certain days than usual, do it. But only write down what is manageable and what you’re willing to commit to. 

Commitment

If you’ve gone this far, why not go ahead and sign it. Put your signature and date somewhere on this as a written contract to yourself. Now take it a step further and post it somewhere where you will see it every day, or maybe several times a day. Put it on the fridge if you have to. This can help you hold yourself accountable for your goals. 


My personal recommendation is to document your progress once a month until you’ve reached your goal. Review your contract. Are you still reaching for the same goal? What have you been doing to make this happen? Is it working? Why or why not? And if it’s not working as well as you’d like, are there modifications to make to your plan? If so, write it down. Sign it. Date it. And keep going!! If you say you can, or say you can’t, you’re right!! You are in control! You are the only one that can make this happen for yourself. You’re worth it!! If you want it, go for it! You got this!! 

Cheers!

Want more support to life your best life? We offer counseling for both children and parents! Not sure if counseling is right for you? Do a free screening to see if it's the right fit!

Get Started Now!
]]>Fri, 03 Dec 2021 14:42:20 -0600<![CDATA[2-Wheel Bike Riding ]]>https://www.theratreepeds.com/blogs/post/Bike-RidingThe sun is shining, the wind is blowing, and it is a beautiful day for bike riding. Have you ever wondered how children learn to bike ride? Have you ever tried bike riding and everytime it ended in tears? You may not know where to start with teaching bike riding and that is okay.]]>

By Kaitlin Alvey, MS, OTRL

The sun is shining, the wind is blowing, and it is a beautiful day for bike riding. Have you ever wondered how children learn to bike ride? Have you ever tried bike riding and everytime it ended in tears? You may not know where to start with teaching bike riding and that is okay.


Bike riding is a big skill that we expect children to learn between the ages of four and eight years old. When I say that age it is all based on development. If your child is developmentally behind, you can expect that bike riding may take longer to learn and/or happen at a later age. I wanted to provide you all with some information about the skills needed for bike riding along with some tips in progressing with bike riding.

Skills Needed for Bike Riding 

So let’s start with the skills. Below is a breakdown of some of the things required to bike ride:


Leg Strength: Pedaling and pushing a bike requires strength to push in a downward motion to move it forward.


Balance: It takes a lot of coordination to balance on the seat and maintain position while it is moving.


Core strength: Core muscles are vital to our participation in many movement activities and especially bike riding.


Bilateral coordination: This means that the child has to use both sides of their body at the same time. Bike riding requires this skill in being able to hold both handle bars and coordinate both legs to propel.


Visual motor skills: Some people also refer to these skills as hand-eye coordination. If you think about bike riding, we have to be able to look with our eyes and tell our body what to do. This helps a child decide whether they are going to keep going or stop or move side to side to avoid an obstacle.

Steps & Tips for Bike Riding

So now that we have the skills, let’s talk a little bit about some recommendations for progression. Often times, I do not recommend children starting with training wheels on their 2 wheeled bike. Especially with children who are developmentally delayed or having difficulty in any of the above skills, they may use the training wheels as a crutch for their skills. This is not true for every child, so it is something to consider for what fits best for your child.


STEP 1: Modify the Bike


PEDALS: When a child first gets a two wheel bike, I recommend removing the pedals. Removing the pedals?? Yes! When you remove the pedals, it allows your child to get used to balancing on the seat and propelling the bike forward. If you have ever seen a balance bike, this is the same concept without having to get another bike. Without the pedals, a child can work on coordinating where to put their hands, pushing with their feet, and looking at where they are going. Make sure you child can first try in a straight path and then can work on steering a little later.


SEAT: When you remove the pedals, the next step is to lower the seat. You want the seat to be low enough so that they can propel through pushing with the ball of their foot.


Tip: You do not want your child to be able to push all the way through their heel because they may rely on that more for balance than using their core muscles.


STEP 2: Add One Pedal

So your child has mastered balancing and riding the bike without pedals. They can steer, propel it forward, and can feel the wind across their face! Next it is time to add on one pedal. You can choose which ever side would work best for your child. If they are five years or older and have hand dominance, I would recommend putting the pedal on their preferred side first. So this may seem kind of silly and that is okay! Putting one pedal on allows your child to master the motor movement on one side rather than having to coordinate both sides together. They can also still use their other leg to help catch them from falling. Once they have mastered pedaling with one side, take that pedal off and put the one on the other side. Repeat the process until they are able to coordinate and propel the bike forward.


Tip: You do not want to switch your child’s pedal until they have mastered it on the one side. The length of time to master this skill varies for each child and is discovered by them practicing on the bike.


STEP 3: Add The Second Pedal

It is time for two pedals!! At this point your child has learned all of the small skills required for pedaling with two pedals. When you place the two pedals on, they will learn the new balance of having two legs off the ground and watch them go!


Bike riding is one of my favorite summer time activities and I hope that this has helped to provide a way to support your child in bike riding this year! If you have any questions or concerns about your child and development please reach out to an occupational therapist at TheraTree. You can reach us by phone at 270-688-8449 or email at contact@theratreepeds.com.

]]>Wed, 30 Jun 2021 15:10:48 -0500