Welcome to the School Age Resource Center
SCHOOL AGE-RELATED SERVICES AND EVALUATIONS PROVIDER RESOURCE CENTER
Here you will find the essential resources, tools and information to effectively deliver School Age services with New York Therapy. Whether you need guidance on procedures, access to important documents, or connections to key NYT contacts, everything is readily available to help you navigate your role with confidence and efficiency.
Meet the Support Team
Long Island Team
Donna Bernesser, B.S Marketing and Consumer Sciences
Director of
School Age Services
Clare Burke, LMSW
Assistant Director of
School Age Services
Kristin Hoefler, MS. Ed
School Age Evaluations Placement &
Senior Coordinator
Kristine DiMasi, OTR/L
School Age
Coordinator
Mary Siemers, MS. Ed
School Age
Coordinator
Jennifer Pastore, BS MT
School Age
Coordinator
Mikaela Encizo
School Age
Coordinator
Linda Muzik
CPSE & CSE Speech
Placement Coordinator
Brianna Connolly
Placement
Coordinator
Stacey Gouzos
Behavioral Programs
Specialist
Christine Rickert
Billing Manager
Mary Fiorentino
School Age
Billing Coordinator
Michelle Stancati
School Age
Billing Coordinator
Hillary Teger
Senior Compliance
Manager
Jaclyn Dekhtyar
Compliance
Coordinator
New York City Team
Dana Hall, MS, LBA, BCBA
Director of
Behavioral Services
Kate Lieberman, MS. Ed
Director of
Non-Contract Services
Donna Sutherland
NYC Non-Contract
Service Manager
Cindy Burger
Manager of School Age Evaluations &
Non-Contract RS Coordinator
Stacey Gouzos
Behavioral Programs
Specialist
David Tellerman, MA CCC-SLP, TSHH, SDA
Chief Business Development &
Community Engagement Officer
Yanet Etienne
Related Services Manager
Stephanie Ruggiero
Facilities Coordinator
Gina Torre
Assistant Billing
Manger
Hillary Teger
Senior Compliance
Manager
Val McIntyre
Compliance
Coordinator
Key Resources
NYT Portal
Providers can view current caseload (treatment and evaluations) download pre-printed provider session notes, view prescriptions, view student records, and view compliance items.
NYT Portal Link
NYT Portal Training Video
Instructional Video on our NYTPortal.
Compliance
All compliance, annual trainings, and requirements have been successfully completed as part of your onboarding packet. Please note that the following listed items are ongoing compliance requirements, mandated by New York State, the Department of Health (DOH), the Department of Education (DOE), and/or NYTPS, in accordance with district regulations and contracts with New York State. These requirements are due either annually, semi-annually, or every 2 to 3 years, as specified. Please note that you will receive regular email notifications regarding any upcoming or missing compliance requirements or documents. These “compliance issues” emails will provide ample notice prior to any items missing, coming due or expiring, helping you stay on track with all necessary documentation. Please contact the compliance department if you have any questions.
Annually Renewed Compliance Documents for All Providers
A6.0 Annual Health Assessment (SA RS only, not for Evals)
(SA RS only, not for SA Evals) An annual physical health exam completed by a healthcare professional is required of all EI providers. Have your physician fill the NYTPS "Annual Health Assessment" form. This must include the annual TB screening Questionnaire attached (signed and dated by healthcare professional).
C1.0 Child Abuse Recognition Training Certificate
All providers in NYS are required to have on file with NTYPS a completion certificate for; Child Abuse Recognition and Mandated Reporter training. All EI Providers are required to have on the most recent NYS updated training.
LI - Submit one time (most recent update 11/01/2022).
NYC – Required to complete and submit every two years.
C3.0 Corporate Compliance Plan Training Video
Annual Training Video
C3.0 Corporate Compliance Training Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
CSP1.0 Cyber Security Practices Training Video
Annual Training Video
CSP1.0 Cyber Security Practices Training Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
D5.0/D5.1 Data Privacy & Security Training Video
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
D5.0/D5.1 Data Privacy & Security Training Info & Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
H13.0 Annual HIPPA Training Presentation
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
H13.0 Annual HIPPA Training Acknowledgement
Annual Training, please watch the video, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
O1.0 Osha/HIV Manual
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
O1.0 Osha/HIV Annual Acknowledgement
Annual Training, please read through presentation, download, sign and date this acknowledgment form and upload to the NYTPS compliance folder.
S1.5 NYC Annual Sexual Harassment Prevention Training (NYC Providers ONLY)
NYC Providers ONLY
S4.0 State Child Abuse Registery Database Check
All providers are required to be screened in the State Central Register Database of persons who are the subject of indicated child abuse or maltreatment report. Fill out an LDSS-3370 form and upload it to the NYTPS compliance folder.
Your completed application will be submitted to NYS for processing and clearance. Please be sure to include BOTH THE MONTH AND YEARS for all addresses list. This must include ALL addresses for the past 28 years, or from birth if you are younger than 28. There can be NO gaps in dates.
NYC providers to submit every 2 years.
School Age Billing
Here you will find information on how to bill for provided School Age Services.
Long Island Billing Documents & Guidelines
The information in this section will guide you through the process. If you have any questions, please feel free to contact:
- Christine Rickert 631-215-3596 – Billing Manager – [email protected]
- Mary Fiorentino 631-469-3069 – Billing Coordinator – [email protected]
- Michelle Stancati 631-215-3290 – Billing Coordinator – [email protected]
Billing fax number 631-476-5937
School Age Billing Requirements:
- Personal Invoice submitted on your letterhead
- Required Provider Session Note or Billing Grid if entering notes electronically
- Group Record of attendance form if grouping student
- Billing Period 1st through the 15th and 16th through the 30th/31st
- Billing can be uploaded to Billing or Faxed to School Age Billing
Provider Session Note
To complete by provider when Provider Session Note is not available to be printed from the NYTPortal. Send in with billing.
Provider Session Note - Fillable
To complete by provider when Provider Session Note is not available to be printed from the NYTPortal. Send in with billing.
NYC/5 Boroughs Billing Documents & Guidelines
The information in this section will guide you through the process. If you have any questions, please feel free to contact:
Gina Torre – Assistant Billing Manager – 516-342-7135 – [email protected]
PS Related Services - Session Notes
Provider to complete and send with billing if child is not available on SESIS.
PS&SA Related Services - Confirmation of Monthly Consult log
After Monthly Consultations are entered into SESIS for all children on your caseload, please complete to advise NYTPS.
Tips and Resources
Long Island School Age CSE Manuals
IEP Direct Training Manual for Related Services(Providers)
How to enter session notes into IEP Direct.
Long Island School Age Technical Support
Instructions and Videos
How to Allow Pop-ups
Instructions how to allow pop-ups.
How to enter goals into Front line/IEP Direct
Instructional video on how to enter goals into Frontline/IEP Direct.
How to enter SPAMS/PLEPS/MAPS
Instructional video on how to enter goals into Frontline/IEP Direct.
How to update progress marks Frontline/IEP Direct
Instructional video on how to enter goals into Frontline/IEP Direct.
How to Upload School Age Evaluations
Instructions how to upload School Age Evaluations.
Find a Form
Long Island School Age forms
All the forms you will need while servicing your caseload.
Billing fax number 631-476-5937
Department Fax Number 631-546-7493
1. LI School Age Service Forms
All forms you may need during the duration of a School Age case.
Prescription form 25-26
In most cases, related services cannot begin until a prescription is in place. For details on your district’s specific prescription requirements, please contact your coordinator.
Provider Session Note
To complete by provider when Provider Session Note is not available to be printed from the NYTPortal. Send in with billing.
Provider Session Notes Fillable
Fillable provider session notes. No need to download to complete. You can compete them online and then download the completed form.
School Age FBA Template-NYTPS
Template for functional behavior assessment.
Service Ratio Change Form
Provider to complete if unable to service a child in a group session as stated on the IEP.
Speech Referral
Speech Pathologist to complete for all children on their caseload.
2. LI School Age IEP Direct
Generic and district specific Non-disclosure forms.
Copiague IEP Direct Confidentiality and Non-Disclosure form
IEP Direct Confidentiality and Non-Disclosure form for the Copiague School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
Elmont - IEP Direct Confidentiality and Non-Disclosure
IEP Direct Confidentiality and Non-Disclosure form for the Elmont School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
Hauppauge - IEP Direct Confidentiality and Non-Disclosure
IEP Direct Confidentiality and Non-Disclosure form for the Hauppauge School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
IEP Direct Training Manual for Related Services(Providers)
How to enter session notes into IEP Direct.
Pat-Med Confidentiality and Non-Disclosure Agreement
IEP Direct Confidentiality and Non-Disclosure form for the Patchogue-Medford School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
Sachem-IEP Direct Confidentiality Agreement
IEP Direct Confidentiality and Non-Disclosure form for the Sachem School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
Sewanhaka IEP Direct Confidentiality and Non-Disclosure form
IEP Direct Confidentiality and Non-Disclosure form for the Sewanhaka School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
Smithtown-IEP Direct Confidentiality Agreement
IEP Direct Confidentiality and Non-Disclosure form for the Sachem School district. To be completed by provider if never accepted cases from this district prior and send back to NYTPS.
VS 24 Confidentiality Non-Disclosure Agreement
IEP Direct Confidentiality and Non-Disclosure form for the Patchogue/Medford School district. To be completed by provider if never accepted cased from this district prior and send back to NYTPS.
VS30 IEP Direct Confidentiality
IEP Direct Confidentiality and Non-Disclosure form for the Patchogue/Medford School district. To be completed by provider if never accepted cased from this district prior and send back to NYTPS.
3. LI School Age Kinney System Forms
Forms and manual for Kinney System.
4. LI School Age Progress Report Template
Progress Report Template
Progress Report Template - CSE
If you are unable to enter progress marks directly into the child's IEP, use this form and upload once completed.
5. LI School Age Annual Review Form
In accordance with district regulations, annual review reports must be completed for all students receiving services prior to the student’s scheduled annual review meeting.
Contact:
Mary Siemers – [email protected]
Mikaela Encizo – [email protected]
Kristin Hoefler- [email protected]
Kristine Dimasi – [email protected]
Jennifer Pastore – [email protected]
Reports must be submitted directly to our office for quality assurances purposes. ALL Reports are to be uploaded via the provider section of our website. We do not accept reports via email.
NYC/5 Boroughs School Age forms
All the forms you will need while servicing your caseload.
NYC School Age Service Forms & Reminders
Reminders
Your first session with each child should be within 5 school days of the authorization date or date you are assigned to the case (if it differs from the authorization date.)
First attend forms are to be submitted for each child on your caseload 24 hours after your first session.
Notify the Placement Coordinator if there will be a delay in providing the first attend.
Speech referrals should be completed prior to the start of service, and no later than 10 days following the start of service.
Encounter Attendance is to be entered into SESIS contemporaneously (within 24-48 hours) for all scheduled sessions, including absences and cancellations.
Contact the RS Coordinators for children not listed on your SESIS account: Yanet Etienne – [email protected]
Trouble signing in to SESIS?
All SESIS users are encouraged to use the self-service site to reset their own passwords via:
NYC DOE Password & Profile Management (nycenet.edu)
If you have further issues, please create a support ticket to obtain assistance.
Quarterly Progress Reports Due Dates:
November 15
February 15
May15
August 15 (for 12-month IEP)
Turning 5 Reports Due to NYTPS:
December 15
Annual Review Report and IEP Pages:
See your Student’s IEP. The First Page shows Date of IEP Meeting. Report is due to NYTPS 2 months prior.
NYC Rationale for Change In IEP
To be completed when IEP needs updating.
Facilities Forms
Facilities Coordinator:
Stephanie Ruggiero – 516-342-7850 – [email protected]
Facility Timesheet Template
Please download, complete, and submit billing through the Document Submission section at the bottom of this page.
