Archives: Lessons
Course Wrap-Up
Summary
Final Quiz
Lesson 7: Printing and Processing Checks
Lesson 9: Guardianship Compensation
Lesson 8: Bank Reconciliation
Lesson 6: Processing Returned Checks
Lesson 5: Processing Daily Checks
“DAIL is responsible for handling and processing income for individuals under guardianship in a safe and secure manner. This includes obtaining income and assets, depositing funds, and timely distribution of payments to meet individual needs.”
Lesson 4: Automated Clearing House and State Supplementation Direct Deposit
“State Supplementation deposits are also processed via ACH. Let’s take a moment to review how the process works.”
ACH Process:
Step 1:
Fiduciary receives a file from the Kentucky Department for Medicaid Services that contains a breakdown that includes names of individuals under guardianship and the amount to be deposited for the month.
Step 2:
Fiduciary must research all state supplemental deposits received after the 1st of the month through a CHFS accounting database.
Step 3:
A monthly report can be pulled from KYGFIS to verify all state supplemental deposits.
Step 4:
ACH deposits received in error are logged via journal entry and returned to sender.
Lesson 3: Automated Clearing House and Direct Deposit
“CHFS utilizes an Automated Clearing House (ACH) to conduct electronic fund transfers on behalf of individuals under guardianship.
ACH Process:
The process starts with an electronic financial deposit file, sent from an external agency’s bank to the Fiduciary bank account for processing.
Examples of external agencies are the Social Security Administration, Veteran’s Affarirs, pension companies, etc.
Next, the Fiduciary Branch imports the file into KYGFIS for deposit processing.
Once the file is imported, the system verifies the deposit information matches up with transactions within each individual account.
In cases where the system is unable to verify a match, Fiduciary staff will conduct research based on the information given in the file to identify potential errors. E.g., claim number, social security number, individual’s name, etc.
If an individual earns wages and the financial file does not match the system, Fiduciary staff will check identifying information and make needed corrections for a match. “
Lesson 2- Welcome
“Hello, and welcome to this Fiduciary Branch Pre-Service Training. In this course, we’ll review deposits, payments, and transfers handled by the Fiduciary Branch for individuals under guardianship. Today you’ll be working with Chris to better understand how these financial responsibilities are processed and managed.”
“Hello, I’m Chris. As part of the Fiduciary Branch staff, it is my responsibility to help manage payments, deposits, and transfers for individuals under guardianship. I’ll be working with you to help you better understand how these processes work and any requirements that must be met.”
In this course, we will:
Course Objectives:
- Define how the Fiduciary Branch utilizes Automated Clearing House (ACH) to conduct electronic fund transfers.
- Describe how checks are processed.
- Explain the protocol for handling returned checks.
- Identify how and when the Fiduciary Branch reconciles bank statements.
- Describe Guardianship compensation and how it is collected.
Lesson 1: Start Here- Contact Us
Select the accessibility widget on the right hand of the screen to access features such as:
Screen Reader: Reads content on the page.
Contrast Adjuster: Adjust color to meet your individual needs.
Text Magnifier: Adjust the size of text on the page to make reading easier.
And more!
Need Help?
Course Content
For help with course content reach out to Jennifer Rosenberg.
Technical Assistance
For help with HDI Learning and issues with the website, please use the “Contact Us” button.
Acknowledgments and Background
Dr. Stephanie Meredith
Dr. Nicholas Wright
Dr. Stephanie Meredith is the Director of the Lettercase National Center for Prenatal and Postnatal Resources at the University of Kentucky’s Human Development Institute (HDI) and the mother of a young man with Down syndrome. Her identity as a parent gave her particular access and understanding of the family experience after learning about a diagnosis. Dr. Nicholas Wright is a multiracial man who serves as Director of DEI at HDI and has a traumatic brain injury.
“We were both worried about leading this work because we both have ways in which we’re similar and different from Black and Hispanic mothers of children with Down syndrome. We were so grateful that as we started the conversations with the 20 parents who participated in this project, they were generous in sharing their thoughts and insights about what types of research were important to them and how to improve the systems. In fact, when we asked the first question about their research priorities, they were so eager to talk about their thoughts on the diagnosis experience that we had to repeat the question to gather all their important insights.”
“At the risk of being vulnerable and emotional, their willingness to share felt sacred, and they correspondingly expressed that they appreciated the opportunity to offer those insights. We were also grateful to our health equity and medical professional teams for sharing their unique insights and for being wonderful professionals who are committed to helping families.”
Many Thanks
We want to thank our team of 36 parent and professional reviewers who made this resource possible and gave their excellent input!
- Angela Trepanier, MS, CGC, Professor, Center for Molecular Medicine and Genetics, Wayne State University, School of Medicine
- Asha N. Talati MD MSCR, Assistant Professor of Maternal Fetal Medicine and Clinical Genetics and Genomics at the University of North Carolina Chapel Hill
- Beth A. Pletcher, MD, FAAP, FACMG, Emeritus Professor, Rutgers New Jersey Medical School, Emeritus Professor, Rutgers New Jersey Medical School
- Brian Skotko, MD, MPP, Emma Campbell Endowed Chair on Down Syndrome, Massachusetts General Hospital
- Dena Cherry-Brown, MPH, Health Equity Reviewer
- Evelyn J. Acevedo, Parent Facilitator for Club21, Former Early Childhood Educator, Inclusion Leadership Team Member for local preschool program (IEEEP), and Parent Reviewer
- Jennifer de la Cruz, MMSc, PA-C, Health Equity Reviewer
- Jessica L. Franks, DrPH, MPH, CHES, Health Equity Reviewer
- Julianna Cebollero, PharmD, BCOP, Parent Reviewer
- Linda Smarto, Executive Director from the National Association for Down Syndrome
- Martha Padilla, Parent Reviewer
- Murugu Manickam, MD, MPH, FACMG, Clinical Geneticist/Genomicist at Nationwide Children’s Hospital
- Sarah Cullen, Family Support Director at the Massachusetts Down Syndrome Congress and the National Parents First Call Center
- Sharon Tate, Parent Reviewer
- Tawana Williams, Parent Reviewer
- Terria Brown, First Call Program Leader, Down Syndrome Association of Maryland, Parent Reviewer
We’d also like to thank our student LEND trainees who assisted in preparing this resource: Cameron Elder (currently pursuing a Doctorate in Physical Therapy) and Hannah Keene, MS (currently pursuing a Doctorate in Early Childhood, Special Education, and Counselor Education).
Tips and Tricks for Training Planning – March 2024
Zoom Recording
Resources
Discussion
Use this space to continue our conversation on Tips and Tricks for Training Planning, so that we support each other in this work. Ask/answer questions, share successes and challenges, and respond to each other!
(If you have any trouble posting, email your questions to julie.halitzka@uky.edu, and we will post for you.)
Top Patient Centered Outcomes Research (PCOR) Questions Valued by Black and Hispanic Parents of Children with Down Syndrome
Studies show that there are specific research questions and information that are valued more by Black and Hispanic parents, and there is research that is universally valued by all parents of children with Down syndrome. The list below highlights these questions.
[ld_video]
Top PCOR Questions Valued by Black and Hispanic Families:
| Research Priorities for All Parents of Children with DS | Research Priorities for Black and Hispanic Parents of Children with DS | |
| Benefits and drawbacks of different prenatal testing/screening options | Yes1 | Yes: Black parents raised concerns about possibly receiving less information about prenatal screening options than White counterparts. |
| Benefits and drawbacks of different treatments for common medical issues experienced by people with DS (such as heart defects, gastrointestinal defects, etc.) | Yes1 | Yes |
| Impact of prenatal care and insurance coverage options on miscarriage and stillbirth rate | Yes: Black mothers noted specific concerns about higher rates of maternal morbidity and mortality during pregnancy, and Hispanic mothers who were recent immigrants noted concerns about insurance coverage. | |
| Benefits and drawbacks of different feeding strategies, like breastfeeding, pumping, formula-feeding, and supplementing, and methods to optimize feeding and weight gain in children with DS | Yes2 | Yes: Black mothers noted specific concerns about historic discrimination in breastfeeding. |
| Impacts of different social determinants of health on short and long-term outcomes for people with DS. | Yes3 | Yes: Hispanic parents, particularly among those of lower socioeconomic status, raised concerns about health insurance options. Black parents raised specific concerns about the impact of marital status. |
| Impact of early connection to parent support and advocacy groups on all members of the family (including mother, father, siblings) | Yes4,5 | Yes: Black and Hispanic parents wanted additional information about the long-term impact of racially and ethnically concordant sub-groups within local DS organizations. |
| Outcomes and potential benefits of peer mentors and DS organizations and available supports at the moment of diagnosis | Yes1 | Yes: Black and Hispanic parents added specific focus on peer mentors with racial and ethnic concordancy. |
| Best treatment options for psychological support and counseling for parents following a DS diagnosis | Yes5 | Yes |
| Impacts of different early intervention strategies on meeting developmental milestones and long-term outcomes | Yes1 | Yes |
| Benefits and drawbacks of raising a child with DS to be bilingual, including sign language | Yes3 Parents of children generally express they want this information about sign language instruction. | Yes: Hispanic parents who are bilingual or Spanish-speaking specifically expressed an interest in this information. |
Person Testimonies:
Listening to Individuals and Families
The Diaz Family
Learn from families about what matters most to them at the moment of diagnosis in this video from Boston Children’s about the Diaz family:
Kelli Caughman
Black Down Syndrome Association Founder, Kelli Caughman, and Mercedes Lara discuss their experiences raising children with Down syndrome as women of color on The Lucky Few podcast focusing on “A Conversation About Race & Down Syndrome w/Mercedes Lara & Kelli Caughman.”
References:
1. Ansong EO, Jones K, Santoro SL. Timing of referrals to a Down syndrome parent group by race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704
5. Carter EW, Bumble JL. The promise and possibilities of community conversations: Expanding opportunities for people with disabilities. J Disabil Policy Stud. 2018;28(4):195-202. doi:10.1177/1044207317739408
Resources:
Introduction
When referring to Black parents of children with Down syndrome in this course, we are describing parents who identify as Black, African-American, of African descent. When we refer to Hispanic parents of children with Down syndrome, we are referring to parents with ancestry from Spanish-speaking countries.
Research shows significant health disparities exist when comparing Black and Hispanic children with Down syndrome to White children with Down syndrome and more limited access to services and support.1–3
One problem is the extent to which parents of color learning about a diagnosis receive the latest accessible and research-based information about Down syndrome from their medical providers. The moment of diagnosis is the first point on the life course, often described as a flashbulb memory that is remembered with vivid clarity for decades.4 That moment frames the whole experience and establishes a trajectory for understanding the condition and accessing services and healthcare.
Research shows that families of children with Down syndrome are able to cope better when they receive information about the condition in that moment; however, new and expectant parents often experience trauma when they receive limited or no additional resources or support systems during that vulnerable time.4 Parents also experience trauma when the information is exclusively negative, so they also need positive information to be included.
“Yes, in relation to the doctors, really, they are the ones who give you the news, they give you the diagnosis. Yes, they should be more steeped in the topic. Because badly handled news affects mothers a lot.” —Spanish-speaking caregiver
Therefore, it is essential that all new and expectant parents of children with Down syndrome receive accessible, understandable patient-centered outcomes research (PCOR) to make informed decisions about healthcare and to access support and services.
Listen to Dr. Brian Skotko and Albert Pless, MA lead a discussion about their project regarding the experiences of Black and Hispanic parents of individuals with Down syndrome also funded by the Patient Centered-Outcomes Research. We will reference this video throughout the course. Here they provide background on the health disparities faced by these parents. They also discuss the importance of the diagnosis moment.
[ld_video]
Personal Testimonies:
Listening to Individuals and Families
Sofia Jirau and Chris Gonzalez
Watch this video to learn more about Hispanic adults thriving with Down syndrome and how to approach Down syndrome with open expectations:
References:
1. Ansong EO, Jones K, Santoro SL. Timing of Referrals to a Down Syndrome Parent Group by Race. Pediatr Qual Saf. 2023;8(1):e632. doi:10.1097/pq9.0000000000000632
2. Chung J, Krell K, Pless A, et al. Healthcare experiences of patients with Down syndrome from primarily Spanish‐speaking households. Am J Med Genet A. 2023;191(8):2132-2141. doi:10.1002/ajmg.a.63250
3. Krell K, Pless A, Michael C, et al. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A. 2023;191(3):742-752. doi:10.1002/ajmg.a.63069
4. May CP, Dein A, Ford J. New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories. Appl Cogn Psychol. 2020;34(5):1154-1165. doi:10.1002/acp.3704