WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS...

WELCOME TO:WELCOME TO:TRAIN THE COORDINATORSTRAIN THE COORDINATORS

Presented by:Presented by:

Department of Health Care Department of Health Care Services (DHCS)Services (DHCS)

ACLSS BranchACLSS Branch

and and

Local Educational ConsortiumLocal Educational Consortium

FALL 2008FALL 2008

THE DAY AT A GLANCETHE DAY AT A GLANCE

• Housekeeping

• National Updates

• Time Survey Overview

• Site Visit Findings

• Activity Codes

• Short Break

• Interactive Memory Enhancement Exercise

HOUSEKEEPINGHOUSEKEEPING

• INTRODUCTIONS

• RESTROOMS/BREAKS

• CELL PHONES

• TRAINING MATERIALS

• QUESTION PROCESS

WHAT’S IN THE PACKET?WHAT’S IN THE PACKET?

• PowerPoint Handout

• Code 1 vs. Code 16 Matrix

• Samples of financial reports

• Activity Code Samples

• Operational Plan Checklist

• Evaluation Form

PURPOSE OF THIS TRAININGPURPOSE OF THIS TRAINING

• Provide an overview of the time survey process to ensure program compliance

• Ensure each participant identifies the actual time performing the MAA activities reported on the time survey

• Provide information to help identify activities that are eligible for federal reimbursement under the MAA program

• Provide Activity Code Samples

NATIONAL UPDATESNATIONAL UPDATES

• CMS 2287 – F Elimination of SMAA

• CMS 2258 – F Changes definition of “Unit of Government”

• Moratorium until 4/09

• CMS 2213 – P Outpatient Clinics

• Free Care Principle – CMS would like to codify

• Parental Consent to Bill

• 2nd Stimulus Bill??????

HEALTH CARE SERVICES HEALTH CARE SERVICES (DHCS) UPDATE(DHCS) UPDATE

• DHCS will continue the SMAA program until FFP is no longer available

• Audits/Oversight

• Contingency Fee Contracts are not allowed

SMAA Time Survey Overview

PURPOSE OF TIME SURVEYPURPOSE OF TIME SURVEY

• The time survey is the basis for claiming federal funds

• The time survey captures what activities LEAs do on a regular basis

WHICH LEA STAFF SHOULD TIME WHICH LEA STAFF SHOULD TIME SURVEYSURVEY

Consider two factors:

1. Do they perform MAA?

2. Are appropriate non-federal funds expended to receive federal reimbursement?

TIME SURVEY PARTICIPATIONTIME SURVEY PARTICIPATION

• How do LEAs participate in MAA?

• When must staff be trained?

• PPL 08-016 Training Participation

WHEN TO TIME SURVEYWHEN TO TIME SURVEY

• DHCS randomly selects a time survey week period for each quarter

• The LECs/LGAs are notified of the time survey dates, via PPL, no later than the first day in May of the first-quarter time survey period and 45 days prior to the beginning of the second, third, and fourth quarter

WHEN TO TIME SURVEYWHEN TO TIME SURVEY

When School is:

• Students in session

• Students out of session for fewer than 30 days

• Students out of session for more than 30 days

• If for whatever reason the claiming unit does not time survey on the designated date, then they should document the reason for delay in the audit file.

TIME SURVEY TIME SURVEY ADMINISTRATIONADMINISTRATION

• The responsibility for proper administration of the time survey is shared by;

California Dept. of Health Care Services

LEC/LGA MAA CoordinatorLEA MAA CoordinatorTime Survey Participant and

his/her supervisor

TIME SURVEY REVIEW TIME SURVEY REVIEW PROCESSPROCESS

• It is the responsibility of the LEC/LGA coordinators who sign the invoices and claiming grid to assure the accuracy of the time surveys

• Site and Desk Reviews

• On each time survey form the sample descriptions of MAA activities must maintain a minimum of 80% accuracy for inclusion into the invoice

THINGS TO LOOK FORTHINGS TO LOOK FOR……

• Identical time recorded for each day?

• Individuals with the same job class and significantly different survey coding?

• Paid time off not coded correctly?

• Cross-outs not initialed or easily understood?

• Percentages that do not match?

• Clean, legible recording of hours or portions of hours for the entire paid workday

• Correct totaling of MAA and non-MAA hours

• Correct sample descriptions for MAA activities

• Ensure time survey forms are signed and dated by participant and supervisor

THINGS TO LOOK FOR…Cont.THINGS TO LOOK FOR…Cont.

2004/05 Site Visit Findings Conducted During 2007/08

Time Survey FormsTime Survey Forms

#1 Finding: Narratives are not Medi-Cal specific

Code 4: “Sent Flyers home with students.”

“Attended an IEP meeting.”

Code 6: “Helped a family fill out application form.”

Code 8: “Consulted with a school nurse about student’s health needs.”

Code 12: “Provided Translation for a family with a special needs child.”

Time Survey FormsTime Survey Forms

Finding: Narratives are not Medi-Cal specific

Follow the Five W’s

WHO? WHAT?

WHEN?

WHERE ? WHY?

TIME SURVEY FORMSTIME SURVEY FORMS

• Misuse of activity codesCode 8: “I made an initial referral to a

student’s family regarding the Medi-Cal Healthy Families Program.”

Code 10: “Driving from one school district to another to provide direct speech and language therapy.”

Code 12: “Translation of IEP. Psychological speech & language reports.”


• Acronyms not specific

• Signatures

• Participant did not attend training

• Use original DHCS templates

www.dhcs.ca.gov/provgovpart/Pages/SMAA


General Findings

• Activity sample given with no recorded time

• Incorrect time survey dates

• Incorrect calculation of hours


Things to Remember

1)80% accuracy for sample descriptions

2)Initial all corrections

3)No whiteout

OPERATIONAL OPERATIONAL PLANSPLANS

• Missing documentation

- copy of indirect cost rate via CDE www.cde.ca.gov/fg/ac/ic

- copy of Medi-Cal Percentage

http://www.cde.ca.gov/fg/ac/ic

OPERATIONAL OPERATIONAL PLANSPLANS

• Missing documentation

• Missing duty statements

• Photocopied training logs

• Support for Code 4 and Code 8 activities

ORGANIZATIONAL TIPS FOR ORGANIZATIONAL TIPS FOR FUTURE SITE VISITSFUTURE SITE VISITS

• Use a Table of Contents and readable tabs

• Include a “Print Name” field on all Sign-In Sheets

• Arrange OP by fiscal year using three ring binders

The Who, What, Where, The Who, What, Where,

When and Why of it!When and Why of it!

SMAA PURPOSESMAA PURPOSE

• MAA Activities must directly support

−Identification and enrollment of potentially eligible students/families into Medi-Cal

−Medical services covered under the state Medi-Cal plan

SMAA ACTIVITY GUIDANCESMAA ACTIVITY GUIDANCE

• CA School-Based MAA Manual

• DHCS Policy and Procedure Letters

• School-Based MAA Time Survey Form

SMAA Activity ExamplesSMAA Activity Examples

• SMAA Codes 4, 6, 8, 10, 12, 14, 15 and 16

SMAA Activity SamplesSMAA Activity Samples

• Must Clearly Describe the MAA Activity Performed

−Who was involved?

−What was done?

−Why, how, when, and where was the MAA Activity performed?

• What Medi-Cal outreach, enrollment assistance or service was directly supported?

Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach

Initial activities that inform eligible or potentially eligible individuals about Medi-Cal programs and services and how to access them


• Prepared paperwork referring two (2) disruptive 6th Grade students to psychologist for initial Medi-Cal covered counseling evaluations


• Told Parents of 1st Grade student about the Medi-Cal program and services. Referred them to a Medi-Cal eligibility worker to seek health services for their young children


• I noticed a student was not eating his lunch, and I discovered he had tooth decay that was causing him pain. I contacted his parents with initial dental referral.


…integral parts or extensions of direct medical services,…..are not claimable due to the potential for duplicate payments.

Medicaid School-Based Administrative Claiming Guide, May 2003, Page 9

Code 6Code 6Facilitating Medi-Cal Facilitating Medi-Cal

ApplicationApplication

Assisting an individual in becoming eligible for Medi-Cal/Healthy Families

Code 6Code 6Facilitating Medi-Cal ApplicationFacilitating Medi-Cal Application

• Parents of a Kindergarten student needed transportation to a Medi-Cal eligibility office, and I worked with staff at a community agency to arrange that transportation.


• Reviewed National School Lunch information to facilitate Medi-Cal/Healthy Families enrollment


• During IEP meeting, assisted parents with Medi-Cal/Healthy Families application

Code 8Code 8OngoingOngoing Referral, Coordination, Referral, Coordination,

and Monitoring of Medi-Cal and Monitoring of Medi-Cal ServicesServices

• Making ongoing referrals for, coordinating, and/or monitoring the delivery of Medi-Cal covered services

• Activities take place after initial referrals have been made



• Called parent to verify student appointment with Pediatrician for evaluation of recurring ear aches



• Revised student’s therapy schedule to coordinate community-based Pediatric otolaryngology services for speech disorder evaluation



Administrative activities performed in support of medical services that are not coverable or reimbursable under the Medicaid program would not be allowable as Medicaid administration

Medicaid School-Based Administrative Claiming Guide, May 2003, Page 16

Code 10Code 10Arranging Transportation in Arranging Transportation in Support of Medi-Cal ServicesSupport of Medi-Cal Services

• Assisting an individual or family to obtain transportation to services covered by Medi-Cal


• Coordinated transportation arrangements with parent taking student to medical center for Medi-Cal covered mental health services


• Talked with transportation supervisor about bus changes added to route of student who receives Occupational Therapy services in the community

Code 12 - TranslationCode 12 - Translation

• Arranging or providing Medi-Cal translation services by a third party to facilitate access to Medi-Cal covered services


• Called several translators to arrange services for various parent meetings regarding Occupational Therapy, Physical Therapy, and/or Speech services


• Translated for Certified Application Assistant, who was working with Farsi-speaking parents applying for Medi-Cal

Code 14Code 14Program Planning, Policy Program Planning, Policy

Development, and Interagency Development, and Interagency Coordination Related to Medi-Cal Coordination Related to Medi-Cal

ServicesServices

• Developing and implementing strategies to improve the coordination and delivery of Medi-Cal covered medical/mental health services to students and their families



ServicesServices

• Only employees whose position descriptions include the Code 14 functions should use this code

• Staff surveying under this code should include related paperwork, clerical activities, or travel required to perform these activities

CA SMAA Manual, September 2003, Pgs. 5-11



ServicesServices

• Traveled to County Office of Education to attend a Student Health Meeting where we evaluated countywide need for additional Medi-Cal providers who accept new patients



ServicesServices

• Finalized my notes from meeting with countywide agencies to coordinate health service agreements – sent notes to all participants

Code 15Code 15Medi-Cal Claims Administration, Medi-Cal Claims Administration,

Coordination and TrainingCoordination and Training

• Performing activities that are directly related to MAA Program administration, coordination, and training

• As MAA Assistant for my school site, I verified that each survey participant had either a paper copy of the time survey form or access to the electronic version

Code 15Code 15Medi-Cal Claims Administration, Medi-Cal Claims Administration,

Coordination and TrainingCoordination and Training

• Reviewed with supervisor which daily activities should be coded as Code 14

• I attended brief refresher MAA training during our staff meeting at the district office

• I completed my MAA time survey daily

Code 16Code 16General Administration/Paid Time General Administration/Paid Time

OffOff

• Performing general administration activities that are not what you were specifically hired to do

• Paid time off

• I was on jury duty for the full survey period.

Code 16Code 16General Administration/Paid Time General Administration/Paid Time

OffOff

• Attended in-service training on new employee information system and reviewed my employee record

• Attended committee meeting to review district policies regarding school site utilization by community groups

Code 16Code 16General Administration/Paid General Administration/Paid

Time OffTime Off

• Daily paid lunch periods per contract for my position

• Presented emergency preparedness information to staff and classroom volunteers

• Met with my supervisor, who gave me an employee performance evaluation

Code 1 and Code 16Code 1 and Code 16

• 2008 Code 1 and Code 16 Matrix−Activities sorted by category−All operations activities are

listed as Code 1−Assistant Superintendents,

Principals, and Assistant Principals are specifically addressed under Operations

Code 1 ActivitiesCode 1 Activities

• Education Requirements

• Instruction

• Individualized Education Program Elements

• Operations

Code 1 or Code 16Code 1 or Code 16

• Meetings and Trainings

• Review and Planning

• Supervision

• Survey Participant Paperwork

Code 16Code 16

• Paid Time Off

Training Section ConclusionTraining Section Conclusion

• California School-Based MAA is

_____________________________

BREAK TIMEBREAK TIME

TEN MINUTESTEN MINUTES

WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS...

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Transcript of WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS...