Presentation on theme: "WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS Branch and Local Educational Consortium FALL 2008."— Presentation transcript:
WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS Branch and Local Educational Consortium FALL 2008
THE DAY AT A GLANCE Housekeeping National Updates Time Survey Overview Site Visit Findings Activity Codes Short Break Interactive Memory Enhancement Exercise
HOUSEKEEPING INTRODUCTIONS RESTROOMS/BREAKS CELL PHONES TRAINING MATERIALS QUESTION PROCESS
WHATS 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 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 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 2 nd Stimulus Bill??????
HEALTH CARE SERVICES (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 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 SURVEY Consider two factors: 1. Do they perform MAA? 2. Are appropriate non-federal funds expended to receive federal reimbursement?
TIME SURVEY PARTICIPATION How do LEAs participate in MAA? When must staff be trained? PPL Training Participation
WHEN 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 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 ADMINISTRATION The responsibility for proper administration of the time survey is shared by; California Dept. of Health Care Services LEC/LGA MAA Coordinator LEA MAA Coordinator Time Survey Participant and his/her supervisor
TIME SURVEY REVIEW PROCESS 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 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.
2004/05 Site Visit Findings Conducted During 2007/08
Time 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 students health needs. Code 12: Provided Translation for a family with a special needs child.
Time Survey Forms Finding: Narratives are not Medi-Cal specific Follow the Five Ws WHO? WHAT? WHEN? WHERE? WHY?
TIME SURVEY FORMS Misuse of activity codes Code 8: I made an initial referral to a students 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.
TIME SURVEY FORMS Acronyms not specific Signatures Participant did not attend training Use original DHCS templates
TIME SURVEY FORMS General Findings Activity sample given with no recorded time Incorrect time survey dates Incorrect calculation of hours
TIME SURVEY FORMS Things to Remember 1)80% accuracy for sample descriptions 2)Initial all corrections 3)No whiteout
OPERATIONAL PLANS Missing documentation - copy of indirect cost rate via CDE - copy of Medi-Cal Percentage
OPERATIONAL PLANS Missing documentation Missing duty statements Photocopied training logs Support for Code 4 and Code 8 activities
ORGANIZATIONAL TIPS FOR FUTURE 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, When and Why of it!
SMAA 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 GUIDANCE CA School-Based MAA Manual DHCS Policy and Procedure Letters School-Based MAA Time Survey Form
SMAA 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 4 Initial Medi-Cal Outreach Initial activities that inform eligible or potentially eligible individuals about Medi-Cal programs and services and how to access them
Code 4 Initial Medi-Cal Outreach Prepared paperwork referring two (2) disruptive 6 th Grade students to psychologist for initial Medi-Cal covered counseling evaluations
Code 4 Initial Medi-Cal Outreach Told Parents of 1 st 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
Code 4 Initial Medi-Cal Outreach 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.
Code 4 Initial Medi-Cal Outreach …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 6 Facilitating Medi-Cal Application Assisting an individual in becoming eligible for Medi-Cal/Healthy Families
Code 6 Facilitating 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.
Code 6 Facilitating Medi-Cal Application Reviewed National School Lunch information to facilitate Medi-Cal/Healthy Families enrollment
Code 6 Facilitating Medi-Cal Application During IEP meeting, assisted parents with Medi-Cal/Healthy Families application
Code 8 Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services Making ongoing referrals for, coordinating, and/or monitoring the delivery of Medi-Cal covered services Activities take place after initial referrals have been made
Code 8 Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services Called parent to verify student appointment with Pediatrician for evaluation of recurring ear aches
Code 8 Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services Revised students therapy schedule to coordinate community-based Pediatric otolaryngology services for speech disorder evaluation
Code 8 Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services 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 10 Arranging Transportation in Support of Medi-Cal Services Assisting an individual or family to obtain transportation to services covered by Medi-Cal
Code 10 Arranging Transportation in Support of Medi-Cal Services Coordinated transportation arrangements with parent taking student to medical center for Medi-Cal covered mental health services
Code 10 Arranging Transportation in Support of Medi-Cal Services Talked with transportation supervisor about bus changes added to route of student who receives Occupational Therapy services in the community
Code 12 - Translation Arranging or providing Medi-Cal translation services by a third party to facilitate access to Medi-Cal covered services
Code 12 - Translation Called several translators to arrange services for various parent meetings regarding Occupational Therapy, Physical Therapy, and/or Speech services
Code 12 - Translation Translated for Certified Application Assistant, who was working with Farsi-speaking parents applying for Medi-Cal
Code 14 Program Planning, Policy Development, and Interagency Coordination Related to Medi-Cal Services Developing and implementing strategies to improve the coordination and delivery of Medi-Cal covered medical/mental health services to students and their families
Code 14 Program Planning, Policy Development, and Interagency Coordination Related to Medi-Cal Services 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
Code 14 Program Planning, Policy Development, and Interagency Coordination Related to Medi-Cal Services 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
Code 14 Program Planning, Policy Development, and Interagency Coordination Related to Medi-Cal Services Finalized my notes from meeting with countywide agencies to coordinate health service agreements – sent notes to all participants
Code 15 Medi-Cal Claims Administration, Coordination 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 15 Medi-Cal Claims Administration, Coordination 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 16 General Administration/Paid Time Off 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 16 General Administration/Paid Time Off 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 16 General Administration/Paid Time 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 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 Activities Education Requirements Instruction Individualized Education Program Elements Operations
Code 1 or Code 16 Meetings and Trainings Review and Planning Supervision Survey Participant Paperwork
Code 16 Paid Time Off
Training Section Conclusion California School-Based MAA is _____________________________