1. + A Framework for Developing and Sustaining a Part C Finance System Anne Karasek US Department of Education Office of Special Education Programs

2. + … gain an understanding of the importance of developing a State specific finance framework and the logical progression of adhering to a strategic plan. … have an understanding of how to use the framework to meet their individual state needs. … work with content experts to tailor a State finance plan to their needs. SESSION OUTCOMES Participants will…

3. + Building the Plane It sometime feels like you are building the plane while you are flying it!! 3

4. + Key Phases of Development Demographics Fiscal Resources Political and Economic Context Phase I Design a System Based on Information and Priorities Identified in Phase I Phase II Agreements for Use of Resources Infrastructure Policies and Procedures Guidance and Support Phase III System Monitoring Phase IV 4

5. 5 A Framework for Developing and Sustaining a Part C Finance System Demographic Information Fiscal Resources Political and Economic Context Design a Finance System Agreements for Use of Resources Infrastructure Policies and Procedures Guidance and Support System Monitoring VISIONVISION Phase I Phase II Phase III Phase IV

6. + Phase I: DEMOGRAPHIC INFORMATION Eligibility Definition – What are the preexisting or potential eligibilities? Child Find Delivered vs Planned Services Regional Differences What proportions of children are likely to be eligible for which resources and supports? Where are they in the state?

7. + Phase I: Fiscal Resources Medicaid/CHIP Access Family Fees Private Insurance Affordable Care Act – Medicaid Expansion, Insurance Coverage Plan Requirements (eligibility and reporting )? What can each support or pay for? Who is eligible? What is the cost benefit ratio? How does your State include all EI services under Part C as part of “essential health benefits?

8. + Phase I: POLITICAL AND ECONOMIC CONTEXT State budget cuts Sequestration Interagency Relationships Billing systems – central reimbursement/billing Where are existing resources and supports? What are the traditional and current uses of resources and supports? Competing priorities? Anticipated political changes?

9. + Phase II: SYSTEM DESIGN Transition Plan Cost Study Medicaid utilization and flow Using data to plan and implement the transition Cost data Gaps in revenue data Planned vs Delivered services data Verification of payments Design a system based on demographics, current and potential resources, reflecting the political and economic context of the state and utilizing a public participation process

10. + Phase III: NECESSARY AGREEMENTS, NEGOTIATIONS AND APPLICATIONS Infrastructure Interagency Agreements Policies and procedures Guidance and Support Shared responsibilities MOUs? Interagency Agreements? Waivers?

11. + Phase III: INFRASTRUCTURE Identify a mechanism for billing Data system Interagency Coordination Resources and Supports provided where funds may not change hands Support the documentation of use of resources, supports and/or billing

12. + Phase III: DEVELOPMENT/REVISION OF POLICIES AND PROCEDURES System of Payments Policies Interagency coordination Embracing the vision Use of reported data as a management tool Clear guidelines for accessing resources and supports and/or billing

13. + Phase III: DEVELOPMENT/ REVISON OF GUIDANCE Training Technical Support Feedback from the Field Provision of ongoing support for regions and service providers in implementing policies and procedures

14. + Phase IV: ONGOING MONITORING Data-based decisions Measuring progress/delays against your vision Supporting or changing your VISION Changing demographics Changing political and economic context? Need new interagency agreements? Need new resources/supports? Revised policies? Better support and guidance? More state funding? Changes in Part C eligibility criteria?

15. + Comments? Questions? Clarifications? http://ectacenter.org/~pdfs/pubs/nnotes23.pdf