JEOPARDY! Desiree Aragon Kings County.

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Presentation transcript:

JEOPARDY! Desiree Aragon Kings County

TCM CMAA SMAA MHMAA TIME SURVEY MIX & MATCH 200 200 200 200 200 200 400 400 400 400 400 400 600 600 600 600 600 600 800 800 800 800 800 800 1000 1000 1000 1000 1000 1000

TCM 200 Case Management services that assist Medi-Cal eligible individuals with specified Target Populations to gain access to needed medical, social, educational, and other services Category Targeted Case Management (TCM)

TCM 200 What is TCM? Category Targeted Case Management (TCM) ? End

County-Based MAA 200 Participating agencies are reimbursed for their work in linking, connecting, and coordinating services for the benefit of their clients, rather than being direct providers. Category Medi-Cal Administrative Activities (MAA)

What is County Based MAA? Category Medi-Cal Administrative Activities (MAA) ? End

School-Based MAA 200 This program offers a way for Local Governmental Agencies (LGAs) and Local Educational Consortia (LECs) to obtain federal reimbursement for the cost of certain administrative activities necessary for the proper and efficient administration of the Medi-cal Program. Category Medi-Cal Administrative Activities (MAA)

What is School-Based MAA? Category Medi-Cal Administrative Activities (MAA) ? End

Mental Health MAA 200 County Mental Health Plans (MHPs) may claim federal reimbursement for the cost of administrative activities that support the Medi-Cal program. Category Medi-Cal Administrative Activities (MAA)

What is Mental Health MAA? Category Medi-Cal Administrative Activities (MAA) ? End

Time Survey 200 The approved method to determine the percentage of costs that are allocable to each administrative activity or TCM service claimed by the LGA or LEC. Category MAA/TCM Time Survey

What is a Time Survey? Time Survey 200 Category MAA/TCM Time Survey ? End

Mix & Match 200 An entity that enters into an agreement (contract, lateral agreement, Memorandum of Agreement or Understanding) with the LGA to perform MAA. Category TCM and/or MAA

What is a subcontractor? Mix & Match 200 What is a subcontractor? Category TCM and/or MAA ? End

TCM 400 Individuals performing Targeted Case Management (TCM) and who meet the qualifications as outlined in the California State Plan and the California Code of Regulations (22 CCR §51272). Category Targeted Case Management (TCM)

What are TCM Case Managers? Category Targeted Case Management (TCM) ? End

County-Based MAA 400 When CMS approved the currently used ‘County-Based Medi-Cal Administrative Activities Program Operational Plan’ Category Medi-Cal Administrative Activities (MAA)

What is May 2013? County-Based MAA 400 Category Medi-Cal Administrative Activities (MAA) ? End

School-Based MAA 400 A process used to identify the number of Medi-Cal eligible students enrolled in a claiming unit and used as the basis to calculate their Medi-Cal percentage. Category Medi-Cal Administrative Activities (MAA)

What is a DHCS Tape Match? School-Based MAA 400 What is a DHCS Tape Match? Category Medi-Cal Administrative Activities (MAA) ? End

Mental Health MAA 400 This item came out dated October 1,2016 as the program guide for Mental Health MAA. Category Medi-Cal Administrative Activities (MAA)

What is the MH MAA Implementation Plan? Mental Health MAA 400 What is the MH MAA Implementation Plan? Category Medi-Cal Administrative Activities (MAA) ? End

Time Survey 400 Method mentioned in OMB A-87 that collects moments performing activity for allocation to programs. 2,401 moments are held to be statistically valid for any size 'population'. Category MAA/TCM Time Survey

What is a Random Moment Time Survey/Study (RMTS)? Category MAA/TCM Time Survey ? End

Mix & Match 400 Medi-Cal Outreach Facilitating the Medi-Cal Application Referral Coordination and/or Monitoring Non-Emergency, Non-Medical Transportation Category TCM and/or MAA

What are the four main MAA activities? Mix & Match 400 What are the four main MAA activities? Category TCM and/or MAA ? End

TCM 600 Children under the age of 21 (14 CH) Medically Fragile Individuals (15 FA) Individuals at Risk of Institutionalization (16 IR) Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes (17 NO) Individuals with a Communicable Disease (18 CD) Category Targeted Case Management (TCM)

What are TCM Target Populations? Category Targeted Case Management (TCM) ? End

County-Based MAA 600 Volunteers who receive no compensation for their work. Staff positions funded 100% by non-allowable matching fund federal dollars. Category Medi-Cal Administrative Activities (MAA)

What are Ineligible CMAA Participants? County-Based MAA 600 What are Ineligible CMAA Participants? Category Medi-Cal Administrative Activities (MAA) ? End

School-Based MAA 600 A legal agreement composed by educational professionals, with input from the child's parents, for students identified as disabled in accordance with IDEA requirements. This agreement guides, coordinates, and documents instruction that is specially designed to meet the student's unique needs. Category Medi-Cal Administrative Activities (MAA)

What is a Individualized Education Plan (IEP)? School-Based MAA 600 What is a Individualized Education Plan (IEP)? Category Medi-Cal Administrative Activities (MAA) ? End

Mental Health MAA 600 The State requires each Mental Health Provider to submit one of these for each of it’s MH MAA claiming units for each MH MAA activity the agency will be performing. Category Medi-Cal Administrative Activities (MAA)

What are MH MAA Claim Plan Activity Sheets? Mental Health MAA 600 What are MH MAA Claim Plan Activity Sheets? Category Medi-Cal Administrative Activities (MAA) ? End

The guideline for this is: Time Survey 600 The guideline for this is: 0 – 99 Each Work Day 100 – 199 20 Consecutive Work Days 200 – 399 10 Consecutive Work Days 400 + 5 Consecutive Work Days Category MAA/TCM Time Survey

What is the Time Survey Frequency Requirements? Category MAA/TCM Time Survey ? End

Mix & Match 600 These public funds are appropriated directly to the State or local Medicaid agency, or are transferred from other public agencies (including Indian tribes) to the State or local agency and under its administrative control, or certified by the contributing public agency as representing expenditures eligible for FFP under this section. Category TCM and/or MAA

What is Certified Public Expenditure Revenue? Mix & Match 600 What is Certified Public Expenditure Revenue? Category TCM and/or MAA ? End

TCM 800 These services include: Comprehensive Assessment and Periodic Reassessment Development and Periodic Revision of Specific Care Plan 3. Referral and Related Activities Monitoring and Follow-up Activities Category Targeted Case Management (TCM)

What are Service Components? TCM 800 What are Service Components? Category Targeted Case Management (TCM) ? End

This is the deadline to make changes to your CMAA Claim Plan. County-Based MAA 800 This is the deadline to make changes to your CMAA Claim Plan. Category Medi-Cal Administrative Activities (MAA)

What is the end of the prior quarter? County-Based MAA 800 What is the end of the prior quarter? Category Medi-Cal Administrative Activities (MAA) ? End

School-Based MAA 800 Represent all LEAs, Special Education Local Program Area (SELPA), charter school, or County Offices of Education). Category Medi-Cal Administrative Activities (MAA)

What is a SMAA Claiming Unit? School-Based MAA 800 What is a SMAA Claiming Unit? Category Medi-Cal Administrative Activities (MAA) ? End

Mental Health MAA 800 A comprehensive package and agency sends to DHCS and must be approved by DHCS in order to participate in the MH MAA claiming process. Category Medi-Cal Administrative Activities (MAA)

What is a MH MAA Claiming Plan? Mental Health MAA 800 What is a MH MAA Claiming Plan? Category Medi-Cal Administrative Activities (MAA) ? End

Time Survey 800 This must be shown on the time survey form to the nearest 15 minute increment. Category MAA/TCM Time Survey

How is time recorded on the MAA/TCM Time Survey? Category MAA/TCM Time Survey ? End

Mix & Match 800 Part of an LGA, such as a public agency or private community based organization (CBO) contracted to an LGA to perform MAA or TCM, whose costs can be segregated as a separate budget unit. Category TCM and/or MAA

Mix & Match 800 What is a Claiming Unit? Category TCM and/or MAA ? End

TCM 1000 Due November 1st each year, this financial document estimates the current reimbursement rate, and reconciles the prior year’s encounter rate. Category Targeted Case Management (TCM)

What is the TCM Cost Report? Category Targeted Case Management (TCM) ? End

County-Based MAA 1000 A questionnaire required to be completed for each Skilled Professional Medical Personnel (SPMP) involved in an agency’s CMAA program. Category Medi-Cal Administrative Activities (MAA)

What is the CMAA SPMP Questionnaire? County-Based MAA 1000 What is the CMAA SPMP Questionnaire? Category Medi-Cal Administrative Activities (MAA) ? End

School-Based MAA 1000 The governing body of any school district or community college district, the County Office of Education, a state special school, a California State University campus, or a University of California campus. Category Medi-Cal Administrative Activities (MAA)

What is a Local Educational Agency (LEA)? School-Based MAA 1000 What is a Local Educational Agency (LEA)? Category Medi-Cal Administrative Activities (MAA) ? End

Mental Health MAA 1000 Medi-Cal Outreach (Activity 4) Medi-Cal Eligibility Intake (Activity 6) Referral in Crisis Situations for Non-Open Cases (Activity 8) Category Medi-Cal Administrative Activities (MAA)

What are the three main activities in MH MAA? Mental Health MAA 1000 What are the three main activities in MH MAA? Category Medi-Cal Administrative Activities (MAA) ? End

Time Survey 1000 Participants who complete a daily or perpetual time survey are not required to complete this with two written descriptions of activities during the Time Survey period. Category MAA/TCM Time Survey

What is a time survey activity description document? Category MAA/TCM Time Survey ? End

Mix & Match 1000 Document describing all of the current duties and responsibilities assigned to a specific position and how they relate to MAA. Includes the position classification, LGA name, submission date and the program or claiming unit name. Category TCM and/or MAA

What is a Duty Statement? Mix & Match 1000 What is a Duty Statement? Category TCM and/or MAA ? End

Thank You We hope this review has been helpful. Please feel free to check out the LGA Consortium website at http://maa-tcm.com If you would like to learn more about your program, the following workgroups offer year round information and opportunities: CMAA Guidelines Financial Management MHMAA Probation CMAA SMAA TCM Guidelines ? Board Slide 2