Presented by: Understanding Special Education Funding The School-Based ACCESS Program (SBAP)

Federal and State Medicaid Program In 1988, Congress enacted legislation to encourage state and local education agencies across the nation to access federal Medicaid reimbursement for health-related services for disabled children. PDE launched the SBAP in as an avenue for schools to receive federal funding through Medicaid. In 1988, Congress enacted legislation to encourage state and local education agencies across the nation to access federal Medicaid reimbursement for health-related services for disabled children. PDE launched the SBAP in as an avenue for schools to receive federal funding through Medicaid.

Overview SBAP allows the following school entities to receive federal Medicaid funds for providing IEP health-related services to Medical Assistance (MA) special-education students: School DistrictsSchool Districts Intermediate UnitsIntermediate Units MAWAsMAWAs School DistrictsSchool Districts Intermediate UnitsIntermediate Units MAWAsMAWAs Charter SchoolsCharter Schools Approved Private SchoolsApproved Private Schools Charter SchoolsCharter Schools Approved Private SchoolsApproved Private Schools Federal Medicaid Assistance Percentage 54.39% 54.39%

SBAP is a partnership DPW PDE Department of Public Welfare Pennsylvania Department of Education Local Education Agency Billing Agent Leader LEA

Eligible Services Assistive Devices Audiology IEP Development Nursing (RN & LPN) Occupational Therapy Orientation and Mobility Personal Care Assistant Physical Therapy Physician Assistive Devices Audiology IEP Development Nursing (RN & LPN) Occupational Therapy Orientation and Mobility Personal Care Assistant Physical Therapy Physician Psychiatry Psychology Social Work Speech/Language Teacher of Hearing Impaired Special Transportation Vision (limited) Psychiatry Psychology Social Work Speech/Language Teacher of Hearing Impaired Special Transportation Vision (limited)

SBAP Reimbursement Totals In the school year, LEAs received: $70 million In the school year, LEAs received: $70 million In the school year, LEAs received: $110 million In the school year, LEAs received: $110 million In the school year, LEAs received: $90 million In the school year, LEAs received: $90 million

Reimbursement Rate Factors The amount of reimbursement generated can vary greatly based on: Special education population MA population Health-related services provided by LEA and contracted staff Number of qualified providers Level of program oversight Special education population MA population Health-related services provided by LEA and contracted staff Number of qualified providers Level of program oversight

Requirements for Success Oversight by someone who will ensure the program’s integrity:  Track service provider billings  Timely claims submissions to Leader  Perform self-audits  Monitor students for MA eligibility  Outreach to families not enrolled in MA  Give service providers positive feedback  Track service provider billings  Timely claims submissions to Leader  Perform self-audits  Monitor students for MA eligibility  Outreach to families not enrolled in MA  Give service providers positive feedback

What’s My Role in SBAP? 1. Determine which service providers are eligible to participate in SBAP. a. Salaries for service providers or contracted providers must be partially or fully funded by state and/or local dollars. b. Providers must meet SBAP credential requirements. a. Salaries for service providers or contracted providers must be partially or fully funded by state and/or local dollars. b. Providers must meet SBAP credential requirements.

What’s My Role in SBAP? 2.Complete the Cost Calculation Worksheet

What’s My Role in SBAP? 3. Review your account balance monthly provided by Leader.

What’s My Role in SBAP? 4. Review guidelines for allowable expenditures prior to applying for funds withdrawal.

What’s My Role in SBAP? Submit LEA cover letter describing the programs, services, or products to be acquired. Do not send copies of purchase orders. a. A PDE 352 Form (school-age withdrawal) b. A PDE 352M Form (EI withdrawal) a. A PDE 352 Form (school-age withdrawal) b. A PDE 352M Form (EI withdrawal) 5. Apply for funds withdrawal at least bi-annually (for actual or projected expenses) using either:

What’s My Role in SBAP? PDE 352 Form (for school-age withdrawals) PDE 352 Form (for school-age withdrawals) All requests must be for a minimum of $1,000.

How Funds Have Been Spent Assistive devices to help disabled children function to their full capacity in both the home and classroom settings. Hiring additional special education staff. Assistive devices to help disabled children function to their full capacity in both the home and classroom settings. Hiring additional special education staff. SBAP funds have been used by LEAs for:

How Funds Have Been Spent Purchasing small buses to transport students with special needs. Updating special education classrooms with new computers and printers. Funding field trips for special education students. Making capital improvements (require prior approval). Purchasing small buses to transport students with special needs. Updating special education classrooms with new computers and printers. Funding field trips for special education students. Making capital improvements (require prior approval).

SBAP Funds Flow LEA submits SBAP transactions to Leader. Leader processes transactions nightly and submits weekly MA claims file to DPW. PDE Comptroller’s Office receives check from DPW. LEA submits SBAP transactions to Leader. Leader processes transactions nightly and submits weekly MA claims file to DPW. PDE Comptroller’s Office receives check from DPW. It helps to understand how the SBAP funds flow in this process:

SBAP Funds Flow PDE posts payment to LEA’s restricted account. LEA submits funds request to PDE by completing Withdrawal Form. Upon approval, PDE transfers funds to the LEA’s account. Monthly, Leader reconciles that correct fund amounts were transferred to the correct LEA. On average, reimbursement funds are disbursed within 8 weeks from time of request. PDE posts payment to LEA’s restricted account. LEA submits funds request to PDE by completing Withdrawal Form. Upon approval, PDE transfers funds to the LEA’s account. Monthly, Leader reconciles that correct fund amounts were transferred to the correct LEA. On average, reimbursement funds are disbursed within 8 weeks from time of request.

New Challenges facing LEAs... Medicaid cutbacks targeting school- based programs Costing methodologies that would considerably decrease amount of reimbursement Medicaid cutbacks targeting school- based programs Costing methodologies that would considerably decrease amount of reimbursement Federal audits of states have prompted:

New Challenges... continued Require states to obtain written parental consent prior to billing Medicaid Federal OSEP regulations... State audits have prompted... More stringent and detailed documentation

Service Offerings As the statewide SBAP vendor, Leader provides the following services: Web sites to record service provider logs and/or service billing data Call center (800 number) Phone and teleconferencing On-site and regional trainings Custom-report generation Program analysis Web sites to record service provider logs and/or service billing data Call center (800 number) Phone and teleconferencing On-site and regional trainings Custom-report generation Program analysis

Your SBAP Account Manager Phone:(800) Your SBAP Account Manager Phone:(800) Contact Information Your SBAP Liaison Name:Roni Russell Your SBAP Liaison Name:Roni Russell Please us your comments at: Please us your comments at: