1. Presenter: Thelma Galario LGA MAA/TCM Annual Conference SMAA HOT Topics 2016

2. Recent Changes to the SMAA Program Facts about the RMTS Review of Coded Moments Comprehensive Audit File MAA Participation Outreach Other Topics Session Agenda

3. Worker Log to RMTS Software System Platform (SSP) requirement Centralized Coding Process LGA SMAA Collaborative NEW RMTS Invoice SMAA Program – Recent Changes

4. RMTS basic requirements: RMTS System Software Platform (SSP) ₋ A web system that generates and catalogs time survey moments (a hard copy version is available). Centralized Coding SMAA Admin Hub for the LGA Collaborative Recent Changes

5. Seven (7) LGAs decided to form a time study consortia which we call the SMAA LGA Collaborative to make the process cost efficient and to allow smaller LGAs/LEAs to participate. SMAA Collaborative

6. Alameda Pasadena Riverside Sacramento San Francisco San Luis Obispo Tulare SMAA Collaborative

7. SMAA Collaborative: 7 LGAs and member LEAs ₋ are part of the time study universe and share the vendor costs and time study results for invoicing Administrative Hub ₋ is required and holds the contract with the software and coding service providers Recent Changes

8. RMTS Invoice: All LEAs within the collaborative will use the same time survey results Averaged Time Survey results of first 4 RMTS quarters will be applied to the deferred invoices from prior years that are subject to backcasting. Recent Changes

9. Implemented by DHCS on January 1, 2015 The RMTS method polls selected TSPs on an individual basis at random intervals on a quarterly basis and totals the results to determine the work effort for the entire population of TSPs over the quarter. What is RMTS?

10. Each moment is randomly assigned and each Time Survey Participant (TSP) has an equal opportunity to be selected. Some TSPs may be selected multiple times in a quarter and others may not be selected at all.

11. Facts about RMTS RMTS changed the role of all entities involved: DHCS LGA Coordinator LEA Coordinator Time Study Participant (TSP) Vendors Admin Hub

12. RMTS Roles The RMTS Process requires more management involvement from the LGA as well as the LEA Coordinators. The Admin Hub serves as the liaison between the LGAs under the collaborative.

13. RMTS Roles It is essential for all LEA MAA Coordinators and TSPs to understand the purpose of the time studies, the accurate and timely submission of all moments, quarterly time lines, and that their role is crucial to the success of the program.

14. Compliance Requirement Non-compliance of a TSP may affect the claiming of the entire collaborative. Each LEA is required to meet an 85% response rate to be compliant. An LEA who is non-compliant for two (2) quarters regardless of the fiscal year is suspended from participation in the SMAA program for one quarter.

15. Compliance Requirement After one (1) quarter of non-participation, the LEA will be conditionally reinstated. If the LEA does not meet 85% compliance in the conditional quarter, the LEA will be suspended for an additional quarter.

16. RMTS Roles – LEA Coordinator Quarterly input/update TSP List, District Calendar, and shifts. Coordinate changes of the above information to the LGA Regular monitoring of assigned moments to ensure compliance.

17. RMTS Roles – LGA Coordinator RMTS Administration ₋ LGA level Ensures LEAs meet quarterly due dates and requirements Regular monitoring of assigned moments/compliance review Technical assistance to LEAs

18. RMTS Roles – Vendors PCG – Public Consulting Group is DHCS authorized RMTS System provider Generates sample moments Provides technical support to LGAs Systems training Automated notifications and due date reminders

19. RMTS Roles – Vendors Fairbanks – contracted by the LGA Admin Hub to serve as the Coding Service provider for the SMAA Collaborative: Assigns codes to RMTS moments Requires a minimum of two (2) primary coders and one (1) senior coder

20. RMTS Roles – Other Vendors LEAs have the option to prepare their own RMTS invoices or contract with a vendor of their choice for this service.

21. RMTS Roles – TSPs Watches out for moment notification e-mails Submits their assigned moments before they expire Attend training for the following: ₋ Overview of the SMAA program ₋ Overview of the required process to participate in RMTS ₋ Standards for RMTS documentation ₋ Moment and Clarifying questions response process

22. Review of Coded Moments Levels of Review: LGA – minimum of 10% LGA Moments LEA – 100% of district’s moments Administrative Hub – 10% of SMAA Collaborative moments; randomly generated Fairbanks – 10% of SMAA Collaborative moments; randomly generated DHCS – 10% of total moments

23. Comprehensive Audit FIle Each claiming unit must develop an Audit File/Operational Plan beginning the first quarter in which a time survey is conducted. According to the current SMAA Manual (draft), all documents supporting the SMAA invoice must be retained for a minimum of five (5) fiscal years.

24. Comprehensive Audit FIle If an audit is in progress, or is identified as forthcoming, all records relevant to the audit must be retained through the audit’s duration, or the final resolution of all audit exceptions, deferrals, and/or disallowances – whichever is later.

25. Comprehensive Audit FIle Audit File/Operational Plan documents: Copies quarterly TSP Lists Job Descriptions/Duty Statements Medi-Cal Percentage Documentation All MAA-related Contracts/MOUs

26. Comprehensive Audit FIle Audit File/Operational Plan documents: Invoice Documents Organizational Charts Resource Directories DHCS approved outreach material and a copy of DHCS approval letter

27. Comprehensive Audit FIle Quality Control – Levels of Review LEA Coordinator – ensures completeness of the OP LGA Coordinator – includes training, site visits, desk review, and review of the Ops to ensure accuracy, reasonableness, and completeness DHCS – monitors and review various components of the SMAA program in California

28. Comprehensive Audit File A DHCS Review includes, but is not limited to, the following areas: TSP Universe List RMTS Time Survey RMTS Central Coding Training Compliance Financial Reporting Documentation Compliance

29. SMAA Participation Outreach Contact the appropriate person Use DHCS SMAA Outreach Flyer Be prepared to give a presentation Discuss how SMAA can benefit their district

30. SMAA Participation Outreach Review responsibilities and roles with prospective claiming unit: ₋ DHCS ₋ LGA ₋ Vendor/consultant ₋ LEA and TSPs (Time Survey Participants) Compliance with SMAA requirements Current time survey methodology issues SMAA Agreement

31. Program Costs Vendor costs based on services offered: ₋ RMTS Software (PCG) ₋ Central coders (Fairbanks) ₋ Invoice Preparation (LEA’s Choice) LGA Administration Fees: ₋ Training ₋ Oversight ₋ Invoice Submission ₋ Liaison

32. Program Costs RMTS Software (PCG) Central Coders (Fairbanks) ₋ These costs are built into the LGA Participation Fees which are passed on to the LEAs. LEA’s cost is calculated by: Total cost/number of TSP universe. LGAs must have a process of recovering these costs from the LEA. Invoice preparation (LEA’s Choice)

33. Questions?