1. Random Moment Time Study Training (RMTS) School Year 2012-2013 Presented By: Sheena Joslyn SHARS/Medicaid Specialist Assistant to the Associate Superintendent for Finance

2. What is RMTS? A federally accepted statistically valid random sampling technique that measures the participant’s time performing work activities. – RMTS results allow Health and Human Services (HHSC) to determine what portion of the selected group of participant’s workload is spent performing Medicaid reimbursable activities. Significantly reduces staff time needed to record participant activities. Source: Texas Health and Human Services 2013 RMTS Training

3. SHARS/MAC Programs? SHARS (School Health and Related Services) – SHARS allows local school districts to obtain Medicaid reimbursement for certain health- related services provided to students in special education. MAC (Medicaid Administrative Claiming) – Texas School Districts [have the] opportunity to submit reimbursement claims for administrative activity that support[s] the Medicaid program. Source: Texas Health and Human Services 2013 RMTS Training

4. Purpose of the Time Study RMTS: – Measures the amount of time spent by the eligible staff on SHARS activities. – The same data is used to measure the amount of time spent on MAC activities. – Determine the percentage of time the Independent School Districts incur assisting individuals to access medically necessary Medicaid funded services. Source: Texas Health and Human Services 2013 RMTS Training

5. What are Medically Necessary Medicaid Funded Services? Direct Medical – Providing care, treatment and/or counseling Outreach – Informing students, families and groups about available services Eligibility – Assisting students or families with the Medicaid eligibility process Referral, Coordination, and Monitoring – Making referrals, coordinating and/or monitoring activities on a student’s IEP Staff Training – Coordinating, conducting or participating in training pertaining to medical or Medicaid services Translation – Arranging or providing translation to a student or family to access medical or Medicaid services Program Planning, Development & Interagency Coordination – Developing strategies to improve the coordination and delivery of medical or Medicaid services Provider Relations – Activities to secure and maintain Medicaid providers Source: Texas Health and Human Services 2013 RMTS Training

6. What’s Being Asked of Me? A “moment” is a specific minute in a day – Randomly selected throughout each of the 3 quarters. Not necessary to know if Medicaid eligible Important to know if the student has an ARD/IEP Answer 3 questions (Never use names): Question 1. Who was with you? Question 2. What were you doing? Question 3. Why were you performing this activity? Follow-up questions from Fairbanks within 3 calendar days from email receipt If you are not at work on selected moment, choose paid or unpaid leave You must respond to your sampled moment within 7 days Source: Texas Health and Human Services 2013 RMTS Training

7. Time Study Quarters What timeframe can I be selected? 1st Quarter TS 10/01/2012-12/07/2012 2nd Quarter TS 01/07/2013-03/29/2013 3rd Quarter TS 04/01/2013-05/31/2013 Source: Texas Health and Human Services 2013 RMTS Training

8. Time Study Process Do Not Delete Emails Source: Texas Health and Human Services 2013 RMTS Training

9. Fairbanks Website Source: Texas Health and Human Services 2013 RMTS Training

10. Moment Login Source: Texas Health and Human Services 2013 RMTS Training

11. Beginning the Moment Source: Texas Health and Human Services 2013 RMTS Training

12. RMTS Instruction Screen Source: Texas Health and Human Services 2013 RMTS Training

13. Time Study Example Fairbanks Website

14. 1.Who was with you? Never use specific names Student, Special Ed – (Age 0-2) – (Age 3-20) – (Age >21) Student, Special Ed, Lifeskills – (Age 0-2) – (Age 3-20) – (Age >21) Student, Not Special Ed Student (Multiple) No one alone District staff – Administrator – Teacher – School nurse – SHARS Service Provider – Non SHARS Service Provider Source: Texas Health and Human Services 2013 RMTS Training On the phone with parent Community Contact Staff meeting Staffing – No student/family present – Student and/or family present Student's family – Non special Ed students – Special Ed student Student AND Family – Non special Ed students – Special Ed student Not Working – Paid time off – Non Paid time off Other – please specify below

15. 2.What Were You Doing? Never use specific names Typically a 3-4 sentence description that provides sufficient information. The activity should be a detailed response as to what the participant was doing – Keep in mind that the person coding the moment has no idea of the participant’s job description, tasks performed or why they are performed. If you were not working moment should indicate whether the participant was on paid/unpaid time off. Refrain from using acronyms – If necessary, define your usage ALWAYS note whether your provided service was in IEP – If you do not know, contact your diagnostician Source: Texas Health and Human Services 2013 RMTS Training

16. 3.Why were you performing this activity? Never use specific names To provide a direct medical service as defined on a student’s IEP To provide a direct medical service not defined on a student’s IEP To provide a educational service as defined on a student’s IEP To provide a educational service not defined on a student’s IEP To determine a student’s eligibility: – For SHARS – For All Other Services To improve health services for the district’s students To provide or obtain information to or from a student’s family: – Regarding SHARS (School Health and Related Service) – Regarding all other service – Regarding an evaluation/assessment for SHARS – Regarding an evaluation/assessment for all other services To assist student/family in applying for health benefits Source: Texas Health and Human Services 2013 RMTS Training

17. 3.Why were you performing this activity? Never use specific names To assist student/family in applying for other services To upgrade professional skills through training – Through medical/health related training – Through educational training To improve social/vocational/educational services for the district’s students To coordinate transportation – To a SHARS (School Health and Related Service) – To all other services To coordinate translation – For a SHARS (School Health and Related Service) – For all other services To provide translation – For a SHARS service – For all other services To provide guidance counseling Source: Texas Health and Human Services 2013 RMTS Training

18. Direct MedicalEducational Activities that do require human intervention to accomplish the tasks the student would normally do for themselves if they did not have a disability or chronic medical condition, such as: – Hands on assistance – Supervision – Cueing Activities that do not require human intervention to accomplish the tasks the student would normally do for themselves if they did not have a disability or chronic medical condition, such as: – Reading/English/Language Arts – Writing – Mathematics Direct Medical or Educational? Source: Texas Health and Human Services 2013 RMTS Training

19. What If I Was Monitoring a Student(s)? Monitoring is a Direct Medical Service when: a) The student just received medication as indicated on his/her IEP. The participant is monitoring the student for a reaction. b) Student’s IEP requires that he/she receive continuous monitoring due to a behavior problem (PCS) c) The teacher’s aide is monitoring a student in a wheelchair to ensure they do not slide down in their wheelchair. (PCS) Monitoring is an Educational Service when: General monitoring of students in a cafeteria to ensure all students’ behaviors are in accordance with school policy. Source: Texas Health and Human Services 2013 RMTS Training

20. Time Study Example-PCS Fairbanks Website

21. Insufficient Answer Examples Examples of responses where the “What you are doing” does not clearly indicate what type of service is being provided. Source: Texas Health and Human Services 2013 RMTS Training

22. Insufficient Answer Examples If insufficient information is provided, the participant will receive a follow up email or phone call from Fairbanks requesting additional information. If the participant does not respond within 3 days Fairbanks will send a follow up email to Sheena Joslyn. Source: Texas Health and Human Services 2013 RMTS Training

23. Not Working/Absent Response Examples No need to provide details on a moment other than the sampled moment. When absent, it is important to indicate whether it was paid or un-paid time off. Source: Texas Health and Human Services 2013 RMTS Training

24. Personal Care Service (PCS) Examples I was going over an ABC letter chart with my students: I was co-teaching (two certified teachers) Social Studies to a group of students whom are a variety of learners. My students with disabilities were participating in classroom discussions with their non disabled peers. Today's lesson was an introduction of the Constitution. Source: Texas Health and Human Services 2013 RMTS Training

25. Completion Source: Texas Health and Human Services 2013 RMTS Training

26. REMINDERS Name Change – Email Sheena JoslynSheena Joslyn May be selected multiple times during 3 quarters Training is an annual requirement Failure to enter information – Disqualifies the moment 7 calendar days to answer RMTS questions 3 calendar days to reply to follow-up emails If you are not/were not at work – Paid/Unpaid Leave (option to email Sheena) Source: Texas Health and Human Services 2013 RMTS Training

27. Contact Information Sheena Joslyn – (817) 547-5735 – Sheena.joslyn@birdvilleschools.net Sheena.joslyn@birdvilleschools.net To learn more about RMTS: – BISD MAC/SHARS Website BISD MAC/SHARS Website – FAQ's FAQ's Source: Texas Health and Human Services 2013 RMTS Training