Albuquerque, New Mexico -...

October 11th – 14th, 2011 Albuquerque, New Mexico

www.MedicaidForEducation.org

http://www.medicaidforeducation.org/

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Table of Contents

Page

Welcome Letter……………………………………………………………………………………………….2

Conference Schedule-at-a-Glance…………………………………………….……………….3

Session Details, Descriptions, Objectives………………………..………………………. 9

Bios of Speakers………………………………………………………………………….……….......22

About NAME ………………………………………………………………………………………………..35

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Welcome from the President

On behalf of NAME’s Board of Directors and Committee Chairpersons, I welcome you to the

9th Annual Conference of the National Alliance for Medicaid in Education (NAME, Inc.). Our

Conference theme this year is: “Aspire to New Heights with Medicaid in Education”. We hope

you enjoy your Conference experience with us in beautiful Albuquerque New Mexico. We are

pleased with the program and hope you will aspire to learn, network and have fun during

your stay in the Southwest.

We hope those of you arriving early and who have registered for our “Academy” will enjoy

this popular session. It has been designed for new participants and gives a broad overview

of the intersection of Medicaid and Education through a sharing of federal regulations by

knowledgeable veterans from state agencies and LEAs. The Academy is followed by

“Innovations”, which is an opportunity for all attendees to come together and learn from

one another about programs, practices, policies…in our states and school districts.

Wednesday morning kicks off the first full day of our time together in a general session.

After greetings by dignitaries from New Mexico, we will hear from nationally-known leaders

in our field to kick off the Conference.

Included in our program this year are more than a dozen breakout sessions and the popular

Nugget sessions presented by our colleagues from around the country. Our hope is that

you will learn about policies or programs you can bring back to your own states. The annual

updates from our federal partners has a new look this year. Representatives from each

agency— the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of

Education’s Office of Special Education Programs (OSEP) and Office of Special Education and

Rehabilitation Services (OSERS)—will provide separate general session presentations.

The Conference Committee has planned social and networking events including a reception

on Wednesday, a trolley tour of Albuquerque on Thursday, and our Annual business meeting

with election results on Friday. We encourage you to take advantage of breaks between

sessions and meal times to introduce yourself to other attendees and to catch up with old

friends.

Bids for the Charity fundraiser Silent Auction open on Wednesday and continue through

Friday morning. The local charity selected this year is Martineztown House of Neighborly

Service, which provides bilingual education and support to vulnerable children and families.

We hope you bring items from your state for others to bid on, and that you bid often and

high to support this wonderful local charity.

I hope you enjoy your time in Albuquerque and have an opportunity to say hello and tell me

about your connection to NAME. I look forward to seeing you in Rhode Island in 2012 for

NAME’s 10th Annual Conference.

Sincerely,

Denise Achin Denise Achin, NAME President

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Program-at-a-Glance

Tuesday, October 11, 2011

Noon-6:00 pm

Registration

North Atrium

2:00 pm-5:30 pm NAME Academy:

Understanding Medicaid in Education

Kay Dole (MN; Janet Lowe (MN); Nora Poisella

(NC); Jane Reagan (MI)

Alvarado C

Noon-6:00 pm

Exhibit Set-Up

East Atrium

Noon-6:00 pm

Auction Items Drop-Off

North Atrium

6:30 pm–8:00 pm

Innovations Alvarado A & B

Wednesday, October 12, 2011

7:30 am–5:00 pm

Registration

North Atrium

7:00 am-5:00 pm

Exhibits

East Atrium

7:00 am-5:00 pm

Charity Silent Auction

North Atrium

7:00 am-8:30 am

Breakfast Alvarado D & E

8:30 am-9:30 am

General Session:

Welcome

Michelle Lyons-Brown, Immediate Past President &

Conference Co-Chair (AK)

Alvarado D & E

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Invocation

Chenoa Bah Stilwell-Jensen, Member of the Dine

(Navajo) Nation (NM)

Greetings from New Mexico:

Julie Weinberg, Medical Assistance Division

Director, New Mexico Human Services

Department

Michael Vallejo, Deputy Director, Special

Education, NM Department of Education

Tito Madrid on Behalf of Albuquerque Mayor

Richard J. Berry

Conference Overview

Michelle Lyons-Brown, Conference Co-Chair (AK)

NAME Update

Denise Achin, NAME President (RI)

9:30 am–10:30 am

General Session:

Washington Update

Bruce Hunter, Associate Executive Director-

Advocacy, Policy and Communications, American

Association of School Administrators (VA)

John Hill, NAME, Chair of Government

Affairs/Public Relations Committee (IN)

Alvarado D & E

10:30 am–10:45 am

Morning Break

East Atrium

10:45 am-12:15 pm

Featured Speaker

Quality of Children’s Health Care

Dr. Jane McGrath, Professor of Pediatrics,

University of New Mexico

Alvarado D & E

12:15 pm-1:30 pm Charity Luncheon:

Martineztown House of Neighborly Service

Alvarado D & E

1:30 pm-3:30 pm NAME Nuggets

Health Care Compliance for School-Based

Medicaid Claiming - Larry Charny (NY)

Alvarado A

Elevate: Preparing for the Journey – Chuck

Muirhead (CA)

Alvarado B

Heighten Your Knowledge and Be Prepared—A

Quick Overview of Federal Audits - Patsy

Crawford (MA); Bryan Hawkom (MA); Nancy

Kuprewicz (NJ); Elaine Lerner (NJ)

Alvarado C

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Mining Documentation to Capture Medical

Necessity and Related Progress - Carlynn Higbie

(WI); Mark Smith (OH)

Alvarado F

Medicaid in Education: A Focus on Health Policy

and Legislation - Brooke Denton (CA); Alicia

Neumann (CA); Amanda Way (CA)

Alvarado G

Elevate Your Newsletter Skills - Susan Douglas

(FL)

Alvarado H

The Importance of Clinical Notation in Audit

Readiness – Chris Meroff (TX); Cindy Levesque

(ID)

Turquoise Room

All About NAME—its New Face - Anysia

Drumheller (CA); John Hill (IN)

Weavers Room

A Partnership That Works to Improve Health!

Sarah Daugherty-Pineda (NM); Michael Gibson

(NM); Chris O’Donnell (NM); Carol Pierce (NM)

Potters Room

3:30 pm-3:45 pm

Afternoon Break

East Atrium

3:45 pm-5:15 pm

Break Out Sessions:

School Based Health Care Compliance Requirements

Lawrence Charny (NY)

Alvarado A

Knock, Knock…Who’s There? The Office of the

Inspector General. Sorry, no one is at home now.

Charles Tyler (MD)

Alvarado B

Maximization of Medicaid Reimbursement Through

Continuous Improvement - Michael Sausa (NY);

Gloria Sullivan (NY)

Alvarado C

Alphabet Soup: EPSDT and IDEA…OMG, this is

TGTBT!! - Anne Karasek (NC); Tammy Whitlock

(VA)

Alvarado F

What Everyone Should Know About HIPAA 5010 and

ICD-10 - Jack McCoy (NM); Siva Kakuturi (NY);

Mark Pitcock (NM)

Alvarado G

5:15 pm-7:15 pm Welcome Reception Pavilion

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Thursday, October 13, 2011

7:30 am–5:00 pm

Registration

North Atrium

7:00 am-5:00 pm

Exhibits

East Atrium

7:00 am-5:00 pm

Charity Silent Auction

North Atrium

7:00 am-8:30 am

Breakfast Alvarado D & E

8:30 am-10:00 am Break Out Sessions

Student Confidentiality: HIPAA and FERPA in

the School Setting - Tia Campbell (VA)

Alvarado A

Reaching New Heights with Private Insurance

Companies - Mary Hall (VA)

Alvarado B

Heighten Your Billing Program – Best

Practices for Program Design and Compliance

- Patsy Crawford (MA); Bryan Hawkom

(MA); Nancy Kuprewicz (NJ); Elaine Lerner

(NJ)

Alvarado C

Soaring Above the Progress Reporting

Paradox Carlynn Higbie (WI); Lauren

Holahan (NC); Mark Smith (OH)

Alvarado F

Program Integrity is Not a Lofty Ideal – It is

Imperative - Lisa Carnes (IL); Isamu

Fairbanks (IL); Rick Jacobs (IL); Andrew

Joseph (IL)

Alvarado G

10:00 am-10:15 am Morning Break East Atrium

10:15 am-12:15 pm

General Session:

Annual Federal Medicaid Update and

Discussion

From The Centers for Medicare and Medicaid

Services (CMS): onsite - Sharon Brown (MD); Judi

Wallace (MD) and remotely - Mary Cieslicki (MD);

Jason Frandson (MD);

Alvarado D & E

12:15 pm-1:15 pm

Lunch

Alvarado D & E

1:15 pm-2:15 pm

Annual Federal Education Update and

Discussion

Representatives from the US Department of

Education’s (DOE) Office of Special Education and

Rehabilitative Services (OSERS) and the Office of

Special Education Programs (OSEP)

Alvarado D & E

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2:15-2:30 pm

Afternoon Break

East Atrium

2:30 pm-4:00 pm

Break Out Sessions:

The Cost Settlement Process—Heighten Your

Perspective! - Kathy Cummins Merry (MI);

Melinda Hollinshead (AZ); Michelle Simmons

(CA)

Alvarado A

360 Degrees of Program Accountability - Ann

Herrick (IL); Terryn Murphy (IL)

Alvarado B

Mission Possible: SBHCs as Patient-Centered

Medical Homes – Michael Archuleta (NM);

Michael Gibson (NM); Victor Lunsford (NM);

Chris O’Donnell (NM); Carol Pierce (NM)

Alvarado C

EPSDT Funding: How to Get it, How to Use it

Successfully and How to Keep it - Steven Kossor

(PA)

Alvarado F

Meeting at the Summit: Medical Necessity in a

Student-Centered, Educational World - Carlynn

Higbie (WI); Lauren Holahan (NC); Laurie Ray

(NC)

Alvarado G

4:00-5:00 pm

On Your Own

5:00 pm and

6:30 pm

The Best of Albuquerque Trolley Tour

Preregistration and ticket purchase required.

Spaces are still available but limited!! Purchase

ticket through Regonline

Hotel Lobby

5:00 pm

Dinner and Networking on Your Own

Friday, October 14, 2011

7:30 am-1:00 pm Registration

North Atrium

7:00 am-9:00 am

Silent Auction (Last Chance for Bidding) North Atrium

7:00 am-8:00 am

Breakfast

Alvarado D & E

8:00 am-8:45 am

General Session:

NAME Annual Membership Meeting and Election –

President Denise Achin Presiding

Alvarado D & E

8:45 am-8:55 am

Morning Break

East Atrium

http://www.regonline.com/builder/site/Default.aspx?EventID=960177

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8:55 am-10:25 am Town Hall Meetings, with “New” Regions

Region 1 Connecticut, Massachusetts, Maine, New

Hampshire, New Jersey, New York, Pennsylvania, Rhode

Island, Vermont, Delaware, District of Columbia,

Kentucky, Maryland, North Carolina, South Carolina,

Tennessee, Virginia, and West Virginia

Region 2 Alabama, Arkansas, Florida, Georgia,

Louisiana, Mississippi, Oklahoma, Texas, Puerto Rico,

US Virgin Islands, Illinois, Indiana, Iowa, Michigan,

Minnesota, Missouri, Ohio, and Wisconsin

Region 3 Arizona, Colorado, Kansas, Montana,

Nebraska, New Mexico, North Dakota, South Dakota,

Utah, Wyoming, Alaska, California, Hawaii, Idaho,

Nevada, Oregon, and Washington

Alvarado D & E

Franciscan

Alvarado G & H

10:25 – 10:35 am

Morning Break

East Atrium

10:35 -10:50 am

Silent Auction Winners Announced – Debbie

Geer (CA)

Alvarado D & E

10:50 am - 11:50 am

Reaction to Town Hall Discussions

Panel Discusses Issues, Fields Questions and

Develops Action Plans

Alvarado D & E

11:50 am – 12:15 pm

Passing the Gavel / Call to Rhode Island and

Closing Reflections

Denise Achin, Outgoing President

Jane Reagan, Incoming President

Alvarado D & E

12:45 pm-2:45 pm

Public Board Meeting

Fireplace Room

3:00 pm-5:00 pm

Long Range Planning Meeting (Leadership Team)

Fireplace Room

Saturday, October 15, 2011

8:00 am-4:00 pm

Strategic Planning Meeting (Leadership Team)

Fireplace Room

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Session Details

Tuesday, October 11, 2011 NAME Academy: Understanding Medicaid in Education (2:00-5:30) If you are new to Medicaid in Education, this popular Pre-Conference feature is for you! It is

broad in scope and packed with details while small enough to allow for meaningful

discussions. You will gain a basic understanding about Medicaid and Special Education,

including history and federal regulations. In addition, experienced presenters will share how

best to integrate both worlds in a school setting. The Academy has much to offer new staff

from State Agencies, LEAs, vendors and partner organizations who want to understand the

unique nuances and relationships of these two federal programs and how it works locally.

Objectives: Participants will be able to:

1) Describe at least three of the primary features of the Medicaid Program that are

pertinent to all states in the country.

2) Explain at least three of the primary features of the federal IDEA law as it applies to

Special Education programs in the country’s public schools.

3) Discuss three considerations for developing a school-based billing program.

Location: Alvarado C

Speakers: Medicaid: Nora Poisella (NC) Special Education: Jane Reagan (MI)

Integrating Medicaid and Education at the Local Level: Kay Dole (MN);

Janet Lowe (MN)

Innovations (6:30-8:00 pm) Whether you are new to Medicaid in Education or a seasoned veteran, join us for this Pre-

Conference session that will be in an Open Forum format. We encourage you to come

prepared to share, along with colleagues from across the country, your district’s or state’s

best practices, innovations, big news, or other helpful information related to School-Based

Medicaid programs.


1) List at least three best practices identified by states, LEAs or vendors.

2) Discuss one innovation that may have potential to improve current programs or services

in their work environment.

3) Describe at least five new concepts related to serving and/or funding services for

children and youth with special needs.

Location: Alvarado A & B

Facilitator: Michelle Lyons-Brown (AK), NAME Immediate Past President, Conference

Co-Chair

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Wednesday, October 12, 2011

General Session Washington Update (9:30-10:30 am)

Bruce Hunter will provide an update on the potential impact on schools, of the “Super

Committee” that Congress recently formed as a part of the debt ceiling deal. NAME is a

member of the coalition of collaborating partner organizations that is focused on educating

Super Committee members about the positive impacts that the school-based Medicaid

programs have on the educational and medical needs of our nation’s most vulnerable

children. Bruce will report on the numerous activities of that coalition. He will also briefly

review the progress or lack thereof of reauthorization of ESEA and some IDEA policy issues.

John Hill will provide a report on the current status of the IDEA regulation 34 CFR §

300.154(d)(iv)(A), also known as the School-Based Medicaid parental consent

regulation.


1) Understand and be able to re-state the long term benefits and key talking points of the

School-Based Medicaid program.

2) Provide at least three key points regarding why Parental Consent to access Medicaid

should not be included in IDEA regulations

3) Initiate contact with, communicate and educate policy makers about at least two issues

that are important to the Medicaid School-Based Medicaid program.

Location: Alvarado D & E

Speakers: Bruce Hunter, Associate Executive Director-Advocacy, Policy and

Communications, American Association of School Administrators

John Hill, NAME, Chair of Government Affairs/Public Relations Committee

General Session Featured Speaker

Quality of Children’s Health Care

Dr. Jane McGrath’s passion for child and adolescent health, her work at the local, state and

national levels on behalf of school health programs, and her current emphasis on quality of

health care for children will all be woven in to her Opening Keynote Address. She will relate

her experiences with and the importance of, collaborating with other partners to share and

develop best practices, including cross-agency coordination, so that health care delivered to

children and youth improves. She has recently obtained and is implementing a grant to help

find the best methods for improving quality of health care for children and youth, that has

interagency collaboration as a central feature.

Dr. McGrath will relate one of her beliefs, that allocation of some dollars for school health

care is a major factor that can improve outcomes. She will suggest that school-based health

care can improve if we all work together, share information to understand the similarities

and differences among our programs across the country.


1) Provide two examples of measures of quality of health care for children

2) Describe the grant project that is seeking methods for improving quality of health

care for children

3) Explain how and why mapping information and data occur when comparing different

health

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Speaker: Dr. Jane McGrath, Professor of Pediatrics, University of New Mexico

NAME Nuggets

1:30 – 3:30 pm

Health Care Compliance for School-Based Medicaid Claiming

Consider how a 2009 settlement between the Centers for Medicare and Medicaid Services

(CMS) and NY Department of Health impacted schools in NY and how compliance

requirements are required by new federal regulations that may soon influence how LEAs in

your state approach Medicaid billing. This nugget is an introduction to a breakout session

on the topic of Medicaid compliance in an education setting.


1) Anticipate future requests from the Office of the Inspector General

2) Identify three areas where LEAs in your state may be at risk.

Location: Alvarado A

Speaker: Larry Charny (NY)

Elevate: Preparing for the Journey

If someone asked “What” you do, or “How” you do it, it would be fairly easy to answer. But

what if someone asked you, “Why”. Why do you do what you do? When you and your

followers are committed to the “Why”, the “What and How” fall into place. This session will

focus on getting to the “Why”.


1) Understand the “Why” behind “what” we do every day.

2) Develop strategies that help them implement the information learned from this NAME

Conference.

3) Be inspired to a “Call to Action” that involves real action when returning to their

organizations.

Location: Alvarado B

Speaker: Chuck Muirhead (CA)

Heighten Your Knowledge and Be Prepared—A Quick Overview of Federal

Audits

This session is the NUGGET-version of a full breakout scheduled Thursday morning. It will

emphasize the importance of being prepared for audits and compliance with documentation

and service requirements by highlighting results and key federal findings in various states so

you can help prevent such errors in your program! Learn the key things Federal Auditors

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generally look for in Fee-For-Service and Medicaid Administrative Claiming programs, actual

findings across multiple states, and state and local responses to the findings.


1) Understand major past and current audit findings and their impact on your compliance

practices.

2) Learn how to prepare for and work through Federal audits.


Speakers: Patsy Crawford (MA); Bryan Hawkom (MA); Nancy Kuprewicz (NJ); Elaine

Lerner (NJ)

Mining Documentation to Capture Medical Necessity and Related Progress

Learn how to communicate therapeutic concepts in an education system when writing IEPs,

plans of care and tracking progress. This nugget is an introduction to a breakout session on

this topic.


1) Understand why it is important to have a documentation methodology.

2) Know what aspects to consider for acceptable documentation practices.

3) Discuss Medicaid audit findings from one state.

Location: Alvarado F

Speakers: Carlynn Higbie (WI); Mark Smith (OH)

Medicaid in Education: A Focus on Health Policy and Legislation

Get a snapshot of the current landscape for school-based Medicaid. This is a high-level

overview of the past year's major federal policy initiatives that affect school-based

Medicaid programs. Topics will include specific CMS regulations and federal legislation

(including Health Reform).


1) Discuss policy, why it matters and how it is implemented.

2) Review regulatory and legislative policy changes from the past year.

3) Summarize opportunities associated with the ACA (Health Reform).

4) Exchange information on how to get involved and how to stay current.

Location: Alvarado G

Speakers: Brooke Denton (CA); Alicia Neumann (CA); Amanda Way (CA)

Elevate Your Newsletter Skills

This session will offer tips on creating an informative, lively and engaging newsletter

that recipients will actually read.


1) Format a newsletter.

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2) Use plain language in a newsletter.

3) Employ white space, quotes, and photos in a newsletter.

4) Choose relevant topics for a newsletter.

Location: Alvarado H

Speaker: Susan Douglas (FL)

The Importance of Clinical Notation in Audit Readiness

Gain a greater understanding about clinical notation and its impact on student progress

monitoring. This session unpacks the key elements of clinical notation, describes how

documentation helps be audit ready and assists school districts prior to and during an audit.


1) Understand the importance of clinical notation during service delivery.

2) Appreciate the best practices of clinical notation for audit readiness

and improved student outcomes.

3) Assist school districts during the audit process from beginning to end.

Location: Turquoise Room

Speakers: Chris Meroff (TX); Cindy Levesque (ID)

All About NAME—its New Face

Are you new to the NAME Organization? Confused about NAME’s reconfiguration? If you

answered YES to either of these questions, this is the Nugget session for you! The

organization’s Membership Committee Chair Drumheller will share the history and

development of NAME, while the Government Affairs and Public Relations Committee Chair

Hill will discuss the organization’s reconfiguration. Learn more about the organization that

“Advocates program integrity for school based Medicaid reimbursement.”


1) Understand why the NAME organization was developed.

2) Relate three key events in the history of NAME.

3) Briefly explain the current reconfiguration of the NAME Board of Directors including the

number of regions.

Location: Weavers Room

Speakers: Anysia Drumheller (CA); John Hill (IN)

A Partnership That Works to Improve Health!

Together, the NM Alliance for School-Based Health Care, Blue Cross/Blue Shield of NM

(BCBSNM), Apex Education and a school-based health (SBHC) center developed a patient

registry within the SBHC electronic patient management system (Welligent). The system

met the partners needs by improving patient health tracking and provision of data to

BCBSNM and improved patient health outcomes. See how this project led to other

important developments to improve care and sustain the SBHCs through commercial

insurance billing.

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1) Describe the benefits of SBHC partnerships to improve their patient health outcomes.

2) Identify key components of a patient registry for health improvement and collection

of data.

3) List ways in which SBHCs can use electronic patient management systems as a

transition toward the use of electronic health records.

Location: Potters Room

Speakers: Sarah Daugherty-Pineda, NM; Michael Gibson, NM; Chris O’Donnell, NM;

Carol Pierce, NM

Wednesday, October 12, 2011, cont’d

Break Out Sessions

3:45 – 5:15 pm

School Based Health Care Compliance Requirements

Consider how a 2009 settlement between the Centers for Medicare and Medicaid Services

(CMS) and NY Department of Health impacted schools in NY and how compliance

requirements are required by new federal regulations that may soon influence how LEAs in

your state approach Medicaid billing. This session is a continuation of an earlier Nugget

session and drills deeper into the discussion about the divergence between the medical and

educational models and the implications for compliance.


1) Discuss healthcare compliance as it relates to Medicaid claimable services delivered in a

school setting.

2) Identify three areas of convergence and divergence between the medical and educational

models.

3) Anticipate the range of compliance implications within this integrated medical and

educational environment.


Speaker: Lawrence Charny (NY)

Knock, Knock…Who’s There? The Office of the Inspector General. Sorry, no one

is at home now.

This breakout session will capture the essence of audits from the perspective of the

Local Education Agency (LEA). LEA’s in the State of Maryland have been visited by the

Office of the Inspector General (OIG), as well as an annual state audit, and have

participated in the PERM audits on several occasions. Mr. Tyler will will review the audit

process and outline preparation techniques in order to ensure an organized and

successful audit.


1) Identify the documentation required for an audit

2) Determine frequent pitfalls made by school districts in an audit

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3) Identify strategies for ensuring that audits are reasonably successful


Speaker: Charles Tyler (MD)

Maximization of Medicaid Reimbursement Through Continuous Improvement

Using Lean Six Sigma principles, find out how to design Medicaid procedures,

communications and systems. This presentation focuses on effective and efficient methods

to establish expectations, protocols, communication, organization, documentation, timeline

flow charts and monitoring to maximize reimbursement for Medicaid claims and minimize

risk exposure for audits. The emphasis is on continuous improvement.


1) Define and communicate expectations for all staff involved in the Medicaid in

Education process.

2) Develop effective protocols with appropriate time lines.

3) Establish efficient systems that are easy to understand and monitor.

4) Minimize risk of exposure for "non-allowable' on an audit.


Speakers: Michael Sausa (NY); Gloria Sullivan (NY)

Alphabet Soup: EPSDT and IDEA…OMG, this is TGTBT!!

Gain an understanding about how Virginia’s Department of Medical Assistance Services and

the Virginia Part C Office worked together to utilize Early Periodic Screening, Diagnosis and

Treatment (EPSDT). Through their collaborative efforts they now use EPSDT funds to

support early intervention services for children birth to three. The results are positive

outcomes for families and service providers.


1) Increase their understanding of the Individuals with Disabilities Education Act (IDEA).

2) Develop an understanding about how Medicaid EPSDT may be used to support early

intervention services for children birth to 3.) List at least two strategies for producing

positive outcomes for families and service providers.


Speakers: Anne Karasek (NC); Tammy Whitlock (VA)

What Everyone Should Know About HIPAA 5010 and ICD-10

Be prepared! Find out about the basics of two new key mandates that will dramatically

affect how you submit claims. Starting on January 1, 2012 the HIPAA 5010 transaction

standard is required for electronic billing. ICD-10 diagnosis codes are required beginning on

October 1, 2013. Will you be ready?


1) Understand the requirements and impact of the HIPAA 5010 transaction standard.

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2) Be aware of the requirements and impact of the transition from ICD-9 to ICD-10 codes.

3) Formulate an action plan and next steps to ensure organizational readiness for these two

mandates.


Speakers: Jack McCoy (NM), Siva Kakuturi (NY); Mark Pitcock (NM)

Thursday, October 13, 2011 NAME Committees Breakfast NAME’s Committees work all year long on a variety of activities to further the mission and

work of the organization. At the Annual Conference some Committees take time to meet

with each other face to face. If you are currently part of a Committee, join your colleagues

for coffee, camaraderie and planning for next year. If you are interested in learning more

about becoming active on one of NAME’s standing Committees, pull up a chair and get

acquainted. Look for signs on the tables.

Committees:

Bylaws

Membership

Finance

Education and Research

Conference

Communications

Governmental Affairs/ Public Relations

Web

Nominating

Financial Review

Policy and Procedures


Breakout Sessions

8:30 – 10:00 am

Student Confidentiality: HIPAA and FERPA in the School Setting

Participants of this session will receive a brief overview of the privacy laws that impact

student confidentiality in the school setting. Topics of discussion include parent/student

rights, information that can be shared without prior consent, FERPA and public health, and

where HIPAA and FERPA collide. Model forms will be provided.


1) Describe HIPAA and FERPA as they apply to student confidentiality

2) Discuss how privacy laws impact school health services

3) Describe annual notification of rights under FERPA and annual notice for directory

information

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Speakers: Tia Campbell (VA)

Reaching New Heights with Private Insurance Companies

Learn how to reach past the barriers to billing private insurance companies when you

identify yourself as a public school division or district. Maximize the revenue for your

school by billing Medicaid and private insurance companies for your Early Intervention

services.


1) Understand the steps necessary to obtain contracts with private insurance companies.

2) Have a clear picture of the process involving private insurance companies.

3) Determine if it is cost effective for your school division to bill in house.


Speakers: Mary Hall (VA)

Heighten Your Billing Program – Best Practices for Program Design and

Compliance

Do you wonder how your billing program compares with other school districts or in other

states? How about audit findings? Come learn about the key aspects of optimal Medicaid

billing programs. Topics covered will include: 1) Developing the best menu of covered

services to maximize allowable reimbursement (and which ones may not be worth the time

and effort); 2) Requirements for physician authorization and provider qualifications – is

your program unnecessarily restrictive? 3) National Compliance and Audit Review – learn

about key federal audit findings in various states so you can prevent such errors in your

program! 4) Learn the high level impact of a solid cost settlement process


1) List several characteristics of an “optimal” billing program design related to provider

qualifications, covered services, and physician authorization.

2) Explain several major past and current audit findings and their impact on your

compliance practices.

3) Analyze how cost settlement could impact your FFS and MAC programs


Speakers: Patsy Crawford (MA), Bryan Hawkom (MA), Nancy Kuprewicz (NJ), Elaine

Lerner (NJ)

Soaring Above the Progress Reporting Paradox

Explore ways to address the data and policy needs of multiple stakeholders including

families, educators and Medicaid. The panel will discuss and offer varying perspectives

regarding how multiple regulatory agencies (medical and educational) view progress and

explain that there is more than one approach to achieve the Medicaid requirements for

medical progress.

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1) Develop strategies to assure compliance in progress reporting and justification of ongoing

medical necessity.

2) Understand the elements to consider when developing progress reporting guidelines.

3) Discuss strategies in defining a progress reporting process that are defendable in a

Medicaid audit.

4) Confidently defend their documentation of progress in the event of a Medicaid audit.


Speakers: Carlynn Higbie (WI), Lauren Holahan (NC), Mark Smith (OH)

Program Integrity is Not a Lofty Ideal – It is Imperative

The imperative to assure integrity of Medicaid claiming has never been more important than

it is today. Increasing federal and state mandates combine with reduced resources to

create challenges that increase risk for states' Medicaid programs. This presentation

provides state and local officials with a deeper understanding of CMS requirements and

presents how improved use of technology and monitoring, along with examples of best

practices from states, enables the integration of the time study, cost reporting and

settlement processes to comply with CMS requirements.


1) Identify and describe key areas that are critical for states to achieve and maintain

program compliance and integrity for their school-based Medicaid programs.

2) Understand how technology solutions based on compliance and business rules can

significantly enhance program integrity and effective oversight with limited resources.

3) Recognize how Administrative Claiming, Direct Services Claiming and cost reporting

and settlement methodologies and processes can be integrated to achieve effective

and efficient claiming, monitoring and oversight of school-based Medicaid programs.


Speakers: Lisa Carnes (IL), Isamu Fairbanks (IL), Rick Jacobs (IL), Andrew Joseph (IL)

General Sessions, Thursday, October 13, 2011

Annual Federal Medicaid Update and Discussion (10:15-12:15 am)

It is tradition at the NAME Annual Conference to have staff from the federal Centers for

Medicare and Medicaid Services provide both background and updates on each of their

various specialty areas that have relevance to SBS. In addition, the staff will address topics

and questions submitted by NAME members this Summer, and take additional questions

from the audience, time permitting.


Speakers: Onsite: Judi Wallace and Mary Cieslicki from the Centers for Medicare and

Medicaid Services-CMS. Participating remotely from CMS in

Baltimore: Sharon Brown and Jason Frandson

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Annual Federal Education Update and Discussion (1:15-2:15 pm)

In maintaining the tradition of federal agency updates and summaries of hot topics, for

the fourth consecutive year, the federal Office of Special Education and Rehabilitation

Services (OSERS) will provide us with current news from the U.S. Department of

Education.


Speakers Participating remotely from OSERS in Washington, DC: Jennifer Sheehy

Breakout Sessions

2:30 – 4:00 pm

The Cost Settlement Process – Heighten Your Perspective!

Now that the cost settlement process is generally required by CMS when setting rates

for direct services such as OT, PT and speech therapy, best practices and important

lessons learned have emerged. These best practices impact both the state agency as

well as the local districts in terms of operational processes, ability to optimize program

revenue, and opportunities for managing compliance and risk. This session will be in a

panel format, and the panelists will present best practices from the viewpoint of a more

mature program (Michigan’s program was began in 2008) as well as an early stage

program (Arizona’s proposed implementation was for July 1, 2011). Best practices and

challenges around the time study, allowable costs, compliance management,

development of accurate rates, and cost settlement calculation factors will be discussed.

Comparison of the Michigan program and the Arizona program will be highlighted with

respect to program requirements and CMS feedback. In addition, potential program

compliance review and audit considerations will be discussed.

Objectives: Participants will be able to: 1) Understand the federal requirements for cost settlement

2) Explain the impact of cost settlement on state and local district processes and

procedures, including lessons learned and best practices

3) Discuss how cost settlement impacts your FFS and MAC programs, including the time

study process and annual cost reconciliation


Speakers: Melinda Hollinshead (AZ); Kathy Cummins Merry (MI); Michelle Simmons

(CA)

360 Degrees of Program Accountability

This session targets Medicaid program administrators, clinicians and other program

managers who are involved with all students (general education and students with

disabilities) receiving health services in the school environment. It will provide a detailed

discussion of the benefits of utilizing data and data systems to develop management tools

that encourage 360-degrees of identification, review, feedback and resolution. This

discussion focuses on management tools that assist program managers in analyzing

services delivered to all students to ensure the efficiency and quality of service models,

progress toward goals, as well as determining corrective courses of action where

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appropriate. Part of the session will be designed to brainstorm with participants on

techniques to review health service data in order to positively impact health outcomes.


1) Think strategically about analyzing health service information collected at the school l

level to effectively manage staff service models and progress toward IEP goals.

2) Identify techniques to manipulate data and develop reports to assist program

participants in taking an in-depth look at services delivered to all students (general

education and students with disabilities).

3) List at least two ways program review can positively impact short and/or long-term

success of the Medicaid Program.


Speakers: Ann Herrick (IL); Terryn Murphy (IL)

Mission Possible: SBHCs as Patient-Centered Medical Homes

Listen, as staff from the NM Alliance for School-Based Health Care, Molina Healthcare of NM,

Apex Education and a school-based health center (SBHC), describe their partnership project

to implement components of a patient-centered medical home approach at a SBHC. Key

lessons and strategies for SBHCs to become patient-centered medical homes will be shared.


1) Identify key components of the patient-centered medical home approach.

2) Discuss changes that must be made by SBHCs in order to utilize the patient-centered

medical home concepts so that a congruent team approach is applied in providing

comprehensive primary health care for students.

3) List at least two benefits of partnerships to improve quality of care provided through

SBHCs.


Speakers: Michael Archuleta (NM), Michael Gibson (NM), Victor Lunsford (NM), Chris

O'Donnell (NM), Carol Pierce (NM)

EPSDT Funding: How to Get it, How to Use it Successfully and How to Keep it

Learn the truth about the potential use of Early Periodic Screening, Diagnosis and Treatment

(EPSDT) funds for mental health treatment of children. The Medicaid EPSDT mandate is

"the greatest treatment funding secret ever concealed," and it is available under the Social

Security Act as a Civil Right for children with disabilities. The presenter developed a highly

successful model that utilizes EPSDT funding to deliver mental health and behavioral

support services to children in schools. Learn how to replicate this in your state.


1) Learn how to uncover hidden information about EPSDT in their state.

2) Be aware of how to implement highly efficient, effective treatment services in schools.

3) Avoid costly service delivery and documentation pitfalls.


Speaker: Steven Kossor (PA)

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Meeting at the Summit: Medical Necessity in a Student-Centered, Educational

World

Is it possible to meet the documentation requirements of multiple masters when you are an

SLP, OT or PT working in an educational setting? Learn how these three

presenters/practitioners integrate IDEA, Medicaid, professional standards, best practice for

delivery in an educational setting and make the connection between medical necessity and a

student's educational program. Let them help you integrate the multiple requirements that

often make your jobs difficult to manage.


1) Recognize federal legislation that drive the need for related services to support

special education.

2) Identify key differences between educational services and clinical services focused on the

clinician role and documentation including plan of care.

3) Describe legislative parameters and best practices for integrated IEPs and related

services


Speakers: Carlynn Higbie (WI), Lauren Holahan (NC), Laurie Ray (NC)

Friday, October 14, 2011

General Sessions

NAME Annual Membership Meeting and Election Results (8:00-8:45 am)

During this meeting, NAME members will be provided an update from NAME Officers and

Committee Chairs with their activities and accomplishments this past year; a preview of the

proposed budget for review; and the results of electronic elections that were held from

October 7th through noon MT, October 13th

Town Hall Meetings with “New” Regions (8:55-10:25 am)

Each year the NAME Conference seems to fly by, and in spite of several opportunities during

the week to network with our peers, we often wish we’d spent more time discussing major

issues with each other. This session intends to provide you with just that chance. Organized

by the three new geographic regions, attendees will be encouraged to reflect on issues or

events that arose during the week, bring up new topics for consideration, or review those

that arise every year. Several provocative questions will be available for each region to

consider. Each Regional meeting will be led by Board of Directors members, and the

recommendations for next steps and/or action will be reported out to the entire group in the

next session. Bring your creative ideas, data, concerns, suggestions for action, stories of

success, and actively participate!

Locations: Region 1 Alvarado D & E Region 2, Franciscan Region 3, Alvarado G & H

Reaction to Town Hall Discussions (10:50-11:50 am)

The Regional Town Hall discussions will have a recorder summarize the ideas, reflections

and proposed action steps, shared by the attendees, and the summaries will be shared with

the entire Conference during this session. Dialogue and clarification will be encouraged, and

the NAME Board of Directors will compile the results which may be used to assist the Board

with its long range planning.

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Speakers

Denise Achin has over 17 years of experience in working with local education agencies in

Rhode Island, assisting them in accessing Medicaid funds. She was a main contributor to the

following documents and resources: the Rhode Island Department of Human Services

Medicaid Direct Services Guidebook for LEAs; Options and Resources (a brochure describing

formal and informal due process for special education); a web-based resource guide for

parents and providers working with children with special health care needs; IDEA Parent

Consent to access Medicaid resources; and Fact Sheets for CEDARR Direct Services: PASS,

Kids Connect and Respite. She holds a Bachelor of Arts Degree in History from the

University of Massachusetts, Amherst and a Masters in Education Degree from Bridgewater

State College.

Michelle Lyons-Brown came to Alaska nearly 30 years ago to teach in the village of

Shishmaref. She spent 14 years in the Arctic before moving to the capital city of

Juneau. For the past 20 years, she has worked for the Department of Health and Social

Services determining Medicaid eligibility, providing child protective services as a licensed

social worker and spent nine years developing policy and conducting federal negotiations for

the state’s Medicaid program. She was the Project Director for the Positive Behavior

Support (PBS) Statewide Planning Initiative to develop training, certification and evaluation

program for PBS facilitators based on Kansas U’s program. She was the primary negotiator

of the School-Based Administrative Claiming Plan and was instrumental in developing and

implementing the state’s School-Based fee-for-service policy. Her experience as the state’s

Olmstead Coordinator and the Project Director for Alaska’s Home and Community Based

Medicaid demonstration project for children in Psychiatric Treatment Residential Facilities

has served NAME well. She has been successful in collaborating with partner agencies in

policy development, and has extensive team building experience bringing federal, state and

private sector agencies together in innovative policy design efforts. She is currently serving

as the statewide Coordinator for Alaska’s Child Advocacy Centers and Child Justice Act Task

Force. Michelle is completing her term as the Immediate Past President of NAME.

Sharon Brown joined the CMS as a Presidential Management Intern in July

1997. Previously she earned a Master’s of Public Administration at Ohio State University

and worked at the OSU Medical Center in the department of strategic planning. Her major

responsibilities at CMS include review and approval of cost allocation plans, time studies,

and implementation plans for capturing Medicaid-related direct medical service costs and

administrative expenditures in various settings (i.e., schools, tribes, and hospitals).

Tia Campbell received her diploma in nursing from Richmond Memorial Hospital School of

Nursing in 1983. In 1985 she received her bachelor of science in nursing from the Medical

College of Virginia and completed her master of science in nursing, with a concentration in

nursing education from Walden University in 2008. Tia joined the Division of Special

Education and Student Services at the Virginia Department of Education as school health

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specialist in August 2005. She provides technical assistance and training to 132 school

divisions regarding school nursing, school health issues, homebound instruction, and

Medicaid billing in schools. Prior to coming to DOE, she was a school nurse in Hanover

County Public Schools. Tia is a National Board Certified School Nurse and is currently

serving as Vice President of the National Association of School Nurses.

Lisa Carnes has more than 10 years of experience in management consulting, audit and

risk management, and financial services. She manages ongoing client projects and is

responsible for designing, implementing and managing the business processes and

applications for claiming of third party reimbursement for health care services. She is

currently a Principal with Fairbanks LLC. She earned a Masters of Business Administration

from Case Western Reserve University, Weatherhead School of Management and a Bachelor

of Science in Business Administration from Ohio State University.

Larry Charny has been involved with Medicaid claiming for special education school-based

related services for eight years. In 1998 he worked for the Department’s Office of Revenue

Operations, in collaboration with the New York State Education Department and New York

State Department of Health in the design and implementation of the pilot program that has

become the model used in New York State for on-going service coordination/case

management Medicaid claiming. In June 2002, he was retained by the Chief Financial

Officer, the Office of Legal Services and the Office of Special Education Initiatives to direct

the efforts to collect and review documents needed to substantiate Medicaid claims dating

back to 1990, in response to federal audits. Larry serves on the executive committees for

Medicaid and Legislative Issues of Council of New York Special Education Administrators

(CNYSEA) and has presented at several of their conferences on emerging issues and trends

impacting on Medicaid claiming. He is the chair of the Communications Committee and

services on the Governmental and Legislative Issues Committee of the National Association

of Medicaid in Education (NAME). His most recent presentation at NAME’s annual national

conference was on the future impact of health information technology, special education

student records and reconsideration of HIPAA and FERPA compliance and training.

Mr. Charny is a member of the Health Care Compliance Association and has presented

nationally on a wide range of Medicaid issues, including: “School Based Medicaid Claiming:

Agents or Patients in an Increasingly Complex Process”; “Future Implications of Health

Information Technology in School Based Medicaid Claiming”; “School Based Medicaid

Claiming: New Challenges, New Opportunities”; “Coming to Terms with the Educational and

Medical Models”

Mary Cieslicki has been a member of the Centers for Medicare and Medicaid Services

(CMS) Non-Institutional Payment Team (NIPT) since 2002. As a NIPT member she reviews

payment methodologies, including rate based and cost based methodologies, applicable to

individual practitioners and other Medicaid providers such as schools, and hospitals. Prior to

her tenure at CMS she was finance director of a Federally Qualified Health Center in

Baltimore, Maryland. She earned a Master of Health Science degree from the Johns Hopkins

Bloomberg School of Public Health.

Sarah Daugherty-Pineda has a Masters Degree in Nursing and is a Certified Professional

in Healthcare Management and a Certified Professional in Healthcare Quality. In her current

role, she is responsible for managing and ensuring quality management and improvement

programs and resources are in place for the BCBSNM Medicaid/ Salud line of business. Her

role ensures Medicaid Quality Program and core components meet all Contract and

Regulatory Requirements. She supports oversight of the BCBSNM Medicaid Cultural

Competency Program Evaluation and Member Access to Services Evaluation. Her team is

responsible for management of the Medicaid Performance Improvement Projects and

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Performance Measures. She supports the EQRO and NCQA Medicaid Activities and serves as

a Medical Record Review Project Manager for the BCBSNMx HEDIS Project.

Patsy Crawford Attorney at Law, is the Director of Compliance with the Education practice

area of Public Consulting Group, Inc. (PCG), based in the Chicago office. She has managed

Medicaid billing projects for multiple school districts, including Chicago Public Schools (CPS)

and Saint Paul Public Schools. In addition, Ms. Crawford provides legal and regulatory

analyses and consulting services to CPS and other PCG school districts and state clients

nationwide. She has extensive experience with state and federal audits of school based

Medicaid programs.

Brooke Denton has over 13 years experience in business management, project

management, and client relations. Brooke has been working with Paradigm HealthCare

Services for the past nine years, creating and instituting numerous trainings on California’s

MAC and Direct Service Billing programs, establishing new technology service offerings to

ease provider burden and reduce audit risk, and enhancing existing service initiatives by

developing and implementing tools for program support and optimization.

Kay Dole is a district program facilitator with the Minneapolis Public Schools where she is

responsible for Third Party Reimbursement, project management of EasyIEP, and is the lead

for Occupational/Physical Therapy and the district's FASD project. She is an Occupational

Therapist with a Master's Degree in Public Health focusing on Maternal and Child Health.

She has worked with special needs children both in the educational and medical

environments and has extensive experience working with internationally adopted children.

She is a frequent speaker both nationally and internationally and has multiple publications.

She is currently working with Janet Lowe and other Minnesota school districts to change

current state legislation to improve the third party billing process in Minnesota especially

focusing on TPL and parental consent issues.

Susan Douglas was a social worker, worked for the U.S. House of Representatives and the

U.S. Senate, performed editorial and research duties for a labor union, and edited her own

weekly newspaper before joining the Palm Beach County School District and subsequently

moving to her current position as Medicaid Consultant for the Florida Department of

Education. She acts as liaison between Florida’s Medicaid Agency, the Agency for Health

Care Administration, and the state’s 67 school districts to provide guidance and policy

clarification regarding Florida’s Medicaid Certified School Match Program and the School

District Administrative Claiming Program. She hosts a statewide meeting each year in May.

She holds a bachelor’s degree from the University of Florida and a master’s degree from

Catholic University in Washington, D.C. Susan is editor of the NAME newsletter, the NAME

tag.

Anysia Drumheller has served as the Program Manager for the Medi-Cal Programs and

Services Department, in California’s Butte County Office of Education (COE) for the past six

years. Her primary responsibilities are to provide trainings, program oversight and

technical support for administrative claiming and direct services billing for the California’s

Medi-Cal program for the Butte COE and for the local school districts in that county. She has

worked in the field of education administration for the past twenty years and her education

background is in Business Management. She has served as the NAME Membership

Committee Chair for the past four years. Anysia lives in Lincoln, CA with her family.

Amy Edwards is responsible for the daily operations of the Medicaid and Schools program

at the Virginia Department of Education (VDOE) where she has been for nine years. She

works with school divisions to establish and maintain the Medicaid and Schools program and

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provides training and program updates. She also works closely with the Medicaid agency on

State Plan amendments, program requirements, documentation, provider qualifications, etc.

Prior to being the VDOE Medicaid Specialist, she worked for seven years with the Medicaid

and Schools program at the school division level, training, billing and providing information

to the individual clinicians and providers. Amy is a Past President of the NAME and is this

year’s Conference Co-Chair.

Isamu Fairbanks has more than ten years of experience in management consulting with

governmental agencies, project management and implementation of web-enabled tools. He

manages ongoing client projects and has been involved in projects for the states of Arizona,

Ohio, Illinois, North Carolina, Texas, Indiana and Nebraska. He is currently a Principal with

Fairbanks LLC. He earned a Master of Business Administration degree from the University

of Chicago Graduate School of Business and a Bachelor of Arts degree in economics from

Brigham Young University.

Jason Frandson has a BA in Psychology and Communication Disorders as well as an

MBA. During his career he has worn many hats in the Medicaid/Medicare world. As a

Financial Assistance Specialist he determined eligibility for families enrolling in Medicaid

program. He served as a Social Security Advocate helping disabled individuals receive

SSI/SSDI benefits. He also supervised a Medicaid eligibility and managed care team for a

number of years in Minnesota. Currently he works for the Centers for Medicare and Medicaid

Services, Division of Benefits and Coverage, as a Health Insurance Analyst. His work,

among other things, includes reviewing State plan amendments from States for Services in

the School setting.

Michael Gibson has 8 years of experience in data collection, analysis and monitoring of

school-based organizations. He currently works for Apex Education, an organization that

provides training and technical assistance to New Mexico’s SBHCs on the use of the

Welligent electronic patient management system for student, encounter, and billing data

management. Mr. Gibson provides tech support and web management for the New Mexico

SBHC’s, 21st Century Community Learning Centers after-school program, and a handful of

other non-profit organizations.

Mary Hall has a BBA in Marketing. She has worked for Hanover County Public Schools in

Virginia as the Medicaid Account Specialist for three years. In October 2009, she began

billing for services in the Part C program. She was able to obtain contracts with private

insurance companies and successfully secured contracts with four companies with two in the

works. She is now responsible for billing for Hanover’s Early Intervention program for both

Medicaid and privately insured children.

Bryan Hawkom has been with Public Consulting Group (PCG) for 11 years and is currently

a Manager there and he has worked with school districts large and small as well as state

agencies in MA, RI, NH, CT, MN, MI, NJ, TX, IN, Washington DC and more. Mr. Hawkom

currently oversees the work of PCG Education in the Northeast and Midwest. He holds a

Bachelor’s degree in Economics and Master’s degree in Health Care Administration. Part of

Mr. Hawkom’s work at PCG has focused on Medicaid billing and revenue maximization, as

well as program design, rate setting, and the implementation of technology. He

understands relevant state and federal regulations, as well as the challenges faced by states

and school districts in implementing successful Medicaid billing programs. Prior to PCG, Mr.

Hawkom worked to manage state and federal programs at a private, non-profit home care

agency in Massachusetts.

26

Ann Herrick is a Manager with Chicago Public Schools, who works with its Office of Special

Education and Supports and more recently with its Office of Finance. Her responsibilities

have included oversight over the Health Services Management Program in 1995-2003 as

well as review and guidance on the Medicaid claim processing, program audit reviews and

policy analysis relating to Medicaid, SCHIP, IDEA and other federal programs since 1993.

Ms. Herrick has participated in school-based Medicaid conferences organized by NAME, the

Council of Great City Schools and LEAnet. She has collaborated closely with the Illinois

Department of Healthcare and Family Services, the Illinois Board of Education as well as

other school district and state officials in Illinois and elsewhere.

Carlynn Higbie, OTR/L, is the Continuing Education Coordinator and Consultant at MJ Care,

Inc. She has practiced for 35 years in the areas of school-based and outpatient pediatric

therapy, adult rehabilitation and vocational training. Carlynn served on the state of

Wisconsin task force for school-based OT/PT services and contributed to the 1996 Wisconsin

Department of Public Instruction publication for OT and PT Services in the Schools. She

conducts professional continuing education, training and consultation with school districts to

improve evidence-based practices in the least restrictive environment by incorporating

collaborative goal writing strategies within the IEP. In addition, she provides supervisory

support to 19 school-based OTs and PTs and has 14 years experience as a pediatric OT

consultant for Blue Cross Blue Shield. Carlynn also brings her 4 years of experience as an

executive director for a not-for-profit business. Her projects and experiences include:

training in mediation and conflict resolution; she conducts training in the area of

professional misconduct prevention; curriculum and policy development; clinical education

instructor; and program analysis and development

John Hill has over 35 years of experience working with and on behalf of individuals with

disabilities, which included serving as the program manager for Indiana's Home &

Community-Based Services waiver for persons with Developmental Disabilities for 5 years

and serving as the Indiana State Director for the Bureau of Developmental Disabilities for

two years. John served seven years, two of which as the chairperson, on the Indiana

Commission on Rehabilitation Services and currently serves as the Department of

Education’s (DOE) representative on the:

Indiana Governor’s Commission for Persons with Disabilities;

Indiana School for the Deaf school board;

Indiana School for the Blind & Visually Impaired school board; and

Division of Disability & Rehabilitative Service Advisory board.

For the past 11 years John has been with the Indiana DOE, Special Education. Currently his

primary responsibilities include working with LEA’s on issues regarding racial/ethnic

disproportionality and Medicaid reimbursement for both Medicaid Administrative Claiming

and medically related IEP services. John is a member of the Indiana Covering Kids &

Families board and is the co-chair for the School Committee. John was a founding member

of LEAnet and served as secretary for four (LEAnet is a national organization of local public

school corporations whose primary focus is protecting and enhancing funding for public

school health programs and services). John is a founding member and a past President of

the National Alliance for Medicaid in Education (NAME). He currently is the Chair of the

NAME Governmental Affairs & Public Relations Committee.

Lauren Holahan MSOT, has been at the University of North Carolina-Chapel Hill since

1996. She also has 12 years experience in school-based practice in North Carolina and

served as Lead OT for a team of 22 school-based OT practitioners in Durham, NC for 5

years. She currently is the Occupational Therapy and Medicaid Consultant for NC

Department of Public Instruction and has been in the position since 2007. In addition, she

is Chair, North Carolina Board of Occupational Therapy (term 2009-2013). Lauren is

27

pursuing a doctorate in Occupational Science through the UNC School of Medicine, Division

of Occupational Science and Therapy. Her interests include: school-based occupational

therapy, related services under IDEA legislation, administration/management of related

service personnel, ethics in occupational therapy practice, school-based Medicaid cost

recovery, participation of people with disabilities in communities of worship.

Melinda Hollinshead holds a Masters and a Ph.D. in Public Administration from Arizona

State University (ASU), and has over 20 years of public policy experience at both the federal

and state levels of government. Dr. Hollinshead currently works for the Arizona Medicaid

agency, AHCCCS (Arizona Health Care Cost Containment System), as one of the Program

and Policy Managers for the Medicaid School Based Claiming program. Dr. Hollinshead

specializes in the areas of intergovernmental relations and social policy, and has

considerable experience with policy and program analysis and evaluation primarily in the

public health care arena. Prior to joining AHCCCS, Dr. Hollinshead spent several years with

the Urban Data Center at ASU conducting research related to state capacity to manage

social programs, as well as two years as a Legislative Assistant to U.S. House of

Representatives Speaker Thomas Foley. Dr. Hollinshead’s combination of education and

experience provide her an understanding of the unique challenges facing school districts as

they work to participate in school based claiming.

Bruce Hunter came to the American Association of School Administrators (AASA) in 1982 as a

Legislative Specialist, and became Director of Governmental Relations in 1986. During his

tenure AASA has developed a large, active legislative corps that has facilitated school

administrators’ influence on federal policy and legislation. Bruce has helped strengthen the

AASA web site, online publications and the School Administrator Magazine while increasing ad

revenue in a difficult economy. Bruce received a B.A. from the University of Northern Colorado,

an M.A. from the University of Texas at El Paso and did graduate work in education

administration at the University of Colorado. Prior to joining AASA, Bruce taught at both the

secondary and collegiate levels. He also trained Head Start teachers, and was a grant

administrator for the Education Commission of the States. Bruce was born and raised in

Wyoming, and held positions in Wyoming, Colorado, New Mexico and Arizona before coming to

AASA. Most importantly, Bruce is the father of four children, all of whom are intelligent,

successful, charming, well-behaved and good looking. But they are the source of most of his

grey hair.

Rick Jacobs has more than 25 years of experience in government, health care and

management consulting in financial management and operations; hospital administration;

program design, implementation and project management with governmental and non-

profit organizations. He has been the engagement partner for projects that have included

more than 1800 local education agencies and state agencies in ten states. He is currently a

Principal with Fairbanks LLC. He earned Master of Public Administration and Master of

Regional Planning degrees from Syracuse University Maxwell Graduate School of Citizenship

and Public Affairs and a Bachelor of Arts degree from Temple University.

Siva Kakuturi serves as President of Sivic Solutions Group and previously as Vice President

of the MAXIMUS Software Development and Data Center. He holds an M.S. from, Rensselaer

Polytechnic Institute, Troy, New York. Mr. Kakuturi has more than 20 years of software

development and implementation experience, including the use of web-based Microsoft .NET

technologies and implementation of a wide variety of applications, which include Medicaid in

School billing, Medicaid Management Information Systems and IEP systems. Mr. Kakuturi's

range of experience and expertise includes the following: Design and development of

custom application software; Implementation of automated information systems for health

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and human service agencies as well as schools; Comprehensive project management,

planning, budgeting, and forecasting; Systems integration and implementation support;

Technical infrastructure and network design; and Extensive business knowledge related to Medicaid, Child Welfare and Government Finance and Cost Allocation

Anne Karasek holds a Bachelor of Science degree in Family studies with an emphasis in

infancy and early childhood and a Master of Science degree in Early Intervention: Children

at Risk. She has been working in the area of early childhood for more than 25 years with a

special emphasis in providing technical assistance related to the fiscal requirements of the

Individuals with Disabilities education Act (IDEA) for the past 12 years. Ms. Karasek has co-

designed and co-authored numerous publications related to developing and maintaining a

Part C system of finance and possesses extensive knowledge is fund source utilization

including IDEA, Title V, EPSDT, public and private insurance, TANF and similar Health and

Human Services funding.

Steve Kossor was licensed in 1981 and certified in school psychology in 1984. He founded

what has become the largest private practice in Pennsylvania dedicated exclusively to

helping children and especially those who depend on Medicaid for their mental health and

behavioral support needs. He works in four Southeastern PA counties and has served over

600 children who have Medicaid as their sole source of health care coverage. His treatment

programs have been studied by two independent educational institutions (UNC-Chapel Hill

and Thomas Jefferson U in Philadelphia). The results of those studies showed remarkable,

positive effects on children, based on weekly parental and teacher assessments of progress.

Mr. Kossor is recognized in Federal court as an expert witness in Medicaid and Education

matters and he has consulted with organizations in four states to develop successful

Medicaid-EPSDT funded mental health treatment systems for children in their homes,

schools and communities. He has a Master’s degree in clinical psychology from Farleigh

Dickinson University in Madison, NJ.

Nancy Kuprewicz is an Administrative Analyst with the New Jersey Department of the

Treasury, Office of Administration. For over eleven years she has been the state's liaison in

the administration of New Jersey’s Special Education Medicaid Initiative (SEMI) and

Medicaid Administrative Claiming (MAC) programs with her Department as the lead agency.

The New Jersey SEMI program involves the collaboration of state agencies, including Ms.

Kuprewicz, who serves as the project’s contract manager, managing all facets of the

program, including coordination of the Department of Education, Medicaid, OMB, and the

state’s vendor. She works closely on both federal recovery projects with colleagues from the

New Jersey Department of Education and the Department of Human Services, Division of

Medical Assistance and Health Services. She has been deeply involved with the SEMI project

in New Jersey, and has seen the program evolve with all the changes of state and federal

regulations over the years. She has direct experience in shaping the Medicaid billing

program for NJ and direct experience working with Federal OIG auditors.

Elaine Lerner works for the New Jersey Department of Education in the Off Special

Education Programs (NJOSEP) on New Jersey Special Education Initiative (SEMI) Program.

The SEMI Program involves the collaboration of state agencies, including, the Department of

Treasury (serves as the contract manager); Department of Human Services, Division of

Medical Assistance and Health Services. She is the Department of Education representative

and has been integral in helping coordinate sound policy, improve communication with NJ

school districts for their Medicaid billing, and move forward. Elaine was elected to the NAME

Board of Directors and has attended many of the NAME annual conferences beginning with

the first one in Denver.

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Cindy Levesque has over thirty years of direct health service experience as a registered

nurse. She has worked as a health professional for hospitals, private physicians,

municipalities, and most importantly school districts. Cindy has presented a wide range of

health-related information to public groups, students, school administrators and assisted

people of all ages. Cindy is a professional medical coder and a current member of the AAPC.

Janet Lowe, RN, LSN, MA, CNP, Pediatrics, is the coordinator of the Third Party

Reimbursement program in Saint Paul Public Schools and a co-manager of the district’s web

based due process system. Her primary responsibilities are to provide trainings, program

administration and oversight and technical support for the Local Collaborative Time Study

(LCTS), coordination and management for reimbursement for Individual Education Program

(IEP) health related services and other health care services. Janet received her Masters

degree from the College of St. Catherine and completed her thesis on health care services

that are being delivered in Minnesota schools. Janet has published information related to

health care services provided in schools and Third Party Reimbursement and has presented

at many national conferences, including the National Association of School Nurses and the

National Alliance for Medicaid in Education. Janet was the Minnesota School Nurse

Administrator of the Year in 2007 and is the special education co-chair for the School Nurse

Organization of Minnesota and a member of the state Third Party Leadership committee.

Jack McCoy has over 33 years of experience working with Local Educational Agencies

(LEAs) in New Mexico. He is a graduate of LaSalle University in Philadelphia, PA. He worked

for 25 years at the NM State Department of Education holding several cabinet level positions

in that agency. As a state education official, he had lead responsibility for coordination of

liaison activities with the NM state legislature and Governor’s office and with the NM

Congressional delegation. He has significant policy and operations experience with school

based Medicaid claiming, and participated in starting the school Medicaid program in NM in

the early 1990s. For the past 8 years, Mr. McCoy has been the MAXIMUS and Sivic Solutions

Group Project Manager for the NM Cooperative Educational Services (CES) Medicaid

Claiming Project, helping bring in over $20 million in reimbursement for the NM school

districts that use his services.

Jane McGrath, M.D., is a professor of pediatrics at the University of New Mexico, where

she started Envision New Mexico, the Initiative for Child Healthcare Quality. Envision New

Mexico is a statewide Quality Improvement (QI) program focusing on obesity prevention,

early developmental screening, and resident training. It is one of the few programs

nationally that is approved by the American Board of Pediatrics to provide training in quality

improvement to pediatricians as part of their maintenance of certification. Dr. McGrath is a

former member of the American Academy of Pediatrics Committee on School Health and is

the Past President of the National Assembly on School-Based Health Care. She is certified in

adolescent medicine and spent fourteen years as the school health officer for the New

Mexico Department of Health. In her position as the school health officer, Dr. McGrath

helped guide the development of school-based health centers and worked closely with

school nurses throughout the state.

Chris Meroff is the Executive Director at MSB directing school Medicaid programs in school

districts for more than 15 years. He is responsible for school Medicaid startups in 8

different states and developed an industry-leading Medicaid claiming process. Chris is

recognized as one of the foremost advocates for school districts’ access to federal Medicaid

funds to offset the costs of special education and he does this through innovative special

education data management applications including IEP development and Medicaid claiming.

30

Chris also directs product development, operations and sales and marketing efforts across

MSB™

Kathy Cummins Merry is the Executive Director of Medicaid Reimbursement for Wayne

County Regional Education Services Agency (RESA), the first district in Michigan to enroll

and begin billing Medicaid for the School Based Services Program in 1993. Wayne RESA has

over 350,000 school children including Detroit Public Schools; it is the largest (county-level)

intermediate school district in the State. Kathy has been an integral part of the development

of Medicaid SBS programs at both the state and federal level. She is a member of the NAME

Board of Directors representing LEAs in Region 1, serves as the President of the LEAnet, and

is a member of Michigan's Medicaid Advisory Board of Intermediate School District

Superintendents as well as numerous other boards dedicated to helping children. She also

serves as the Wayne RESA lobbyist covering education and Medicaid issues both at the state

and federal levels.

Chuck Muirhead is CEO A&I Advisors Inc., and is an experienced leader with a strong

background in organizational strategic planning, development, staffing, training, budgeting,

and leadership coaching. Chuck has been a speaker at previous Conferences of the National

Alliance for Medicaid in Education, where he has coached and inspired committed leadership

for attendees to improve school-based Medicaid programs. Chuck is also a director for

CSBA’s Practi-Cal, an organization which assists schools and school districts in obtaining

federal reimbursement for medical services provided to students. He has a strong focus on

advocating for our children’s health and working with school districts to ensure they are able

to take advantage of the opportunities available to them. His light and humorous style

engages learners in their knowledge and application of the presented material.

Terryn Murphy has proven to be a skilled professional with a passion for developing user-

friendly technology solutions in the course of her diverse 7-year career in corporate and

government technology services. Immediately following her collegiate experience, Terryn

joined leading consulting firms including KPMG Consulting and Arthur Andersen within their

web development and data management teams. Terryn later joined Chicago Public Schools

in 2004 and served as Compliance Manager for the Office of Special Education and

Supports, which represents over 55,000 students with disabilities. In this role, Terryn was

responsible for monitoring the delivery of student services outlined in their Individual

Education Plans (IEP). Currently, Terryn leads the Health Services Management Program

(HSMP) for the Office of Special Education and Supports. HSMP is a management and

accountability system designed to ensure the delivery, documentation and monitoring of

health-related services to all children of the Chicago Public Schools. Terryn holds a Bachelor

of Science from the University of Illinois at Urbana where her degree is in Business Administration with a Management Information Systems concentration.

Alicia Neumann is a consultant on policy and legislation to Paradigm HealthCare Services.

She is an independent researcher with interests in school-based health care and hospital

participation in the safety net. Prior to her consulting work she spent five years as a Senior

Planner at the San Francisco Department of Public Health where, among other duties, she

oversaw local annual funding of Medi-Cal Administration and Targeted Case Management.

Alicia also has experience in technical writing and software development. She is currently a

PhD candidate in Sociology at the University of California, San Francisco; and has a Master's

in Public Administration from San Francisco State University; and a bachelor's in English

from Occidental College.

Chris O’Donnell has served as a School Based Health Center (SBHC) Program Manager at

the University of New Mexico since 2006. In this role, he oversees the operation of 8 SBHCs

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across the Albuquerque, NM metro area. He has also served on the Boards of several non-

profit organizations, including the NM Alliance for School-Based Health Care, Agora Crisis

Center, the NM Suicide Prevention Coalition, and others. He has nearly two decades’

experience as a nurse and has held both clinical and leadership roles. He earned his nursing

degree in 1993, a BA in psychology in 1996, and an MBA with a concentration in Healthcare

Management in 2006.

Carol Pierce has twenty-five years of experience working in the health field in the public

and private sectors. She has spent the last ten years providing consultation services to

advance organization performance and alignment with vision, mission and values. Through

her work with a wide range of government, private and nonprofit organizations and schools,

qualitative analysis and assessments have been completed and strategic plans implemented

to improve health outcomes. Prior to her consultation work, Ms. Pierce served as New

Mexico Department of Health District One Public Health Director.

Mark Pitcock has supported various aspects of Medicaid program operations since 1983.

He has worked in both the private and public sectors, including fiscal agent roles in

Tennessee, Kentucky, and Georgia and state Medicaid agency positions in Georgia and New

Mexico. During his career, he has completed special projects for 20 other Medicaid agencies.

A graduate of Texas Christian University, Mark has served as the Program Information

Bureau Chief for the New Mexico Human Services Department since 2007. In this capacity,

he manages the Medicaid Management Information System (MMIS) and the fiscal agent

contract. He is responsible for managing New Mexico’s transition to the new HIPAA 5010

transaction standard and ICD-10 diagnosis and procedure codes.

Nora Poisella worked eight years at Governor Morehead School for the Blind in Raleigh

NC. At the school, she was Director of Comprehensive Clinic/Dietary Services, responsible

for the planning, administration, supervision and coordination of the clinic staff which

included a pediatrician, psychiatrist, clinical psychologist, nursing staff, social worker,

occupational, speech and physical therapists as well as dietary department, where she

managed the medical and educational records and was responsible for all compliance

issues. She has worked for 11 years in the North Carolina Division of Medical Assistance

(DMA) and currently is a Local Education Agency (LEA) Program and Independent

Practitioner (IP) Program Manager. She also oversees the prior approval process for all

therapy services. In addition she is assisting with the design of NC’s new MMIS system for

Medicaid as well as NC Health Choice Program (NCCHIP). She currently represents Region

IV on the NAME Board of Directors.

Laurie Ray MPT, is at the University of North Carolina-Chapel Hill, where she has been

since 1999. She spent 12 years in school-based practice in North Carolina; working as the

only physical therapist serving a small, underserved, rural county and as a contracted team

member serving a larger, more urban county. Currently, Laurie is the Physical Therapy

Consultant for NC Department of Public Instruction and has held this position since 2005.

In addition, she has been the Medicaid consultant since 2006 and the Adapted Physical

Education liaison since 2010. Laurie is the Representative for Region V (Southeastern) to

the School-Based Special Interest Group (SIG), APTA’s Section on Pediatrics. Laurie also

serves as Chair of the School-Based SIG’s Research Committee. She represents IDEA and

NC DPI on the NC Vocational Rehabilitation State Rehabilitation Council, and is pursuing a

doctorate in Educational Psychology, Measurement and Evaluation, with a focus on Special

Education, through the UNC School of Education. Her interests include: school-based

physical therapy, assessment for education needs, reverse inclusion, related services under

IDEA legislation, providing services in the least restrictive environment, service delivery

options, service delivery for students with multiple or severe disabilities (especially with

32

high school students), transition into and out of school, embedded interventions, integrated

IEP goals, appropriate PT workload for the school-based setting, appropriate cost recovery

for school-based services, and representative diversity in physical therapy as a profession.

Jane E. Reagan, RDH, MPA has been an employee of the State of Michigan since 1981,

and since July 2002 has served as Department Specialist with the Department of Education

in the Office of Special Education and Early Intervention Services (OSE-EIS) where she

serves as a specialist in Medicaid reimbursement for services provided in Michigan schools.

She previously spent 21 years with the Michigan Department of Community Health, where

she worked in the Policy and Legal Affairs Administration for three years, and at the

Medicaid agency for 18 years. She began her career by spending eight years practicing as a

clinical dental hygienist. She holds an Associate degree in dental hygiene from Ferris State

University, a Bachelor’s degree in Human Nutrition from Michigan State University, and a

Master of Public Administration degree from Western Michigan University. She is a charter

member of the NAME organization and has served on many committees and presented at

many Annual Conferences. Currently she is President Elect, Chair of the Nominating

Committee, Co-Chair of the Conference Sub-Committee on Education and Program, and Co-

Chair of the Communications Committee.

Michael Sausa earned a BA from the University of Brockport in Business Administration –

Concentration Finance. In his current position at the Rochester City School District he is the

Quality Assurance Coordinator for Medicaid Compliance and Reimbursement. His previous

positions include Financial Manager for Early Childhood Department, Financial and Grant

Manager Elementary Schools and School Administration.

Jennifer Sheehy is the Director of Policy and Planning in the OSERS in the US Department

of Education. Prior to her current position, she served as acting Director of the National

Institute on Disability and Rehabilitation Research (NIDRR), acting Deputy Commissioner of

the Rehabilitation Services Administration and Special Assistant to the Assistant Secretary

of OSERS. She came to OSERS from the Presidential Task Force on Employment of Adults

with Disabilities where she was Senior Policy Advisor. She completed a detail as Associate

Director in the White House Domestic Policy Council, implementing the President’s New

Freedom Initiative and advising on policy issues of interest to people with

disabilities. Before she joined the task force staff, she served as Vice President of the

National Organization on Disability and Director of its CEO Council. She earned an MBA with

honors from Georgetown University and a B.A. from Cornell University.

Michelle Simmons holds a Masters and a Ph.D. from the University of Iowa. She has over

12 years of experience in public sector consulting, specializing in education services. She

has supported multiple states with implementation and management of School Based

Services Programs. In addition she has worked in many states in the areas of special

education information management, state longitudinal data systems, and data analytics.

Prior to Dr. Simmons’ work in consulting she managed a nonprofit organization focused on

disability advocacy efforts, and she also taught at the university level.

Mark Smith is the Agency Program Coordinator of the Ohio Medicaid in School Program.

Mark brings 17 years of Medicaid experience to his role as lead for Ohio’s Department of

Education Medicaid activities. In additional to his current role, he also has extended

experience working including developmental disabilities field. Mark’s past work has centered

on needs assessments, vocational and employment service development, and stakeholder

consensus on systems redesign. Mark also has developed a number of web-based

applications to monitor and track various Medicaid initiatives.

33

Mark has both a BA and MPA from the Ohio State University. His Master's thesis focused on

community-based need assessments and funding strategies for Ohio's developmentally

disabled populations. Mark is a Certified Public Manager, as well as a Qualified

Developmental Disabilities Professional. Mark currently serves as CMS Region V director for

NAME.

Chenoa Bah Stilwell-Jensen, MS, is an instructor at the University of New Mexico. She is

also the Community Outreach Coordinator for Envision New Mexico. She works with

community and school-based health center providers in a collaborative manner to support

adolescents they serve with healthy lifestyle resources in rural, frontier, urban and tribal

communities. For the past 12 years, she has applied her collective years of education and

research projects into her professional career, emphasizing the balance between health and

learning. She is from the Dine (Navajo) Nation and is of English and French-Canadian

descent.

Gloria Sullivan graduated from the University of Rochester with a Doctorate in Educational

Administration - Concentration Finance. In addition, she has an MBA - Concentration

Finance, MA- Concentration Instructional Technology and a Six Sigma Black Belt. In her

current position, at the Rochester City School District, she is the Medicaid Compliance

Officer, Director of State and Federal Grants. Previous positions she has held include

Director of Research and Evaluation, School Principal, and educator. She currently is an

instructor at Nazareth College.

Charles Tyler, Jr. holds a Master’s degree in Business Administration from the Earl G.

Graves School of Business and Management at Morgan State University and a Bachelors of

Science degree in Management Science from Coppin State University, where he graduated

cum laude. Mr. Tyler was a member of the National Dean’s List and the All American

Scholars Collegiate Directory in 1992. He is affiliated with several professional organizations

including the Beta Gamma Sigma Honor Society and Maryland Public Finance Officers

Administration. He is the Fiscal Manager of the Office of Third Party Billing of the Baltimore

County Public Schools. His responsibilities include billing for IEP, IFSP, and School-Based

Health center services. Baltimore County Public Schools received $6.3 million dollars in

reimbursement for the billing of these services during fiscal year 2010.

Judi Wallace has worked for the Centers for Medicare and Medicaid Services (CMS) since

February 2005. She is member of the Administrative Claiming Team (ACT) in the Division of

Reimbursement and State Financing (DRSF) for the Financial Management Group (FMG) at

CMS. Her responsibilities include working with all States on the review of Administrative

Claiming Plans, Cost Allocation Plans in the review and approval process for time studies for

all claiming entities such as schools, public health and human service agencies and for

tribes/tribal entities for the Medicaid program. She is currently involved in providing

guidance on 90/10 HIT funding for ARRA and CMS Policy on Payment for Interpreter and

Translation Services Legislation/Law: CHIPRA Section 201(b).

Amanda Way is manager of the Public Policy Division at Paradigm HealthCare Services

where she is responsible for the oversight of the company's policy analysis, research, and

advocacy efforts. She has over seven years experience as a research analyst, including four

years specializing in school-based Medicaid programs. Her specialty is establishing key

relationships with community organizations, legislators, and policy makers, and keeping

LEAs informed on the issues that impact their programs both at the local and national level.

Amanda received her bachelor degree from the University of California at Berkeley.

34

Tammy Whitlock is the Manager of the Specialized Services Unit for the Virginia

Department of Medical Assistance Services (DMAS). Tammy has over twelve years

experience with the Virginia Medicaid office. As Manager of Maternal and Child Health

Services, Tammy is responsible for program operations and policy development for Medicaid

maternal and child health programs including EPSDT, Part C, family planning, school

services, and BabyCare. Tammy’s previous experience in Medicaid includes work with

community based services, hospice, durable medical equipment, and rehabilitation services.

Tammy holds an undergraduate degree in Therapeutic Recreation and a Master’s in Health

Administration.

35

ABOUT NAME

2010-11 Officers President President Elect Secretary

Denise Achin (RI) Jane Reagan (MI) Tracy Brunner (IN)

Treasurer Immediate Past President

Steven Wright (NY) Michelle Lyons-Brown (AK)

2010-11 Board of Directors

Board of Directors by Region (pre-July 2011 Regions)

I: vacant II: Elaine Lerner (NJ) III: Bill Lessard (VA)

IV: Nora Poisella (NC) V: Mark Smith (OH) VI: Suzy Whitehead (NM)

VII: Jim Donoghue (IA) VIII: Rena Steyaert (MT) IX: Melinda Hollinshead (AZ)

X: Chris Bess (WA) LEA Member At-Large: Kathleen Cummins Merry (MI)

LEA Member At-Large: Cathy Bennett (CA)

Committees

Bylaws Web Nominating

Elaine Lerner, Chair (NJ) Cathy Bennett, Co-Chair (CA) Jane Reagan, Chair (MI)

Greg Morris (MI) Jeremy Ford, Co-Chair (CA) Michelle Lyons-Brown (AK)

Elise Pippin (IA) Mike Albino (NY) Anysia Drumheller (CA)

John Hill (IN) Katy Irwin (MI) Elaine Lerner (NJ)

Mark Stapp (CA) Larry Charny (NY)

Rose Uranga (CA)

Policy and Procedures Financial Review

Melinda Hollinshead, Chair (AZ) Kathy Cummins-Merry, Chair (MI)

Elaine Lerner (NJ) Deena Chard (MI)

Kathy Cummins-Merry (MI) Deb Marshall (MI)

Michelle Lyons-Brown (AK)

36

Finance Membership Communications

Steven Wright, Chair (NY) Anysia Drumheller, Chair (CA) Jane Reagan, Co-Chair (MI)

Harold Matott (NY) Cathy Bennett (CA) Larry Charny, Co-Chair (NY)

Dasarath Kiridena (DC) Becky Stoddard (KY) Mike Albino (NY)

Anne Morrow (VA) Jim Donoghue (IA) Susan Douglas (FL)

Jeremy Ford (CA)

Cathy Bennett (CA)

Anysia Drumheller (CA)

John Hill (IN)

Martha Ritter (MN)

Suzy Whitehead (NM)

Governmental Affairs Education and Research Committee

John Hill, Chair, IN Cathy Griffin, Chair (MN)

Kathy Cummins-Merry Vice Chair (MI) Bob Bundy (AK) Denise Achin (RI)

Amy Edwards (VA) Susan Alexander (NY) Anne Karasek (NC)

Patsy Crawford, IL Rena Steyaert (MT) Alicia Neumann (CA)

Rick Jacobs (IL) Tracy Brunner, IN Kathi McConnell(MD)

Michelle Lyons-Brown (AK) Glenelle Bruneske (AZ) Amanda Way (CA)

Greg Morris (MI) Gloria Sullivan (NY) Jim Donoghue (IA)

Alicia Neumann (CA) Kimberley Erickson (CO) Rick Jacobs (IL)

Amanda Way (CA) Kris Johnson (UT) Nora Poisella (NC)

Laurie Ray (NC) Becky Stoddard (KY)

Cindy Levesque (ID) Colleen O’Reilly (CA)

2011 Conference

Michelle Lyons-Brown, Co-Chair (AK) Amy Edwards, Co-Chair (VA)

Budget and Finance Charity Auction Communication

Steven Wright, Chair, NY Debbie Geer, Chair (CA) Brenda Lenhart, Chair (VA)

Phillip Gonzales, WA Tonja Kutz (CA) Cathy Bennett (CA)

Harold Matott, NY Amy Edwards (VA) Cathy Griffin (MN)

Dasarath Kiridena, DC Jane Reagan (MI)

Michelle Lyons-Brown (AK)

On-Site Logistics Education/Program

Mary Hall, Chair (VA) Jane Reagan, Co-Chair (MI) Cathy Griffin, Co-Chair (MN)

Suzy Whitehead (NM) Cathy Bennett (CA)

Amy Edwards (VA) Denise Achin (RI)

Michelle Lyons-Brown (AK) John Hill (IN)

John Hill (IN) Michelle Lyons-Brown (AK)

Anysia Drumheller, CA

Suzy Whitehead (NM)

Martha Ritter (MN)

37

About NAME, Inc. Background:

NAME was established in 2003 in response to the need to find a national forum for

addressing the increasing complexity and challenges of Medicaid in school settings. It has

evolved into a clearinghouse for information, in the service of helping members analyze

their options in daily decision–making. NAME members from around the country are

generous in sharing their expertise that comes from experience, networking and information

disseminated by NAME.

NAME's Mission:

NAME advocates program integrity for school-based Medicaid reimbursement

Who Belongs to NAME?

Generally NAME has 300 members from 45 states and Washington DC. Our members:

Represent State Departments of Medicaid and Education and local educational agencies

(LEAs) and dozens of businesses and professional organizations at the state and national

levels

Are professionals working on the state or local level who are involved in school-based

Medicaid claiming for services provided for students in special education. Our members

are involved in, but not limited to: Medicaid claiming and billing; Medicaid quality

assurance oversight; Medicaid program development; policy making; policy

implementation; and advocacy.

Some Things NAME Does:

Provide professional development by sponsoring an Annual Conference, in

September or October

Hosts telephonic town meetings that focus on one specific topic at a time, allowing

for dynamic interaction of participants and experts sharing news in their fields

Share information with and facilitate networking among members and interested

parties via the NAME Website:

o Member-Only Section new in 2011 to increase the value for membership.

Members can view archived press releases, federal and state technical

advisories, audit reports, an expanding database of relevant documents

for research, links to other websites and other organizations with shared

interests, and time-sensitive articles of the most current information and

news

Distributes a Bi-monthly NAME-tag newsletter with timely updates from a variety of

sources to keep members in touch with their regions, the Conference Committee, the

President, and others

Build relationships and partner with national professional organizations, federal

agencies and others and focus on issues important to NAME members

Develops and conducts a Biennial Survey. This project gathers and interprets data

and information from state Medicaid agencies, state education agencies and LEAs

around the country, to better understand the School Based Medicaid Program

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nationwide. Components include program composition, services covered and fiscal

and programmatic policy. Invaluable information has been provided to the press,

government agencies, policy makers and members.

Past Presidents and Conference Locations

Denver, CO 2003

Dann Stevens (IA) Boston, MA 2004

John Hill (IN) Seattle, WA 2005

Cathy Griffin (MN) Indianapolis, IN 2006

Brenda Mack-Bowman (DE) Minneapolis, MN 2007

Elizabeth Touhey (CA) Philadelphia, PA 2008

Amy Edwards (VA) San Diego, CA 2009

Michelle Lyons-Brown (AK) Williamsburg, VA 2010

Denise Achin (RI) Albuquerque, NM 2011

NAME Provides:

• A growing directory of members to contact with specific questions

• A research data base with information on various state policies for Medicaid funding in

education

• A networking opportunity for like-minded policy makers and professionals to connect at all

levels of involvement in the unique area of Medicaid in Education

www.MedicaidForEducation.org

http://www.medicaidforeducation.org/

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