Understanding Special Education Funding The School-Based ACCESS Program (SBAP)
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Presented by: Understanding Special Education Funding The School-Based ACCESS Program (SBAP)
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Understanding Special Education Funding The School-Based ACCESS Program (SBAP). Presented by:. Federal and State Medicaid Program. - PowerPoint PPT Presentation
Transcript of Understanding Special Education Funding The School-Based ACCESS Program (SBAP)
Presented by:
Understanding Special Education Funding
The School-Based ACCESS Program (SBAP)
Understanding Special Education Funding
The School-Based ACCESS Program (SBAP)
Federal and State Medicaid ProgramFederal and State Medicaid ProgramIn 1988, Congress enacted legislation to In 1988, Congress enacted legislation to encourage state and local education agencies encourage state and local education agencies across the nation to access federal Medicaid across the nation to access federal Medicaid reimbursement for health-related services for reimbursement for health-related services for disabled children.disabled children.
PDE launched the SBAP in 1991-92 as an PDE launched the SBAP in 1991-92 as an avenue for schools to receive federal funding avenue for schools to receive federal funding through Medicaid. through Medicaid.
In 1988, Congress enacted legislation to In 1988, Congress enacted legislation to encourage state and local education agencies encourage state and local education agencies across the nation to access federal Medicaid across the nation to access federal Medicaid reimbursement for health-related services for reimbursement for health-related services for disabled children.disabled children.
PDE launched the SBAP in 1991-92 as an PDE launched the SBAP in 1991-92 as an avenue for schools to receive federal funding avenue for schools to receive federal funding through Medicaid. through Medicaid.
OverviewOverview
SBAP allows the following school entities to SBAP allows the following school entities to receive federal Medicaid funds for providing receive federal Medicaid funds for providing IEP health-related services to Medical IEP health-related services to Medical Assistance (MA) special-education students:Assistance (MA) special-education students:
SBAP allows the following school entities to SBAP allows the following school entities to receive federal Medicaid funds for providing receive federal Medicaid funds for providing IEP health-related services to Medical IEP health-related services to Medical Assistance (MA) special-education students:Assistance (MA) special-education students:
• School DistrictsSchool Districts• Intermediate UnitsIntermediate Units• MAWAsMAWAs
• School DistrictsSchool Districts• Intermediate UnitsIntermediate Units• MAWAsMAWAs
• Charter SchoolsCharter Schools• Approved Private SchoolsApproved Private Schools• Charter SchoolsCharter Schools• Approved Private SchoolsApproved Private Schools
Federal Medicaid Assistance Percentage Federal Medicaid Assistance Percentage 54.39%54.39%
Federal Medicaid Assistance Percentage Federal Medicaid Assistance Percentage 54.39%54.39%
SBAP is a partnershipSBAP is a partnership
DPWPDE
Department of Public Welfare
Department of Public Welfare
Pennsylvania Department of Education
Pennsylvania Department of Education
Local Education AgencyLocal Education Agency
Billing AgentBilling Agent
Leader
LEA
Eligible ServicesEligible Services• Assistive Devices• Audiology• IEP Development• Nursing (RN & LPN)• Occupational Therapy• Orientation and
Mobility• Personal Care
Assistant• Physical Therapy• Physician
• Assistive Devices• Audiology• IEP Development• Nursing (RN & LPN)• Occupational Therapy• Orientation and
Mobility• Personal Care
Assistant• Physical Therapy• Physician
• Psychiatry• Psychology
• Social Work• Speech/Language• Teacher of Hearing
Impaired• Special
Transportation• Vision (limited)
• Psychiatry• Psychology
• Social Work• Speech/Language• Teacher of Hearing
Impaired• Special
Transportation• Vision (limited)
SBAP Reimbursement TotalsSBAP Reimbursement Totals
In the 2003-2004 school year, LEAs received:
$70 million$70 millionIn the 2003-2004 school year, LEAs received:
$70 million$70 million
In the 2005-2006 school year, LEAs received:
$110 million$110 millionIn the 2005-2006 school year, LEAs received:
$110 million$110 million
In the 2004-2005 school year, LEAs received:
$90 million$90 millionIn the 2004-2005 school year, LEAs received:
$90 million$90 million
Reimbursement Rate FactorsReimbursement Rate Factors
The amount of reimbursement generated can vary greatly based on:The amount of reimbursement generated can vary greatly based on:
• Special education population
• MA population
• Health-related services provided by LEA and contracted staff
• Number of qualified providers
• Level of program oversight
• Special education population
• MA population
• Health-related services provided by LEA and contracted staff
• Number of qualified providers
• Level of program oversight
Requirements for SuccessRequirements for Success• Oversight by someone who will ensure the
program’s integrity:• Oversight by someone who will ensure the
program’s integrity: Track service provider billings
Timely claims submissions to Leader
Perform self-audits
Monitor students for MA eligibility
Outreach to families not enrolled in MA
Give service providers positive feedback
Track service provider billings
Timely claims submissions to Leader
Perform self-audits
Monitor students for MA eligibility
Outreach to families not enrolled in MA
Give service providers positive feedback
What’s My Role in SBAP?What’s My Role in SBAP?
1. Determine which service providers are eligible to participate in SBAP.
1. Determine which service providers are eligible to participate in SBAP.
a. Salaries for service providers or contracted providers must be partially or fully funded by state and/or local dollars.
b. Providers must meet SBAP credential requirements.
a. Salaries for service providers or contracted providers must be partially or fully funded by state and/or local dollars.
b. Providers must meet SBAP credential requirements.
What’s My Role in SBAP?
What’s My Role in SBAP?
2. Complete the Cost Calculation Worksheet2. Complete the Cost Calculation Worksheet
What’s My Role in SBAP?
What’s My Role in SBAP?
3. Review your account balance monthly provided by Leader.
3. Review your account balance monthly provided by Leader.
What’s My Role in SBAP?
What’s My Role in SBAP?
4. Review guidelines for allowable expenditures prior to applying for funds withdrawal.
4. Review guidelines for allowable expenditures prior to applying for funds withdrawal.
What’s My Role in SBAP?
What’s My Role in SBAP?
Submit LEA cover letter describing the programs, services, or products to be acquired. Do not send copies of purchase orders.
Submit LEA cover letter describing the programs, services, or products to be acquired. Do not send copies of purchase orders.
a. A PDE 352 Form (school-age withdrawal)
b. A PDE 352M Form (EI withdrawal)
a. A PDE 352 Form (school-age withdrawal)
b. A PDE 352M Form (EI withdrawal)
5. Apply for funds withdrawal at least bi-annually (for actual or projected expenses) using either:
5. Apply for funds withdrawal at least bi-annually (for actual or projected expenses) using either:
What’s My Role in SBAP?What’s My Role in SBAP?
PDE 352 Form (for school-age
withdrawals)
PDE 352 Form (for school-age
withdrawals)
All requests must be for a minimum of
$1,000.
All requests must be for a minimum of
$1,000.
How Funds Have Been Spent
How Funds Have Been Spent
• Assistive devices to help disabled children function to their full capacity in both the home and classroom settings.
• Hiring additional special education staff.
• Assistive devices to help disabled children function to their full capacity in both the home and classroom settings.
• Hiring additional special education staff.
SBAP funds have been used by LEAs for:SBAP funds have been used by LEAs for:
How Funds Have Been SpentHow Funds Have Been Spent
• Purchasing small buses to transport students with special needs.
• Updating special education classrooms with new computers and printers.
• Funding field trips for special education students.
• Making capital improvements (require prior approval).
• Purchasing small buses to transport students with special needs.
• Updating special education classrooms with new computers and printers.
• Funding field trips for special education students.
• Making capital improvements (require prior approval).
SBAP Funds FlowSBAP Funds Flow
• LEA submits SBAP transactions to Leader.
• Leader processes transactions nightly and submits weekly MA claims file to DPW.
• PDE Comptroller’s Office receives check from DPW.
• LEA submits SBAP transactions to Leader.
• Leader processes transactions nightly and submits weekly MA claims file to DPW.
• PDE Comptroller’s Office receives check from DPW.
It helps to understand how the SBAP funds flow in this process:It helps to understand how the SBAP funds flow in this process:
SBAP Funds FlowSBAP Funds Flow• PDE posts payment to LEA’s restricted account.
• LEA submits funds request to PDE by completing Withdrawal Form.
• Upon approval, PDE transfers funds to the LEA’s account.
• Monthly, Leader reconciles that correct fund amounts were transferred to the correct LEA.
• On average, reimbursement funds are disbursed within 8 weeks from time of request.
• PDE posts payment to LEA’s restricted account.
• LEA submits funds request to PDE by completing Withdrawal Form.
• Upon approval, PDE transfers funds to the LEA’s account.
• Monthly, Leader reconciles that correct fund amounts were transferred to the correct LEA.
• On average, reimbursement funds are disbursed within 8 weeks from time of request.
New Challenges facing LEAs...
New Challenges facing LEAs...
• Medicaid cutbacks targeting school-based programs
• Costing methodologies that would considerably decrease amount of reimbursement
• Medicaid cutbacks targeting school-based programs
• Costing methodologies that would considerably decrease amount of reimbursement
Federal audits of states have prompted:Federal audits of states have prompted:
New Challenges...continuedNew Challenges...continued
• Require states to obtain written parental consent prior to billing Medicaid
• Require states to obtain written parental consent prior to billing Medicaid
Federal OSEP regulations...Federal OSEP regulations...
State audits have prompted...State audits have prompted...
• More stringent and detailed documentation
• More stringent and detailed documentation
Service OfferingsService OfferingsAs the statewide SBAP vendor, Leader provides the following services:As the statewide SBAP vendor, Leader provides the following services:
• Web sites to record service provider logs and/or service billing data
• Call center (800 number)
• Phone and teleconferencing
• On-site and regional trainings
• Custom-report generation• Program analysis
• Web sites to record service provider logs and/or service billing data
• Call center (800 number)
• Phone and teleconferencing
• On-site and regional trainings
• Custom-report generation• Program analysis
Your SBAP Account Manager
Phone: (800) 360-8511
E-mail: [email protected]
Your SBAP Account Manager
Phone: (800) 360-8511
E-mail: [email protected]
Contact Information
Your SBAP Liaison Name: Roni Russell
E-mail: [email protected]
Your SBAP Liaison Name: Roni Russell
E-mail: [email protected]
Please e-mail us your comments at:[email protected] e-mail us your comments at:[email protected]
