WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS...
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Transcript of WELCOME TO: TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS...
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WELCOME TO:WELCOME TO:TRAIN THE COORDINATORSTRAIN THE COORDINATORS
Presented by:Presented by:
Department of Health Care Department of Health Care Services (DHCS)Services (DHCS)
ACLSS BranchACLSS Branch
and and
Local Educational ConsortiumLocal Educational Consortium
FALL 2008FALL 2008
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THE DAY AT A GLANCETHE DAY AT A GLANCE
• Housekeeping
• National Updates
• Time Survey Overview
• Site Visit Findings
• Activity Codes
• Short Break
• Interactive Memory Enhancement Exercise
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HOUSEKEEPINGHOUSEKEEPING
• INTRODUCTIONS
• RESTROOMS/BREAKS
• CELL PHONES
• TRAINING MATERIALS
• QUESTION PROCESS
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WHAT’S IN THE PACKET?WHAT’S IN THE PACKET?
• PowerPoint Handout
• Code 1 vs. Code 16 Matrix
• Samples of financial reports
• Activity Code Samples
• Operational Plan Checklist
• Evaluation Form
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PURPOSE OF THIS TRAININGPURPOSE OF THIS TRAINING
• Provide an overview of the time survey process to ensure program compliance
• Ensure each participant identifies the actual time performing the MAA activities reported on the time survey
• Provide information to help identify activities that are eligible for federal reimbursement under the MAA program
• Provide Activity Code Samples
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NATIONAL UPDATESNATIONAL UPDATES
• CMS 2287 – F Elimination of SMAA
• CMS 2258 – F Changes definition of “Unit of Government”
• Moratorium until 4/09
• CMS 2213 – P Outpatient Clinics
• Free Care Principle – CMS would like to codify
• Parental Consent to Bill
• 2nd Stimulus Bill??????
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HEALTH CARE SERVICES HEALTH CARE SERVICES (DHCS) UPDATE(DHCS) UPDATE
• DHCS will continue the SMAA program until FFP is no longer available
• Audits/Oversight
• Contingency Fee Contracts are not allowed
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SMAA Time Survey Overview
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PURPOSE OF TIME SURVEYPURPOSE OF TIME SURVEY
• The time survey is the basis for claiming federal funds
• The time survey captures what activities LEAs do on a regular basis
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WHICH LEA STAFF SHOULD TIME WHICH LEA STAFF SHOULD TIME SURVEYSURVEY
Consider two factors:
1. Do they perform MAA?
2. Are appropriate non-federal funds expended to receive federal reimbursement?
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TIME SURVEY PARTICIPATIONTIME SURVEY PARTICIPATION
• How do LEAs participate in MAA?
• When must staff be trained?
• PPL 08-016 Training Participation
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WHEN TO TIME SURVEYWHEN TO TIME SURVEY
• DHCS randomly selects a time survey week period for each quarter
• The LECs/LGAs are notified of the time survey dates, via PPL, no later than the first day in May of the first-quarter time survey period and 45 days prior to the beginning of the second, third, and fourth quarter
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WHEN TO TIME SURVEYWHEN TO TIME SURVEY
When School is:
• Students in session
• Students out of session for fewer than 30 days
• Students out of session for more than 30 days
• If for whatever reason the claiming unit does not time survey on the designated date, then they should document the reason for delay in the audit file.
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TIME SURVEY TIME SURVEY ADMINISTRATIONADMINISTRATION
• The responsibility for proper administration of the time survey is shared by;
California Dept. of Health Care Services
LEC/LGA MAA CoordinatorLEA MAA CoordinatorTime Survey Participant and
his/her supervisor
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TIME SURVEY REVIEW TIME SURVEY REVIEW PROCESSPROCESS
• It is the responsibility of the LEC/LGA coordinators who sign the invoices and claiming grid to assure the accuracy of the time surveys
• Site and Desk Reviews
• On each time survey form the sample descriptions of MAA activities must maintain a minimum of 80% accuracy for inclusion into the invoice
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THINGS TO LOOK FORTHINGS TO LOOK FOR……
• Identical time recorded for each day?
• Individuals with the same job class and significantly different survey coding?
• Paid time off not coded correctly?
• Cross-outs not initialed or easily understood?
• Percentages that do not match?
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• Clean, legible recording of hours or portions of hours for the entire paid workday
• Correct totaling of MAA and non-MAA hours
• Correct sample descriptions for MAA activities
• Ensure time survey forms are signed and dated by participant and supervisor
THINGS TO LOOK FOR…Cont.THINGS TO LOOK FOR…Cont.
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2004/05 Site Visit Findings Conducted During 2007/08
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Time Survey FormsTime Survey Forms
#1 Finding: Narratives are not Medi-Cal specific
Code 4: “Sent Flyers home with students.”
“Attended an IEP meeting.”
Code 6: “Helped a family fill out application form.”
Code 8: “Consulted with a school nurse about student’s health needs.”
Code 12: “Provided Translation for a family with a special needs child.”
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Time Survey FormsTime Survey Forms
Finding: Narratives are not Medi-Cal specific
Follow the Five W’s
WHO? WHAT?
WHEN?
WHERE ? WHY?
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TIME SURVEY FORMSTIME SURVEY FORMS
• Misuse of activity codesCode 8: “I made an initial referral to a
student’s family regarding the Medi-Cal Healthy Families Program.”
Code 10: “Driving from one school district to another to provide direct speech and language therapy.”
Code 12: “Translation of IEP. Psychological speech & language reports.”
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TIME SURVEY FORMSTIME SURVEY FORMS
• Acronyms not specific
• Signatures
• Participant did not attend training
• Use original DHCS templates
www.dhcs.ca.gov/provgovpart/Pages/SMAA
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TIME SURVEY FORMSTIME SURVEY FORMS
General Findings
• Activity sample given with no recorded time
• Incorrect time survey dates
• Incorrect calculation of hours
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TIME SURVEY FORMSTIME SURVEY FORMS
Things to Remember
1)80% accuracy for sample descriptions
2)Initial all corrections
3)No whiteout
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OPERATIONAL OPERATIONAL PLANSPLANS
• Missing documentation
- copy of indirect cost rate via CDE www.cde.ca.gov/fg/ac/ic
- copy of Medi-Cal Percentage
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OPERATIONAL OPERATIONAL PLANSPLANS
• Missing documentation
• Missing duty statements
• Photocopied training logs
• Support for Code 4 and Code 8 activities
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ORGANIZATIONAL TIPS FOR ORGANIZATIONAL TIPS FOR FUTURE SITE VISITSFUTURE SITE VISITS
• Use a Table of Contents and readable tabs
• Include a “Print Name” field on all Sign-In Sheets
• Arrange OP by fiscal year using three ring binders
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The Who, What, Where, The Who, What, Where,
When and Why of it!When and Why of it!
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SMAA PURPOSESMAA PURPOSE
• MAA Activities must directly support
−Identification and enrollment of potentially eligible students/families into Medi-Cal
−Medical services covered under the state Medi-Cal plan
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SMAA ACTIVITY GUIDANCESMAA ACTIVITY GUIDANCE
• CA School-Based MAA Manual
• DHCS Policy and Procedure Letters
• School-Based MAA Time Survey Form
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SMAA Activity ExamplesSMAA Activity Examples
• SMAA Codes 4, 6, 8, 10, 12, 14, 15 and 16
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SMAA Activity SamplesSMAA Activity Samples
• Must Clearly Describe the MAA Activity Performed
−Who was involved?
−What was done?
−Why, how, when, and where was the MAA Activity performed?
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• What Medi-Cal outreach, enrollment assistance or service was directly supported?
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Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach
Initial activities that inform eligible or potentially eligible individuals about Medi-Cal programs and services and how to access them
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Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach
• Prepared paperwork referring two (2) disruptive 6th Grade students to psychologist for initial Medi-Cal covered counseling evaluations
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Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach
• Told Parents of 1st Grade student about the Medi-Cal program and services. Referred them to a Medi-Cal eligibility worker to seek health services for their young children
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Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach
• I noticed a student was not eating his lunch, and I discovered he had tooth decay that was causing him pain. I contacted his parents with initial dental referral.
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Code 4Code 4InitialInitial Medi-Cal Outreach Medi-Cal Outreach
…integral parts or extensions of direct medical services,…..are not claimable due to the potential for duplicate payments.
Medicaid School-Based Administrative Claiming Guide, May 2003, Page 9
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Code 6Code 6Facilitating Medi-Cal Facilitating Medi-Cal
ApplicationApplication
Assisting an individual in becoming eligible for Medi-Cal/Healthy Families
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Code 6Code 6Facilitating Medi-Cal ApplicationFacilitating Medi-Cal Application
• Parents of a Kindergarten student needed transportation to a Medi-Cal eligibility office, and I worked with staff at a community agency to arrange that transportation.
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Code 6Code 6Facilitating Medi-Cal ApplicationFacilitating Medi-Cal Application
• Reviewed National School Lunch information to facilitate Medi-Cal/Healthy Families enrollment
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Code 6Code 6Facilitating Medi-Cal ApplicationFacilitating Medi-Cal Application
• During IEP meeting, assisted parents with Medi-Cal/Healthy Families application
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Code 8Code 8OngoingOngoing Referral, Coordination, Referral, Coordination,
and Monitoring of Medi-Cal and Monitoring of Medi-Cal ServicesServices
• Making ongoing referrals for, coordinating, and/or monitoring the delivery of Medi-Cal covered services
• Activities take place after initial referrals have been made
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Code 8Code 8OngoingOngoing Referral, Coordination, Referral, Coordination,
and Monitoring of Medi-Cal and Monitoring of Medi-Cal ServicesServices
• Called parent to verify student appointment with Pediatrician for evaluation of recurring ear aches
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Code 8Code 8OngoingOngoing Referral, Coordination, Referral, Coordination,
and Monitoring of Medi-Cal and Monitoring of Medi-Cal ServicesServices
• Revised student’s therapy schedule to coordinate community-based Pediatric otolaryngology services for speech disorder evaluation
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Code 8Code 8OngoingOngoing Referral, Coordination, Referral, Coordination,
and Monitoring of Medi-Cal and Monitoring of Medi-Cal ServicesServices
Administrative activities performed in support of medical services that are not coverable or reimbursable under the Medicaid program would not be allowable as Medicaid administration
Medicaid School-Based Administrative Claiming Guide, May 2003, Page 16
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Code 10Code 10Arranging Transportation in Arranging Transportation in Support of Medi-Cal ServicesSupport of Medi-Cal Services
• Assisting an individual or family to obtain transportation to services covered by Medi-Cal
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Code 10Code 10Arranging Transportation in Arranging Transportation in Support of Medi-Cal ServicesSupport of Medi-Cal Services
• Coordinated transportation arrangements with parent taking student to medical center for Medi-Cal covered mental health services
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Code 10Code 10Arranging Transportation in Arranging Transportation in Support of Medi-Cal ServicesSupport of Medi-Cal Services
• Talked with transportation supervisor about bus changes added to route of student who receives Occupational Therapy services in the community
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Code 12 - TranslationCode 12 - Translation
• Arranging or providing Medi-Cal translation services by a third party to facilitate access to Medi-Cal covered services
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Code 12 - TranslationCode 12 - Translation
• Called several translators to arrange services for various parent meetings regarding Occupational Therapy, Physical Therapy, and/or Speech services
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Code 12 - TranslationCode 12 - Translation
• Translated for Certified Application Assistant, who was working with Farsi-speaking parents applying for Medi-Cal
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Code 14Code 14Program Planning, Policy Program Planning, Policy
Development, and Interagency Development, and Interagency Coordination Related to Medi-Cal Coordination Related to Medi-Cal
ServicesServices
• Developing and implementing strategies to improve the coordination and delivery of Medi-Cal covered medical/mental health services to students and their families
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Code 14Code 14Program Planning, Policy Program Planning, Policy
Development, and Interagency Development, and Interagency Coordination Related to Medi-Cal Coordination Related to Medi-Cal
ServicesServices
• Only employees whose position descriptions include the Code 14 functions should use this code
• Staff surveying under this code should include related paperwork, clerical activities, or travel required to perform these activities
CA SMAA Manual, September 2003, Pgs. 5-11
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Code 14Code 14Program Planning, Policy Program Planning, Policy
Development, and Interagency Development, and Interagency Coordination Related to Medi-Cal Coordination Related to Medi-Cal
ServicesServices
• Traveled to County Office of Education to attend a Student Health Meeting where we evaluated countywide need for additional Medi-Cal providers who accept new patients
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Code 14Code 14Program Planning, Policy Program Planning, Policy
Development, and Interagency Development, and Interagency Coordination Related to Medi-Cal Coordination Related to Medi-Cal
ServicesServices
• Finalized my notes from meeting with countywide agencies to coordinate health service agreements – sent notes to all participants
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Code 15Code 15Medi-Cal Claims Administration, Medi-Cal Claims Administration,
Coordination and TrainingCoordination and Training
• Performing activities that are directly related to MAA Program administration, coordination, and training
• As MAA Assistant for my school site, I verified that each survey participant had either a paper copy of the time survey form or access to the electronic version
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Code 15Code 15Medi-Cal Claims Administration, Medi-Cal Claims Administration,
Coordination and TrainingCoordination and Training
• Reviewed with supervisor which daily activities should be coded as Code 14
• I attended brief refresher MAA training during our staff meeting at the district office
• I completed my MAA time survey daily
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Code 16Code 16General Administration/Paid Time General Administration/Paid Time
OffOff
• Performing general administration activities that are not what you were specifically hired to do
• Paid time off
• I was on jury duty for the full survey period.
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Code 16Code 16General Administration/Paid Time General Administration/Paid Time
OffOff
• Attended in-service training on new employee information system and reviewed my employee record
• Attended committee meeting to review district policies regarding school site utilization by community groups
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Code 16Code 16General Administration/Paid General Administration/Paid
Time OffTime Off
• Daily paid lunch periods per contract for my position
• Presented emergency preparedness information to staff and classroom volunteers
• Met with my supervisor, who gave me an employee performance evaluation
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Code 1 and Code 16Code 1 and Code 16
• 2008 Code 1 and Code 16 Matrix−Activities sorted by category−All operations activities are
listed as Code 1−Assistant Superintendents,
Principals, and Assistant Principals are specifically addressed under Operations
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Code 1 ActivitiesCode 1 Activities
• Education Requirements
• Instruction
• Individualized Education Program Elements
• Operations
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Code 1 or Code 16Code 1 or Code 16
• Meetings and Trainings
• Review and Planning
• Supervision
• Survey Participant Paperwork
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Code 16Code 16
• Paid Time Off
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Training Section ConclusionTraining Section Conclusion
• California School-Based MAA is
_____________________________
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BREAK TIMEBREAK TIME
TEN MINUTESTEN MINUTES