slide1 n.
Skip this Video
Download Presentation
Increasing Revenue: SBAP Funding Procedures

Loading in 2 Seconds...

play fullscreen
1 / 25

Increasing Revenue: SBAP Funding Procedures - PowerPoint PPT Presentation

  • Uploaded on

Increasing Revenue: SBAP Funding Procedures. Looking for Revenues?. SBAP & ACP $ . You’re in the right place!. SBAP & ACP $ .

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Increasing Revenue: SBAP Funding Procedures' - ashton

Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Increasing Revenue:

SBAP Funding Procedures


looking for revenues
Looking for Revenues?


You’re in the right place!



Carlisle Recently Jump Started their SBAP Billing ProgramMay 2010Added 1 FTE – Dedicated Access Billing CoordinatorUpdated Leader Services Software SetupBilling Form/File ManagementJune 2011Revenues increased > $100,000Year 1


14 buildings 4 800 students general fund budget 64m
14 Buildings4,800 StudentsGeneral Fund Budget: $64m

Carlisle Area School District

Special Ed – 15.5% population

of that: 32.2 % MA Eligible

30% Free & Reduced Lunch

Spec Ed Budget $7m

+ Pupil Health $5m



How did we do it?

  • Billed by Service Category:
  • IEP’s and Transportation
  • Speech, OT, PT, and Psych Svc
  • And various smaller categories
  • Year 2-3: need to add:
  • PCA Services
  • Social Work Services

YEAR 3 GOAL: $300,000


sbap direct services overview
SBAP-Direct Services overview

SBAP affords schools the opportunity to receive federal Medicaid funds for providing certain health-related services to special education students who are enrolled in the MA Program.

The program began in 1992 and is jointly operated by the PA Department of Education (PDE) and Department of Public Welfare (DPW).

eligible schools
Eligible schools
  • School Districts
  • Intermediate Units
  • MAWAs
  • Charter Schools
  • Approved Private Schools

Currently, over 600 schools participate.

covered services
Covered services

Assistive Devices


IEP Development

Nursing (RN)

Nursing (LPN)

Occupational Therapy

Orientation and Mobility

Personal Care Assistant

Physical Therapy




Social Work


Teacher of Hearing Impaired

Special Transportation

reimbursements by specialty
Reimbursements by specialty

For the 2010-2011 school year:

Total = $145,233,580

PCA $44,794,541

Speech, Language $28,274,559

OT $15,252,994

Transportation $12,362,406

IEP Development $15,132,210

Physical Therapy $8,596,718

Psychology $7,539,680

RN Nursing $5,191,279

Teacher of HI $2,925,027

Social Work $1,870,712

LPN Nursing $1,533,872

O&M $676,106

Physician $774,464

Asst. Devices $151,314

Psychiatry $56,713

Audiology $100,985


Considerations for participation

  • Do you have:
  • Sufficient staff and resources?
  • Accessibility of records?
  • Ability to maintain internal compliance programs?
  • Commitment to keep current on program regulations?
  • Commitment to training and conducting self-audits?
reimbursement factors
Reimbursement factors
  • Special education population
  • MA population
  • Health-related services provided by school staff and/or contracted services
  • Number of MA-qualified service providers
  • Number of parents providing consent
  • Level of management

Eligible students

  • Student must:
  • Be entitled to services under IDEA.
  • Be three years of age and under 21.
  • Be enrolled in MA.
  • Have an IEP that defines the MA-covered service.

Eligible students

  • Student must:
  • Have written Parental Consent.
  • Have Medical Authorization.
  • Receive the MA-covered service by a school employee or contractor who meets MA Provider qualifications.
  • Must be maintained for six years.
  • Must fully disclose the nature and extent of the service rendered.
  • Must be legible.
  • Must be readily available for an audit.
  • Reimbursements are made to PDE’s Comptroller’s Office and deposited into an LEA-restricted account.
  • Leader provides monthly Financial Reports.
  • LEAs must ensure the availability of funds prior to making a withdrawal request.
  • Funds must be used for special education programs and services.
acp overview
ACP overview

In meeting students’ educational needs, LEA staff members often find themselves delivering services that help ensure students are healthy and ready and able to learn.

The school setting provides an opportunity to enroll potentially eligible children in the MA Program or to assist children and their families who are already enrolled to access the MA services that are available to them.

acp overview1
ACP overview

ACP allows LEAs to receive federal Medicaid funds in addition to the School-Based ACCESS Program(direct services revenue).

Federal matching funds are available for certain administrative activities that are in support of the state’s Medicaid program.

eligible schools1
Eligible schools
  • School districts
  • IUs
  • Charter schools
  • Approved Private Schools

Participating LEAs must also participate in the Direct Services Program.

Currently, over 150 schools participate.

acp time studies
ACP time studies

One-week quarterly time studies held three times per year capture staff time.

The time study must:

  • represent tasks as they relate to the participants’ job descriptions.
  • capture 100 percent of participants’ time.
acp claimable activities
ACP claimable activities

Examples of administrative claimable activities:

  • Informing individuals about the MA Program.
  • Assisting individuals with the MA-application process.
  • Monitoring, referring, or coordinating MA-covered services.
reimbursements by quarter
Reimbursements by quarter
  • For the 2010-2011 fiscal year:
  • July-Sept. 2010 $3,979,820
  • Oct.-Dec. 2010 $3,753,608
  • Jan.-March 2011 $4,016,334
  • April-June 2011 $4,104,988

Total = $15,854,750

  • LEAs receive a check from DPW.
  • Reimbursement is calculated at the Federal Financial Participation rate of 50 percent.
  • DPW retains 50 percent of the reimbursement.
  • Funds should be spent within health-care services.