WELCOME TO: TRAIN THE COORDINATORS

1. WELCOME TO:TRAIN THE COORDINATORS Presented by: Department of Health Care Services (DHCS) ACLSS Branch and Local Educational Consortium FALL 2008

2. THE DAY AT A GLANCE • Housekeeping • National Updates • Time Survey Overview • Site Visit Findings • Activity Codes • Short Break • Interactive Memory Enhancement Exercise

3. HOUSEKEEPING • INTRODUCTIONS • RESTROOMS/BREAKS • CELL PHONES • TRAINING MATERIALS • QUESTION PROCESS

4. 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

5. 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 PURPOSE OF THIS TRAINING

6. NATIONAL 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??????

7. HEALTH CARE SERVICES (DHCS) UPDATE • DHCS will continue the SMAA program until FFP is no longer available • Audits/Oversight • Contingency Fee Contracts are not allowed

8. SMAA Time Survey Overview

9. PURPOSE 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

10. WHICH LEA STAFF SHOULD TIME SURVEY Consider two factors: 1. Do they perform MAA? 2. Are appropriate non-federal funds expended to receive federal reimbursement?

11. TIME SURVEY PARTICIPATION • How do LEAs participate in MAA? • When must staff be trained? • PPL 08-016 Training Participation

12. WHEN 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

13. WHEN 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.

14. TIME SURVEY ADMINISTRATION • The responsibility for proper administration of the time survey is shared by; • California Dept. of Health Care Services • LEC/LGA MAA Coordinator • LEA MAA Coordinator • Time Survey Participant and his/hersupervisor

15. TIME SURVEY REVIEW PROCESS • 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

16. THINGS 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?

17. THINGS TO LOOK FOR…Cont. • 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

18. 2004/05 Site Visit Findings Conducted During 2007/08

19. Time Survey Forms #1 Finding: Narratives are not Medi-Cal specific Code 4:“Sent Flyers homewith 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.”

20. Time Survey Forms Finding: Narratives are not Medi-Cal specific Follow the Five W’s WHO?WHAT? WHEN? WHERE ? WHY?

21. TIME SURVEY FORMS • Misuse of activity codes Code 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.”

22. TIME SURVEY FORMS • Acronyms not specific • Signatures • Participant did not attend training • Use original DHCS templates www.dhcs.ca.gov/provgovpart/Pages/SMAA

23. TIME SURVEY FORMS General Findings • Activity sample given with no recorded time • Incorrect time survey dates • Incorrect calculation of hours

24. TIME SURVEY FORMS Things to Remember • 80% accuracy for sample descriptions • Initial all corrections • No whiteout

25. OPERATIONAL PLANS • Missing documentation - copy of indirect cost rate via CDE www.cde.ca.gov/fg/ac/ic - copy of Medi-Cal Percentage

28. OPERATIONAL PLANS • Missing documentation • Missing duty statements • Photocopied training logs • Support for Code 4 and Code 8 activities

29. ORGANIZATIONAL TIPS FOR FUTURE 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

30. The Who, What, Where, When and Why of it!

31. SMAA 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

32. SMAA ACTIVITY GUIDANCE • CA School-Based MAA Manual • DHCS Policy and Procedure Letters • School-Based MAA Time Survey Form

33. SMAA Activity Examples • SMAA Codes 4, 6, 8, 10, 12, 14, 15 and 16

34. SMAA 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?

35. What Medi-Cal outreach, enrollment assistance or service was directly supported?

36. Initial activities that inform eligible or potentially eligible individuals about Medi-Cal programs and services and how to access them Code 4Initial Medi-Cal Outreach

37. Code 4Initial Medi-Cal Outreach • Prepared paperwork referring two (2) disruptive 6th Grade students to psychologist for initial Medi-Cal covered counseling evaluations

38. Code 4Initial 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

39. Code 4Initial 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.

40. Code 4Initial 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

41. Assisting an individual in becoming eligible for Medi-Cal/Healthy Families Code 6Facilitating Medi-Cal Application

42. Code 6Facilitating 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.

43. Code 6Facilitating Medi-Cal Application • Reviewed National School Lunch information to facilitate Medi-Cal/Healthy Families enrollment

44. Code 6Facilitating Medi-Cal Application • During IEP meeting, assisted parents with Medi-Cal/Healthy Families application

45. Making ongoing referrals for, coordinating, and/or monitoring the delivery of Medi-Cal covered services Activities take place after initial referrals have been made Code 8Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services

46. Code 8Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services • Called parent to verify student appointment with Pediatrician for evaluation of recurring ear aches

47. Code 8Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services • Revised student’s therapy schedule to coordinate community-based Pediatric otolaryngology services for speech disorder evaluation

48. Code 8Ongoing Referral, Coordination, and Monitoring of Medi-Cal Services 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

49. Assisting an individual or family to obtain transportation to services covered by Medi-Cal Code 10Arranging Transportation in Support of Medi-Cal Services

50. Code 10Arranging Transportation in Support of Medi-Cal Services • Coordinated transportation arrangements with parent taking student to medical center for Medi-Cal covered mental health services