MESD Staff Training 2006

Information about MESD Staff Training 2006

Published on January 15, 2008

Author: Perrin

Source: authorstream.com

Content

Medicaid Administrative Claiming:  Medicaid Administrative Claiming Staff Training What is Medicaid Administrative Claiming ?:  What is Medicaid Administrative Claiming ? Medicaid Administrative Claiming is a survey method of identifying and accounting for the time spent by public school staff on medically related activities, that otherwise would be the financial responsibility of the State. Schools provided administrative services that have been found to be necessary for the proper and efficient administration of the State Medicaid plan. Important Facts:  Important Facts You do not need to know who is Medicaid/OHP eligible You do not need to know all about Medicaid/OHP It is the activity you are doing that is being measured, not the outcome of the activity The time study determines your time spent on eligible and non-eligible activities MAC Activities:  MAC Activities Examples of these MAC activities include: discussing access to health care with a student/family assisting in early identification of children who could benefit from health services provided by Medicaid contacting pregnant and parenting teens about the availability of Medicaid prenatal, and well baby care programs and services providing referral assistance to families where Medicaid services can be provided Where do MAC activities take place?:  Where do MAC activities take place? MAC activities may take place anywhere school-age children, their families and school personnel are together. For example: in the classroom in the lunchroom on the playground on a field trip during a meeting (except for IEP) during school conferences Why would a school district choose to participate in MAC?:  Why would a school district choose to participate in MAC? The MAC process permits the costs of allowable administrative activities being performed by school staff, but not otherwise reimbursed, to be reimbursed under Medicaid. Revenue can be used for vital health and social services programs Strengthens local relationships among planning bodies, service providers, and public entities Diversifies funding base for needed programs and opportunities Examples of Projects throughout the State funded with MAC dollars:  Examples of Projects throughout the State funded with MAC dollars Dental Vans Family Advocates working out of the school School Nursing, Mental Health, Substance Abuse services Other health care or social service programs How is MAC time reported for Medicaid reimbursement?:  How is MAC time reported for Medicaid reimbursement? MAC claiming is reported by district staff completing a web-based survey. The survey documents services provided by school personnel on a normal school day. There are three survey periods per school year. Each survey period has five survey days within the period. Survey periods and dates are selected by DHS. September – December January – March April – June How is MAC time reported for Medicaid reimbursement?:  How is MAC time reported for Medicaid reimbursement? District staff participate in the survey All staff who are chosen through the random survey process must be trained prior to taking the survey Staff must sign in at the training Paid time at school is surveyed in the predominant portion of 15 minute increments Staff time falls into any one of ten activity codes How is MAC time reported for Medicaid reimbursement?:  How is MAC time reported for Medicaid reimbursement? It is recommended you complete the survey on the assigned random day, however; to accommodate for times when you may not be able to complete the survey on the assigned day, it is open for 5 days. The survey day, and the next four work days. Example: If the survey day is Tuesday, October 12 you would have until Monday, October 18 (Tuesday, Wednesday, Thursday, Friday, Monday) to fill out the survey for the activities you did on October 12. Slide11:  MESD On-Line Survey Ten Activity Codes:  Ten Activity Codes A. School-Related and Educational Activities, other B1. Medicaid/OHP Outreach B2. Non-Medicaid Outreach C1. OHP Referral, Coordination, Training C2. Non-OHP Referral , Coordination, Training D1. OHP Transportation/Translation D2. Non-OHP Transportation/Translation E1. Medical program planning, policy development, and interagency coordination E2. Non-medical program planning, policy development, and interagency coordination F. Direct Medical Services Claimable Categories – Activity Codes:  Claimable Categories – Activity Codes When a positive code is used (B1, C1, D1 or E1), staff will select the specific code from the activity description pop up screen. Example of B1 activity descriptions: B1.1 - Informing children and their families on how to effectively access, use, and maintain participation in Medicaid/OHP. (Includes describing the range of services, and distributing OHP literature) B1.2 - Assisting the student/family to access, apply for, and/or complete the Medicaid/OHP application. (Includes transportation and translation related to OHP application, and gathering appropriate information) B1.3 - Checking a student and/or family's OHP status. B1.4 - Contacting pregnant and parenting teenagers about the availability of Medicaid/OHP for prenatal and well baby care programs. Code A: School Related and Educational Activities:  Code A: School Related and Educational Activities This code should be used for: any school-related activities such as teaching and educational services developing, coordinating and monitoring of a student’s education plan or IEP discipline or student supervision social services and non-health related services Code A: Activity Examples:  Code A: Activity Examples I developed a lesson plan. I graded tests. I supervised the playground, halls, or lunch time. I discussed a student’s educational progress with a family at parent-teacher conferences. I helped a student to apply for college. I assisted in evaluating a textbook. I attended an IEP team meeting Code B1: Medicaid/OHP Outreach and Facilitating Medicaid/ OHP Eligibility:  Code B1: Medicaid/OHP Outreach and Facilitating Medicaid/ OHP Eligibility This code should be used for: informing students/families about OHP helping to get information for filling out or assisting to fill out the OHP application contacting pregnant and parenting teens about OHP prenatal and well baby care checking a student/family OHP eligibility status Code B1: Activity Examples:  Code B1: Activity Examples I informed a student/family about OHP (B1.1). I helped a family fill out the OHP form (B1.2). I referred a family to the local DHS office for the OHP application (B1.2). I talked to a teen parent about OHP prenatal and/or well baby care programs and services (B1.4). I provided necessary forms to a student/family in preparation for OHP eligibility determination (B1.3). Code B2: Non-Medicaid/OHP Outreach and Facilitating Non-Medicaid/OHP eligibility:  Code B2: Non-Medicaid/OHP Outreach and Facilitating Non-Medicaid/OHP eligibility This code should be used for: Child Find outreach activities informing students/families about social, vocational, or educational (including special ed) programs describing the services/benefits of these programs helping families fill out the necessary program forms Code B-2: Activity Examples:  Code B-2: Activity Examples I informed a student/family about general health information. I assisted a student/family to fill out a Free and Reduced lunch application. I informed a student/family about social service and educational programs such as WIC, childcare, food stamps, community college, higher education, and job training. I participated in Child Find for special education services. Code C1: Referral, Coordination, Monitoring and Training of Medicaid/OHP Services:  Code C1: Referral, Coordination, Monitoring and Training of Medicaid/OHP Services This code should be used for: making referrals for medical, mental and dental health services covered by Medicaid coordinating the delivery of medical, mental and dental health services covered by Medicaid monitoring the delivery of medical, mental and dental health services covered by Medicaid attending training about MAC and OHP covered services and the benefits of those services Code C-1: Activity Examples:  Code C-1: Activity Examples I referred a student to medical, dental or mental health care covered by Medicaid (C1.1). I participated in a meeting/discussion to coordinate or review a student’s need for health related services covered by OHP(C1.2). I spoke with a student’s doctor or parent about a change in medication (C1.2). I monitored and evaluated the medical service component of the IEP not done during the IEP team meeting (C1.3). I gathered information in order to refer a student/family to health care (C1.1). I participated in a MAC training or training about OHP covered service (C1.4). Code C2: Referral, Coordination, Monitoring and Training of Non-Medicaid/OHP Services:  Code C2: Referral, Coordination, Monitoring and Training of Non-Medicaid/OHP Services This code should be used for: participating in or coordinating state mandated health screening activities making referrals for scholastic, vocational, employment and social services referring to non-Medicaid/OHP services Code C-2: Activity Examples:  Code C-2: Activity Examples I participated in IDEA training or other education based in-service training. I participated in a meeting/discussion to coordinate or review a student’s need for scholastic, employment, vocational and other non-health services. I referred a student/family to educational or social services. I helped to coordinate and deliver the state mandated vision and hearing screens. Code D1: OHP Transportation and Translation:  Code D1: OHP Transportation and Translation This code should be used for: scheduling, arranging or providing transportation to OHP covered services scheduling, arranging or providing translation services that assist the individual to access and understand necessary care and treatment Code D1: Activity Examples:  Code D1: Activity Examples Transportation: I arranged transportation (e.g. bus, taxi, transportation brokerage) to take a student to a physical therapy appointment (D1.1). I drove a child to the hospital for emergency medical care (D1.1). I arranged a taxi to take a student to a medical appointment (D1.1) Translation: I used the assistance of a translator to inform a family about medical services for their child (D1.2). I used the assistance of a sign language interpreter to sign with a deaf student about his/her medical/physical, mental health condition and available services (D1.2). Code D2: Non-OHP Transportation and Translation:  Code D2: Non-OHP Transportation and Translation This code should be used for: scheduling, arranging or providing transportation to social, vocational and/or other educational programs and activities scheduling, arranging or providing translation services to assist individual to access and understand necessary non-Medicaid/OHP services Code D2: Activity Examples:  Code D2: Activity Examples Transportation I arranged transportation for a student to go to a vocational assessment. I arranged transportation for a student to attend a recreational program. Translation I arranged for a translator to assist me with tutoring a child in math. I arranged for a translator to assist me to communicate with a students parent about the suspension process. Code E1: Program Planning, Policy Development, Interagency Coordination Related to Medical Services:  Code E1: Program Planning, Policy Development, Interagency Coordination Related to Medical Services This code should be used for: develop strategies to assess or increase the capacity of school medical/health programs work with other agencies and providers to improve coordination and collaboration of Medicaid/OHP services monitoring the delivery of medical services system in the schools creating and reviewing health policies in the schools Code E-1: Activity Examples:  Code E-1: Activity Examples I helped develop strategies to increase the capacity of the school health programs (E1.1). I monitored the medical/health delivery systems in the school (E1.3). I developed an advisory group of health professionals to advise the school on health care services in the school (E1.2). I participated in an Early Childhood planning meeting to discuss the coordination of health care in our community and school (E1.1). Code E2: Program Planning, Policy Development, Interagency Coordination Related to Non-Medical Services:  Code E2: Program Planning, Policy Development, Interagency Coordination Related to Non-Medical Services This code should be used for: working collaboratively with other agencies to identify gaps, overlaps or duplication of non-medical/health services, such as vocational, social or educational services improve coordination, expand access or delivery of non-Medicaid/OHP services develop strategies to assess or increase the capacity of non-medical, dental and mental health school programs Code E-2: Activity Examples:  Code E-2: Activity Examples I developed strategies to increase the capacity of social services in my school. I collaborated with a vocational education program to expand services to students. I coordinated the delivery of social services in my school. I attended a meeting coordinating the use of the school building by a community group for a non-health activity. Code F: Direct Medical Services:  Code F: Direct Medical Services This code should be used for: providing health/dental/mental health services contained in the IEP conducting health/dental/mental health assessments/evaluations and diagnostic testing administering first aid or prescribed injection or medication to a student providing speech, occupational, physical therapies or counseling services Code F: Activity Examples:  Code F: Activity Examples I provided mental health counseling contained in an IEP. I administered first aid to a student on the playground. I completed a psychological evaluation and wrote the evaluation report. I provided direct speech therapy. Coding Details and Guidelines:  Coding Details and Guidelines Code only paid time and actual work hours Paid leave including absences, vacation, and personal leave are Code A Blank increments on the survey are only used for unpaid time—otherwise the survey will default to Code A: other Part-time employees only code the portion of the day they are paid Who do I contact if I need technical assistance?:  Who do I contact if I need technical assistance? 1) The MAC Trainer in your building: ________________________________ 2) The MAC Coordinator for your district/ESD: ________________________________ 3) The MESD Medicaid Facilitator: Wendy Chase – [email protected] 503-257-1775 Taking the Survey:  Taking the Survey Web address: http://www.mesd.k12.or.us/mac/ QUESTIONS:  QUESTIONS

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