School&District&Administrative&& NAME] … · 2014-08-15 · 28% % MSBA%Medicaid%Consortium,%2011%©Missouri%School%Boards’%Association% ELECTRONIC&RMS&PROCESS Ifyouarechosentobesampledduringaparticularquarter

MSBA Medicaid Consortium, 2011 © Missouri School Boards’ Association

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Medicaid Consortium Connecting Students to Healthy & Bright Futures 800-221-MSBA(6722) [email protected]

School District Administrative Claiming Program (SDAC)

[INSERT DISTRICT

NAME]

SDAC Participants’ Training and Resource Manual 2014-‐2015

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Dear SDAC Participant, The commitment of your school district to be involved in School District Administrative Claiming (SDAC) under MO HealthNet Division (Missouri’s Medicaid division) began with a commitment by your Board of Education in concert with your community. According to the MO HealthNet Division (MHD) School District Administrative Claiming Manual, “To effectively implement the program in a district at least two primary supports exist: (a) the Board of Education endorses and actively promotes the effort within the community; and (b) the administration provides the leadership and support required. With these supports in place, the district’s activities and the goals of the program will be compatible.”

You have been selected by administrative leadership in your district to be a participant in the SDAC program because of the roles and responsibilities you are expected to assume as a part of your job. The SDAC program is important to your school district for two reasons: 1) Through SDAC activities conducted by persons such as yourself, it is possible for all children to be connected to and access needed health care services so that they come to school healthy and ready to learn; and 2) schools get reimbursed for eligibility outreach, coordination, and referral activities conducted as an extension of MHD.

We need your help in order to be successful in this endeavor. Please take your involvement seriously. Become knowledgeable about MHD and how to help families get connected to health care services within your school and community. When opportunities arise—a student has a chronic health issue(s); a student is struggling, acting out, or frequently absent; a student is pregnant, appears depressed or not feeling well on a frequent basis—be prepared to advocate on behalf of the student and his/her potential health needs. Take the necessary steps within your school and/or community to connect families and students to needed health care, including helping them to get the necessary information to become insured by MO HealthNet, if deemed eligible. Work with parents to make medical referrals; collaborate with colleagues regarding a child’s health condition and treatment; and follow-‐up with medical providers within the district and within the community regarding a student’s medical condition-‐-‐all, as appropriate and in accordance with law, to ensure health needs of students are met.

Thank you for your dedication and service to the children of Missouri. If you have questions about any content in this manual, please contact your school district’s SDAC Coordinator or Missouri School Boards’ Association.

SDAC Coordinator Missouri School Boards' Association [Insert Coordinators Name] MSBA Medicaid Consortium [Insert Coordinators Contact] 1-‐800-‐221-‐MSBA (6722)

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SCHOOL DISTRICT ADMINISTRATIVE CLAIMING

Responsibilities of an SDAC Participant Resources

• Be knowledgeable about MO HealthNet Division (MHD) Section 2 of Manual and how to help families connect with health care services within the school district and community.

• Receive SDAC training annually. On-‐line or group • Meet expectations of the District in regard to:

o assisting parents with medical referrals; o providing MO HealthNet applications and

information to parents; o collaborating with colleagues in regard to students’

health conditions; and o coordinating and monitoring the delivery of health

care services to students. • Open e-‐mail daily and respond to RMS responsibilities in a Manual, pages 27-‐29

timely manner.

Staff Eligible to be on the SDAC Personnel Roster:

Employees whose job responsibilities routinely include one or more of the following:

• Referring, coordinating and monitoring the delivery of health care services;

• Linking a child and family to an ongoing health care delivery system; and/or • Building or sustaining state and local partnerships for the delivery of MO HealthNet

services.

SDAC Quarterly Calendar Periods

Quarter 1 January 1 through March 31

Quarter 2 April 1 through June 30

Quarter 3 July 1 through September 30

Quarter 4 October 1 through December 31

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INDEX

Section 1: Participant Training Materials (Companion materials to the On-‐line Training or DVD)

Common Terminology and Acronyms ………………………………………. 5 Companion Power Point: Handout for Note Taking ………………….. 6 Sample RMS Form with Instructions Sample Electronic Form………………………………………………….. 27 The Electronic RMS Process……………………………………………. 28 Step-‐by-‐Step Instructions for Correcting an Electronic Form…… 29 MO HealthNet SDAC Manual: Activity Code Descriptions……..…… 30

with Actual Code Examples from Missouri Schools Section 2: SDAC Outreach Resources

Outreach Guide for MO HealthNet for Kids ………..……….….………. 45 Key Times to Conduct Outreach…………………………………….. 45 Health Coverage for Pregnant Teens……………………..….…… 45 Appropriate Outreach/Facilitation Activities…………….….... 45 Discussion Points for MO HealthNet…………………………….... 46 How Families Apply for MO HealthNet Coverage….……….. 46 Area Family Support Division (FSD) Offices ……………………. 47 Healthy Children and Youth (HCY) Information……….……… 48 MO HealthNet for Kids Eligibility Guidelines (Effective April 2014 through April 2015)………..……………. 49

Discussion Points for MO HealthNet Eligibility Guidelines…….….. 50

Section 3: Supplemental Training Guide

Supplement to SDAC Annual Training of Participants…………….…. 53

This manual is a companion piece to the SDAC Participant’s Training DVD. You must participate in

a training of at least 60 minutes annually in order to be eligible to participate in the program, including completing a RMS form.

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Participant Training Materials Section 1.

Companion materials to the On-‐line Training or DVD

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SCHOOL DISTRICT ADMINISTRATIVE CLAIMING

Common Terminology and Acronyms

CMS Centers for Medicare and Medicaid Services DESE Department of Elementary and Secondary Education EPSDT Early Periodic Screening, Diagnosis, and Treatment HCY Healthy Children and Youth MER Medicaid Eligibility Rate MEV Medicaid Eligibility Verification MHD MO HealthNet Division PPR Provider Participation rate RMS Random Moment Sample SDAC School District Administrative Claiming

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Please contact your SDAC Coordinator to obtain additional or revised training and support materials. Thank you.

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ELECTRONIC RMS PROCESS If you are chosen to be sampled during a particular quarter, you will receive a notification of your exact date and time of your moment in an e-‐mail 2 business days prior to your assigned moment. When you open the e-‐mail it will give you (3) three steps to follow: Step 1: “Write down your SDAC PIN.” This pin is used when completing your electronic RMS form. You cannot complete your moment without this PIN as it is your electronic signature. This is a good time to also make note of the date and time of your selected moment. Step 2: Click on the “Confirm” link. This is a very important step because it alerts your SDAC coordinator that you know that you have received and read the notification e-‐mail and that you are aware of your upcoming moment. It is critical that the confirm link be clicked before your moment in time. Step 3: The final step, which can't be done until after the moment occurs, is to click on the “FILL OUT FORM” link. The actual link takes you to your electronic RMS form. This step is very time sensitive. You cannot access the form or click on the link until the moment has passed. You should complete the RMS form within two (2) to five (5) business days after the moment. We understand there are reasons why you cannot meet the timeline, such as illness or a week of snow days. Complete the form when you return to school or access it while absent through your district e-‐mail account. The day your moment is to occur you should receive another reminder e-‐mail about your sample moment. This e-‐mail will only contain 2 steps: Step 1: Write down your SDAC Pin. Step 2: “Fill out Form” link. Assuming your moment has now passed and you have clicked on the “Fill out Form” link, you will now see an electronic RMS form like the one in this booklet. Now complete the five (5) steps below:

1. Write a brief description of your activity at the assigned time. 2. Check 1 box to indicate your position. 3. Check 1 box to indicate activity code related to activity description. 4. Enter your unique SDAC PIN. 5. Click “Send to SDAC Coordinator.”

The process is now complete unless clarification is requested by either your district SDAC Coordinator or MSBA Medicaid Consortium and/or corrections are necessary.

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STEP-‐by-‐STEP GUIDE for CORRECTING ELECTRONIC RMS FORMS IN Therapylog.com 1. Go to www.therapylog.com 2. Enter your email address and password and click “Log In.” (If you don’t know your password, try the 6 digit DESE code with the dash or please call a MSBA rep for assistance.) 3. Click on the “Admin Tools” tab; then click “SDAC Dashboard;” then, click on “Quarter Manager.” 4. Use the slider to select the current year and then click on the desired quarter. 5. The status for that quarter will appear “Time Study in Progress”. Then click on “Manage This Quarter.” 6. Find the row that contains the RMS form in error and click anywhere on that row. 7. On the right side of the page (some may need to scroll up depending on how many moments your district has) you will find a heading labeled “Tools.” Click on the option under that header labeled “View Form.” 8. If you scroll to the bottom of the form you will see a large space and an option labeled “Send Back.” Click into the large space and type the reason why the form is being sent back to the initial respondent. Include any details you feel important and then click “Send Back.” 9. After the screen re-‐loads it will take you back to your list of RMS moments. Note that the status of the form DID NOT change. 10. Contact the respondent to ensure the “Send Back” notice was received and the respondent understands the needed corrections. 11. Monitor the form daily until the corrections are made. 12. When the corrections are complete, click the “Save” option at the bottom of the page. 13. If the correction process started with the form in “Sent Back” status (Returned by MSBA) you are done. If you identified the need for correction when the form was in “Collected” status, then make sure the additional steps (Reviewed, Validated, and Submitted) are performed.

Note: Follow the steps below when:

1. You have received a RMS “Sent Back” notice via email, or 2. The SDAC Coordinator finds an error with a RMS form in the “Collected” status.

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MO HEALTHNET DIVISION SCHOOL DISTRICT ADMINSTRATIVE CLAIMING ACTIVITY CODES

NOTE:

• MO HealthNet Division advises participants when using the Activity Codes below as a reference, to read the general explanation first to establish a basic understanding of the intent of the activity code before reviewing examples.

• Examples appearing in text boxes are actual responses from districts participating in the

MSBA Medicaid Consortium and have received approval by MHD as being appropriately coded.

Use this code when performing activities that inform eligible or potentially eligible individuals about non-‐MO HealthNet social (Food Stamps and Title IV-‐E), vocational, general health and educational programs (including special education) and how to access them; describing the range of benefits covered under these non-‐MO HealthNet social, vocational and educational programs and how to obtain them. Both written and oral methods may be used. Includes related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Scheduling and promoting activities which educate individuals about the benefits of healthy life-‐styles

and practices; • Conducting general health education programs or campaigns addressed to the general population; • Conducting outreach campaigns directed toward encouraging persons to access social, educational,

legal or other services not covered by MO HealthNet; • Assisting in early identification of children with special medical/dental/mental health needs through various child find activities; and

• Outreach activities in support of programs which are 100 percent funded by State general revenue.

Code 1.a: Non-‐MO HealthNet Outreach

Actual Response of a Code 1a Activity from a Missouri School District

• I was helping a student who had requested scholarship information about St. Charles Community College. I provided the student with information to apply for Trustees scholarships.

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Use this code when performing specific activities to inform eligible individuals about MO HealthNet benefits and how to access the program. Information includes a combination of oral and written methods that describe the range of services available through MO HealthNet. Examples:

• Interpreting materials about MO HealthNet to persons with children within the school district boundaries who are illiterate, blind, deaf, or who cannot understand the English language; • Informing foster care providers of foster children residing within school district boundaries about the

MO HealthNet and EPSDT program; • Informing MO HealthNet eligible pregnant students about the availability of EPSDT services for children under the age of 21 (including children who are eligible as newborns);

• Utilizing brochures approved by the Division of Medical Services, designed to effectively inform eligible individuals about the benefits Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program and services, and about how and where to obtain services;

• Providing information about EPSDT in the schools that will help identify medical conditions that can be corrected or ameliorated by services covered through MO HealthNet; • Informing children and their families about the early diagnosis and treatment services for

medical/mental health conditions that are available through the MO HealthNet program; and • Facilitating access to MO HealthNet when a staff member knows that a child does not have appropriate health care, this does not include child find activities directed to identifying children with

educational handicapping conditions.

Use this code when assisting an individual or family to make application for programs such as TANF, Food Stamps, WIC, day care, legal aid, and other social or educational programs and referring them to the appropriate agency to make application. Both written and oral methods may be used. Examples: • Explaining the eligibility process for non-‐MO HealthNet programs; • Assisting the individual or family in collecting/gathering information and documents for the non-‐MO HealthNet program application; • Assisting the individual or family in completing the application; • Developing and verifying initial and continuing eligibility for the Free and Reduced Lunch Program; and • Providing necessary forms and packaging all forms in preparation for the Non-‐MO HealthNet eligibility determination.

Code 2a: Facilitating an Application to Non-‐MO HealthNet Programs

Code 1b: MO HealthNet Outreach

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Use this code when assisting children and families in establishing MO HealthNet eligibility, by making referrals to the Family Support Division for eligibility determination, assisting the applicant in the completion of the MO HealthNet application forms, collecting information, and assisting in reporting any required changes affecting eligibility. Includes related paperwork, clerical activities or staff travel required to perform these activities. Examples:

• Referring an individual or family to the local assistance office to make an application for MO HealthNet benefits; • Explaining the MO HealthNet eligibility process to prospective applicants;

• Providing assistance to the individual or family in collecting required information and documents for the MO HealthNet application; and • Assisting the individual or family in completing the MO HealthNet application.

Use this code when performing any other school-‐related activities that are not MO HealthNet related, such as social services, educational services, teaching services; employment and job training. These activities include the development, coordination, and monitoring of a student’s education plan. Include related paperwork, clerical activities, or staff travel required to perform these activities. Examples: • Providing classroom instruction (including lesson planning);

• Testing, correcting papers; • Developing, coordinating, and monitoring the Individualized Education Plan (IEP) for a student, which includes ensuring annual reviews of the IEP are conducted, parental sign-‐offs are obtained, and the

actual IEP meetings with the parents; • Compiling attendance reports; • Reviewing the education record for students who are new to the school district;

• Providing general supervision of students (e.g., playground, lunchroom); • Providing individualized instruction (e.g., math concepts) to a special education student; • Conducting external relations related to school educational issues/matters;

• Activities related to the immunization requirements for school attendance; • Enrolling new students or obtaining registration information; • Conferring with students or parents about discipline, academic matters or other school related issues;

Code 2b: Facilitating MO HealthNet Eligibility Determination

Code 3: School Related and Educational Activities

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• Participating in or presenting training related to curriculum or instruction (e.g., language arts workshop, computer instruction); and

• Providing Individuals with Disabilities Education Act (IDEA) mandated child find activities.

Use this code when providing direct health care, treatment, and/or counseling services including mental health assessments and evaluations to an individual in order to correct or ameliorate a specific condition. This code also includes administrative activities that are an integral part of or extension of a medical service (e.g., patient follow -‐up, patient assessment, patient counseling, patient education, parent consultations, billing activities). This code also includes all related paperwork, clerical activities, or staff travel required to perform these activities. Examples: • Providing health/mental health services contained in an IEP;

• Medical/health assessment and evaluation as part of the development of an IEP; • Conducting medical/health assessments/evaluations and diagnostic testing and preparing related reports;

• Providing health care/personal aide services; • Providing speech, occupational, physical and other therapies; • Administering first aid, or prescribed injection or medication to a student;

• Providing direct clinical/treatment services; • Providing counseling services to treat health, mental health, or substance abuse conditions;

Code 4: Direct Medical Services

Actual Responses of Code 3 Activities from Missouri School Districts

• I was administering the End of Course exam for Government class. This is a state exam. I was reading the online exam to students. (Special Education Teacher)

• I was typing the IEP meeting agenda notes on a student. (Speech Therapist)

• I was in the library with incoming kindergarteners as part of a kindergarten orientation and building tour. (Counselor)

• I was doing front door duty, greeting all students as they enter the building in the morning. (Assistant principal)

• I was teaching specialized instruction 6th grade math students. (Special Education Teacher)

• I was talking to a student regarding a discipline referral to my office. (Principal)

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• Performing routine or mandated child health screens including but not limited to vision, hearing, dental, and EPSDT screens;

• Providing immunizations; • Targeted Case Management provided or covered as a medical service under MO HealthNet; and • Activities which are services or components of services listed in the State’s Medicaid plan.

This code should be used by school staff when assisting an individual to obtain transportation to services not covered by MO HealthNet, or accompanying the individual to services not covered by MO HealthNet. Include related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Scheduling or arranging transportation to social, vocational, and/or educational programs and activities.

Code 5a: Transportation for Non-‐MO HealthNet Services

Actual Responses of Code 4 Activities from Missouri School Districts

• I was with a female student who is diabetic and we were taking care of her Blood sugar. (School Nurse)

• I was with a student in the early childhood setting providing direct therapy in the therapy room. 2) We were working on walking in the hallway with a gait trainer. 3) The intended result was to increase lower extremity strength for the child. (Physical Therapist)

• I was providing language therapy to a first grade student in my classroom. We were working on expanding expression to increase his vocabulary and comprehension skills. (Speech Language Pathologist)

• I was by myself in my vehicle. I was driving to the high school to provide speech/ language services to students. (SLP)

• I was conducting a vision test on a first grader as part of grade-‐level vision screening. (RN)

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This code should be used by school staff when assisting an individual to obtain transportation to services covered by MO HealthNet. This does not include the provision of the actual transportation service or the direct cost of the transportation, but rather the administrative activities involved in providing transportation. Include related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Scheduling or arranging transportation to MO HealthNet covered services.

This code should be used by school staff when providing translation service for non-‐MO HealthNet activities. Include related paperwork, clerical activities or staff travel required to perform the activities. Examples: • Arranging for or providing translation services (oral or signing services) that assist the individual to

access and understand social, educational, and vocational services; • Arranging for or providing translation services (oral or signing services) that assist the individual to access and understand state education or state-‐mandated health screenings (e.g., vision, hearing,

scoliosis) and general health education outreach campaigns intended for the student population; and • Developing translation materials that assist individuals to access and understand social, educational, and vocational services.

This code should be used by school staff when it is not included and paid for as part of a medical assistance service and must be provided with by separate units or separate employees performing solely translation functions for the school and it must facilitate access to MO HealthNet covered services. Please note that a school district does not need to have a separate administrative claiming unit for translation. Include related paperwork, clerical activities or staff travel required to perform these activities. Examples:

• Arranging for or providing translation services (oral or signing) that assist the individual to access and understand necessary care or treatment covered by MO HealthNet; and • Developing translation materials that assist individuals to access and understand necessary care or

treatment covered by MO HealthNet.

Code 5b: Transportation-‐Related Activities in Support of MO HealthNet Covered Services

Code 6a Non-‐MO HealthNet Translation

Code 6b Translation Related to MO HealthNet Services

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This code should be used by school staff when performing activities associated with the development of strategies to improve the coordination and delivery of non-‐medical services to school age children. Non-‐medical services may include social services, educational services, and state or state education mandated child health screenings provided to the general school population. Only employees whose position descriptions include program planning, policy development and interagency coordination may use this code. Include related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Identifying gaps or duplication of non-‐medical services to school age children and developing

strategies to improve the delivery and coordination of these services; • Developing strategies to assess or increase the capacity of non-‐medical school programs; • Monitoring the non-‐medical delivery systems in schools;

• Developing procedures for tracking families’ requests for assistance with non-‐medical services and providers; • Evaluating the need for non-‐medical services in relation to specific populations or geographic areas;

• Analyzing non-‐medical data related to a specific program, population, or geographic area; • Working with other agencies providing non-‐medical services to improve the coordination and delivery of services and to improve collaboration around the early identification of non-‐medical problems;

• Defining the relationship of each agency’s non-‐medical service to one another; • Developing advisory or work groups of professionals to provide consultation and advice regarding the delivery of non-‐medical services and state mandated health screening to the school populations;

• Developing medical referral sources; and • Coordinating with interagency committees to identify, promote and develop non-‐medical services in the school system.

Code 7a: Program Planning, Policy Development, and Interagency Coordination Related To Non-‐Medical Services

Actual Responses of Code 7a Activities from Missouri School Districts

• I was at MSBA Jefferson City office with the Special Education Action committee. We were discussing legislative action impacting special education and related services for students with disabilities. (Director of Pupil Services)

• I was meeting with other agencies in town to talk about the need for quality after-‐school child care for low-‐income families. (Director of Elementary Education)

• I was meeting with a 6th grade team about what is working well in our building and what we should look at to improve the educational outcomes for children. (Assistant Principal)

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This code should be used by school staff when performing activities associated with the development of strategies to improve the coordination and delivery of MO HealthNet covered medical/dental/mental health services to school age children, and when performing collaborative activities with other agencies and/or providers. Only employees whose position descriptions include program planning, policy development and interagency coordination should use this code. Include related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Developing strategies to assess or increase the capacity of school medical/dental/mental health

programs; • Monitoring the medical/dental/mental health delivery systems in schools; • Developing procedures for tracking families’ requests for assistance with medical/dental/mental

health services and providers, including MO HealthNet. (This does not include the actual tracking of requests for MO HealthNet services); • Evaluating the need for medical/dental/mental health services in relation to specific populations or

geographic areas; • Analyzing MO HealthNet data related to a specific program, population, or geographic area; • Working with other agencies providing medical/dental/mental health services to improve the

coordination and delivery of services, to expand access to specific populations of MO HealthNet eligible, and to improve collaboration around the early identification of medical problems; • Working with other agencies and/or providers to improve collaboration around the early identification

of medical/dental/mental problems; • Developing strategies to assess or increase the cost effectiveness of school medical/dental/mental health programs;

• Working with MO HealthNet resources, such as the MO HealthNet agency and MO HealthNet managed care plans, to make good faith efforts to locate and develop EPSDT health services referral relationships;

• Developing advisory or work groups of health professionals to provide consultation and advice regarding the delivery of health care services to the school populations; • Developing medical referral sources such as directories of MO HealthNet providers and managed care

plans, which will provide services to targeted population groups, e.g., EPSDT children; • Coordinating with interagency committees to identify, promote and develop EPSDT services in the school system;

• Identifying gaps or duplication of medical/dental/mental health services to school age children and developing strategies to improve the delivery and coordination of these services; and • Working with Division of Medical Services to identify, recruit and promote the enrollment of potential

MO HealthNet providers.

Code 7b: Program Planning, Policy Development, and Interagency Coordination Related To Medical Services

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This code should be used by school staff when coordinating, conduction, or participating in training events and seminars for outreach staff regarding the benefit of the programs other than the MO HealthNet program. For example, training may include how to assist families to access the services of education programs, and how to more effectively refer students for those services. Include related paperwork, clerical activities, or staff travel required to perform these activities. Examples: • Participating in or coordination training that improves the delivery of services for programs other than

MO HealthNet; and • Participating in or coordinating training that enhances IDEA child find programs.

Code 8a Non-‐Medical/Non-‐MO HealthNet Related Training

Actual Responses of Code 7b Activities from Missouri School Districts

• I was in a meeting with school nurses talking about how to more effectively meet the needs of the increasing number of students with diabetes in the school district. (Nurse)

• I was meeting with speech therapists to plan the coordination of delivery of speech/language therapy throughout the district for next year. (Coordinator of Special Education)

• I was preparing a list of possible medical referral sources, including designated Medicaid providers, within the community for district staff to use when consulting with parents. (RN Supervisor)


• I was conducting a seminar on how to assist high school students with accessing Vocational Rehabilitation Services. (Director of Special Education)

• I was attending staff training on the Title 1 program, including when and how to make a referral. (Counselor)

• I was coordinating the training component on child find activities under IDEA as part of a broader district-‐wide training for all staff. (Director of Special Education)

• I was attending the MO-‐CASE conference at the Lake of the Ozarks with other Missouri Educators. I was in one of the break-‐out sessions on 504 Plans learning about eligibility criteria. (Speech Therapist)

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This code should be used by school staff when coordinating, conduction, or participating in training events and seminars for outreach staff regarding the benefit of medical/MO HealthNet related services, how to assist families to access such services, and how to more effectively refer students for those services. Include related paperwork, clerical activities, or staff travel required to perform these activities. Examples:

• Participating in or coordination training that improves the delivery of medical/MO HealthNet related services; • Participating in or coordinating training that enhances early identification, intervention, screening and

referral of students with special health needs to such services (e.g., MO HealthNet EPSDT services); and • Participating in training on administrative requirements related to medical/MO HealthNet services.

Code 8b Medical/MO HealthNet Related Training

Actual Responses of Code 8b Activities from Missouri School Districts

• I was with other administrators and staff in a MANDT training. We were being certified in MANDT. MANDT training is a behavioral health program that the district has adopted and all administrators were trained on that day. (Assistant Principal)

• Traveling to Medicaid related training. Training included learning new strategies, resources and activities for improving the delivery of services to students that have speech and language disorders.(Speech Therapist)

• I was at a breakout session at a conference in Kansas City. I gained information to bring back that will improve my counseling sessions with students with mental health issues. (Social Worker)

• I was attending training on the warning signs of students who are potentially suicidal and the referral steps to take on behalf of the child. (Special Education Teacher)

• I was traveling in my car on the way to participate in a mental health seminar on bipolar disorder on identification, diagnosis, and treatment as well as referral options for students. (Social Worker)

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Use this code when making referrals for, coordinating, and/or monitoring the delivery of non-‐ medical, such as educational services. Include related paperwork, clerical activities, or staff travel necessary to perform these activities. Examples:

• Making referrals for and/or coordinating access to social and educational services such as child care, employment, job training, and; • Making referrals for, coordinating, and/or monitoring the delivery of state education agency

mandated child health screens; • Making referrals for, coordinating, and/or monitoring the delivery of scholastic, vocational and other non-‐health related examinations;

• Gathering any information that may be required in advance of these non-‐MO HealthNet related referrals; • Participating in a meeting/discussion to coordinate or review a student’s needs for scholastic,

vocational, and non-‐health related services not covered by MO HealthNet; and • Monitoring and evaluating the non-‐medical components of the IEP as appropriate.

This code should be used when making referrals for, coordinating, and/or monitoring the delivery of medical (MO HealthNet covered) services. Referral, coordination and monitoring activities related to services in an IEP are reported in this code. Activities that are part of a direct service are not included in this code. Include related paperwork, clerical activities, or staff travel necessary to perform these activities.

Code 9b: Referral, Coordination, and Monitoring of MO HealthNet Services

Code 9a: Referral, Coordination, and Monitoring Of Non-‐MO HealthNet Services


• I was talking to a speech language pathologist about a student’s educational IEP goals. (EC Teacher)

• I was alone at the moment, completing paperwork in regard to a student referral for special education testing. The document being completed is a requirement to be in compliance with state regulations for special education under IDEA. (Special Education Coordinator)

• At this moment in time, I was discussing with another teacher ideas to help a student achieve some of her educational IEP goals.(Special Education Teacher)

• Compiling and monitoring academic data for a student in preparation for a meeting with his/her teachers. (Special Education Teacher)

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Examples: • Identifying and referring adolescents who may be in need of MO HealthNet family planning services;

• Making specific medical referrals for and/or coordinating medical or physical examinations and necessary medical/dental/mental health evaluations; • Making referrals for and/or scheduling EPSDT screens, interperiodic screens, and appropriate

immunization, but NOT to include the state-‐mandated health services; • Referring students for necessary medical health, mental health, or substance abuse services covered by MO HealthNet;

• Arranging for any MO HealthNet covered medical/dental/mental health diagnostic or treatment services that may be required as the result of a specifically identified medical/dental/mental health condition;

• Gathering information that may be required in advance of these medical/dental/mental health referrals; • Participating in a meeting/discussion to coordinate or review a student’s needs for health-‐related

services covered by MO HealthNet; • Providing follow-‐up contact to ensure that a child has received the prescribed medical/dental/mental health services;

• Coordinating the completion of the prescribed services, termination of services, and the referral of the child to other MO HealthNet service providers as may be required for continuity of care; • Providing information to other staff on the child’s related medical/dental/mental health services and

plans; • Monitoring and evaluating the MO HealthNet service components of the IEP as appropriate; and

• Coordinating the delivery of community based medical/dental/mental health services for children with special/severe health care needs.

Actual Responses of Code 9b Activities from Missouri School Districts • Assistant Principal and I were meeting with a parent about their child's drug

usage and drug treatment coordination. Releases of information, amount of outside counseling services, aftercare and medications were discussed. (Counselor)

• I was completing a student referral form for BJC mental health services/school based therapy. (Secondary School Counselor)

• Follow-‐up phone call to the parent on a hearing referral. Student went to a doctor and was diagnosed with a significant hearing deficit. I requested written document from the audiologist. (RN)

• With parent and student trying to refer student on to Pathways for a mental health evaluation. (Assistant Principal)

• I was with a PAT parent, discussing their high school daughter and making a referral for counseling. (PAT Educator)

• I was meeting with a learning specialist and we were discussing the current status (motor and behavioral) of a student who is receiving occupational therapy services as per the student's IEP. (Occupational Therapist)

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Use this code when performing activities that are not directly assignable to program activities. Includes related paperwork, clerical activities or staff travel required to perform these activities. Examples: • Taking lunch, breaks, leave, or other paid time not at work; • Establishing goals and objectives of health-‐related programs as part of the school’s annual or multi-‐year plan; • Attending or facilitating school or unit staff meetings, training, or board meetings; • Reviewing school or district procedures and rules; • Reviewing technical literature and research articles; • Providing general supervision of staff, including supervision of student teachers or classroom volunteers, and evaluation or employee performance; and • Performing other administrative or clerical activities related to general building or district functions or operations.

(MO HealthNet SDAC Extended Activity Code Definitions with Examples revised August 2014

Code 10: General Administration

Actual Responses of Code 10 Activities from Missouri School Districts • I was on paid sick leave. (Counselor) • I was having lunch in the teacher’s lounge. It is paid time.(Special Education

Teacher) • I was conducting a staff meeting and explaining lock down procedures to staff in

case of a potential outside threat to our students. (Principal) • I am on lunch break. It is not paid time as I am an hourly employee. (Aide) • At this time, the whole school district was doing a tornado drill. I had no

students at this time. (Remedial Reading Teacher) • I was meeting with a teacher going over her performance evaluation. (Principal)

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SDAC Outreach Resources Section 2.

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OUTREACH GUIDE FOR MO HEALTHNET FOR KIDS

KEY TIMES TO CONDUCT OUTREACH

• At enrollment, if the student does not have health insurance. • Any parent conference when it is apparent that the child may have a medical, mental or

behavioral health problem which is untreated due to a lack of health insurance. • When the school becomes aware of a change in household status that may result in a change in

eligibility for MO HealthNet coverage: o Change in employment status of one or both parents, such as a loss of a job or a

reduction in hours. o Change in household composition:

! One parent leaves the household; or ! Another sibling is born or returns to the home.

• When working with a pregnant teen that needs healthcare coverage for herself and her

unborn child, coverage is available under the MO HealthNet for Pregnant Women and Newborns program.

o This program provides healthcare coverage, including sixty-‐day postpartum coverage, for pregnant women whose family income does not exceed 185% of the federal poverty level (FPL) for their household size. Once eligible, the coverage continues through the postpartum period despite subsequent increases in income.

o Children born to a woman eligible for and receiving MO HealthNet for Pregnant Women or other MO HealthNet health care coverage on the date of the infant's birth continue to be eligible for MO HealthNet coverage throughout the first year of life as long as the child remains in the mother's home and maintains Missouri residence.

APPROPRIATE OUTREACH/FACILITATION ACTIVITIES

• Discussion with the parent/legal guardian which includes some or all of the discussion points listed below.

• Providing a copy of the MO HealthNet for Kids Eligibility Guidelines to the parent/legal guardian. • Assisting the parent/legal guardian in understanding what documents are needed to establish

eligibility and offering assistance to obtain those types of documents. • Providing information to the parent/legal guardian of the location of the local Family Support

Division office (s) in their area. • Printing a MO HealthNet for Kids, Pregnant Women and Parents application and giving it to the

parent/legal guardian. • Assisting the parent/legal guardian in completing either an on-‐line application or paper

application. • Discussing the benefit of regular healthcare screenings provided by the HCY program.


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DISCUSSION POINTS FOR MO HEALTHNET OUTREACH

WHAT IS MO HEALTHNET FOR KIDS?

• MO HealthNet for Kids is a health insurance program for children of low-‐income families.

WHAT IS COVERED BY MO HEALTHNET FOR KIDS?

• Children will receive all medically-‐necessary services including: o primary, acute and preventative care o hospital services (in-‐patient and out-‐patient) o physician services, check-‐ups and sports physicals o physical, occupational and speech therapy o dental services o home and community-‐based services o medical equipment and supplies o pharmacy o vision care, including glasses o hearing services o lab and x-‐ray o behavioral services-‐-‐ outpatient counseling and inpatient psychiatric treatment o Substance abuse treatment o Immunizations

HOW FAMILIES APPLY FOR MO HEALTHNET FOR KIDS

• The application is filed by the parent/ legal guardian of the child. • Applications may be made:

o On-‐line (www.dss.mo.gov/mhk/appl.htm) – application is available in English, Spanish, Bosnian and Vietnamese

o Applications may be downloaded from the internet and printed. (www.dss.mo.gov/mhk/appl.htm)

o Call toll free at 888-‐275-‐5908 to request an application. o At a local Family Support Division office. For the location of an office near you see

www.dss.mo.gov/offices.htm .

• Documentation required to support an application for MO HealthNet: o Proof of household income (check stubs, federal income tax form, etc.). o Social Security numbers for persons in household for whom assistance is requested

(including the parent/legal guardian of the children). o Proof of immigration status for non-‐citizens.

• Applications are processed within 30 days. The parent/legal guardian will be notified in writing

when a decision has been made.

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AREA FAMILY SUPPORT DIVISION (FSD) OFFICE

[Insert Area Office(s) Location & Contact]

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HEALTHY CHILDREN AND YOUTH (HCY) INFORMATION

MC+ eligible infants, children, and youth can get checkups and health care that helps them to stay well. The Healthy Children and Youth (HCY) program covers the health care needed to treat medical and behavioral problems. A full HCY screening includes:

• A comprehensive unclothed physical examination; • A comprehensive health and developmental history including assessment of both physical and

mental health developments; • Health education (including anticipatory guidance); • Appropriate immunizations according to age; • Laboratory tests as indicated (appropriate according to age and health history unless medically

contraindicated); • Lead screening according to established guidelines; • Hearing screening; • Vision screening; • Dental screening

Services must be provided by an approved MO HealthNet provider. If the family lives in a managed care area, the services must be obtained through their Primary Care Provider. The HCY screening can be obtained at the following ages:

• Newborn (2-‐3 days) • By one month • 2-‐3 months • 4-‐5 months • 6-‐8 months • 9-‐11 months • 12-‐14 months • 15-‐17 months • 18-‐23 months • 24 months • 3 years • 4 years • 5 years • 6-‐7 years • 8-‐9 years • 10-‐11 years • 12-‐13 years • 14-‐15 years • 16-‐17 years • 18-‐19 years • 20 years

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MO HEALTHNET FOR KIDS ELIGIBITY GUIDELINES

WHO IS ELIGIBLE

A child:

• Who is under 19 years of age; • Who applies for a Social Security number: • Who lives in Missouri and intends to remain; • Who is a United States citizen or an eligible qualified non-‐citizen; • The parent must cooperate with Child Support Enforcement (CSE) in the pursuit of medical

support; and • Whose countable family income meets the income guidelines below

MO HealthNet for Kids Non-‐SCHIP MO HealthNet for Kids (SCHIP)

HOUSEHOLD SIZE INCOME LIMIT* (196% of FPL) Children under age

1

INCOME LIMIT* (148% of FPL)

Children ages 1-‐18

INCOME LIMIT* (150% of FPL) Children Ages

0-‐18

INCOME LIMIT* (300% of FPL)

Children Ages 0-‐18

1 $1907 $1440 $1459 $2918

2 $2570 $1941 $1967 $3933

3 $3233 $2441 $2474 $4948

4 $3896 $2942 $2982 $5963

5 $4559 $3443 $3489 $6978

Uninsured for six months or more Additional

Requirements Access to health insurance is not a factor

Cannot have access to

affordable health

insurance and must pay a

monthly premium.

*Income guidelines effective April 1, 2014. Guidelines should change again in April 2015.


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DISCUSSION POINTS FOR MO HEALTHNET ELIGIBILITY GUIDELINES

• There is basically one application for all levels of coverage under MO HealthNet. The Family Support

Division (FSD) will make the determination as to which level of coverage the family/children may be eligible.

• On the MO HealthNet for Kids Eligibility Chart, FPL refers to the Federal Poverty Level. o The income amounts listed are the maximum monthly income the family may have and still

be eligible for coverage. For example, if a family of 3 has a monthly income of $4,633 or less they may be eligible under one of the coverage levels. The Family Support Division will determine which level based on all eligibility factors.

• There are several levels of coverage under the MO HealthNet for Kids program. o Children who already have some type of healthcare insurance may still be eligible under the

Non-‐SCHIP levels. o The SCHIP levels are only available to children who have been uninsured by other healthcare

coverage for six months or more.

• Families should be encouraged to submit an application for eligibility determination even if their income is slightly more than the chart indicates, due to other possible income deductions.

o Please encourage families to contact the Family Support Division if they have other questions regarding potential eligibility. FSD staff will assist the family in fully understanding the program and any other information needed.

o Also share with the family that even if they do not qualify for MO HealthNet coverage, there may be other programs and services available through the Family Support Division to assist the family with other needs such as food stamps, child care assistance, etc.

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Supplemental Training Guide Section 3.

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SUPPLEMENT TO SDAC ANNUAL TRAINING OF PARTICIPANTS

Completion of the Random Moment Sample (RMS) Form

When completing an RMS form, there are three major data points that must be completed: 1) the participant’s position; 2) the activity description; and 3) the selection of the code that most closely corresponds with the activity description.

The Participant’s Position

The selection of a proper code to align with an activity description is sometimes contingent on the credentials of the individual completing the form. The required MO HealthNet Division RMS form contains some specification of licensure, such as RN and LPN, but does not contain others. As the form

cannot be changed, it is necessary for some individuals completing the form to provide additional specific information regarding licensure or position so that it can be determined if an activity is correctly coded. Consequently, if you are licensed or certificated in one of the following areas, please always

select 500 Other and specify your licensure or position. If you hold more than one credential, such as a school psychologist who is also a licensed psychologist, choose 500 Other and indicate the licensure. The following should use 500 Other followed by their position name below, instead of selecting one of the

listed position codes appearing on the form: Licensed Clinical Social Worker (LCSW) School Counselor

Licensed Psychologist School Psychologist Personal Care Attendant School Social Worker Professional Counselor (PC) Speech Implementer

Speech Language Pathology Assistant (SLP-‐A) The Activity Description

In recent audit reviews by MHD, RMS forms have been invalidated because activities have either contained too much information or were too vague to make a code selection. As you have been trained, there are generally three questions to answer when describing the activity you were engaged in at your

assigned one (1) minute time period: 1) Who were you with? 2) What were you doing? and, 3) what was the immediate purpose or short-‐term intended outcome of the present activity. Important words in question 3 are immediate, short-‐term and present. Answering Question 3 is not always necessary, such

as when you are “supervising students,” or “teaching a group of students a science lesson” or “conducting a speech therapy session.” It becomes increasingly important when you are involved in an activity that would be coded differently depending on the purpose or short-‐term intended outcome of

the activity. Examples would be “having a phone conversation with a parent,” or “in a meeting with the principal,

speech pathologist, and general education teacher.” If the purpose of the phone conversation was to follow up on missing homework, then a Code 3 would be selected. If the purpose of the phone

conversation was to discuss a child’s recent visit to the physician, then a code 9b would be selected. If

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the purpose of the meeting was to gather information for a possible academic referral, then code 9a would be selected. If the purpose of the meeting was to gather information for a possible referral to a

behavioral health clinic or a speech-‐language referral, then a Code 9b would be selected. It is important not to project beyond the purpose of the RMS activity. The purpose of the present activity should be what is stated, such as “to gather information in advance of a referral for a possible health care plan.”

When in a meeting If you are in a meeting during your assigned moment, simply state “I was in a meeting with… [fill in

positions of persons in the meeting] to discuss… or to determine…or to write… or to plan… or to gather information about… or to review… or to coordinate/monitor..., etc. [state the purpose/intended outcome].

On too much information…it is important to be specific enough in your activity description to know what is occurring and the purpose, if it helps to determine the code, but any additional information runs

the risk of being discarded as too much information to tell what is happening during the assigned single moment in time. For example, sometimes people give a long list of activities that would take an extended period of time to perform and would require different codes. These responses would be

invalid. Other times a detailed lesson plan is written or activities before and after the moment in time are described or a complete dialogue is provided. This is not necessary as it serves to complicate the code selection process and most likely will result in the form being invalid.

On being too vague…too little information results in either the RMS form being sent back to you for

more information or being invalidated because it is impossible to determine a proper code. Examples would be: “I was talking with a parent about a child.” Or “I was in a meeting.” Without knowing the topic being discussed with the parent or with whom you were meeting and for what purpose, it is

impossible to select the appropriate code. Code Selection

Code 4 can only be used to indicate a direct medical service provided by a properly licensed or approved position by MHD. This means that when doing the same activity, two individuals may chose two different codes, depending on their credentials. So, who can use Code 4 and who must use code 3 to

indicate the same direct service activity?

Can Use Code 4 Cannot Use Code 4/Must Use Code 3 RN/LPN Nurse Assistant Personal Care Attendant Health Aide/Aide

Licensed Psychologist School Psychologist Licensed Professional Counselor School Counselor Licensed Clinical Social Worker School Social Worker

Speech Language Pathologist Speech Implementer or SLP-‐A

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Section 504 of the Rehabilitation Act The Medicare Catastrophic Coverage Act of 1988 amended the Social Security Act to permit Medicaid

payment for services (direct and administrative) provided to children under the IDEA through IEP’s. This exception is very specific and does not extend to pay for Section 504 services. Therefore, activities that involve writing or revising a 504 Plan are coded “3”.

Notes

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Notes

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Notes

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Collin Swearingen Brenda Wright Senior Director State Director MSBA Medicaid Consortium MSBA Medicaid Consortium 573-‐673-‐2013 660-‐651-‐1534 [email protected] [email protected]

Documents

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