SPECIAL EDUCATION Professional Development

Policy 2419/Medicaid/IEP

OPENING REMARKS

Todays Agenda

Policy 2419

Medicaid Training

General IEP Topics

Breakout IEP Sessions

Points of Interest

Atmosphere of collegiality

Focus on what matters

Focus on who matters

Don’t sweat the small stuff

Housekeeping

Stipends will be paid based on your signature AM/PM

Lunch Protocol

Room Assignments

Technology Use

Refreshments

Ticket Out the Door

POLICY 2419

• Hot Topics• Need to Know• Big Changes

• I Never Knew That

MEDICAIDRevisions and Procedures

MEDICAID Revisions

Effective October 1, 2014

Under new management - Public Consulting Group (PCG)

Hired by Feds to bring an efficiency model to Medicaid

States must comply with Section 1915(g) of the Social Security Act

Targeted Case Management (TCM) is the result of this mandate

Why do we bill Medicaid?

Positions Count Avg. Salary Total AVG. SalariesAnnual IDEA

Allotment Medicaid (25%) County FundsCentral Office 27 $65,000.00 $9,750,000.00 Teachers 150

$4,000,000.00 $1,200,000.00 $6,650,000.00Aides 60 $35,000.00 $2,100,000.00

Totals 237 $11,850,000.00 $7,850,000.00 $6,650,000.00 $0.00

ALL STAFF 80 Staff 24 Staff 133 Staff

Note: the other 75% of Medicaid Reimbursements are considered “County Funds”

How are we going to face this challenge?

Old Model – 1 unit yielded 70$

Old Model – You billed for 3-6 units per month

New Model – 1 unit yields $10 dollars

New Model – Attempt 7-10 units per month

Calculation Logic Statement

IF: 1 Unit = 10$

AND: 1 Unit = 15 minutes

THEN: 15 minutes = 10$

QUIZ:

If you send 1.5 hours preparing an IEP for the Annual review, how many units may you claim on the TCM form?

ANSWER

1.5 hours = 6 billable units

6 units = 60$

Documenting Your Time

TCM FORM

Demographic Information

• Will be provided to you from the Office of Special Programs• Must be completed in full prior to submission

Date of Service

• The last date service occurred prior to completing this form• Must be in chronological order

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

10/31/2014

Type of Contact

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

1 Face to Face – Meeting with anyone (other than the student) pertaining to the students needs

2 Correspondence – Any written narratives pertaining to the students needs3 Phone Conference – Discussion by any means with any stakeholders in

the students needs

10/31/2014 2

TCM Activity

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

A. AssessmentB. IEP/Service PlanC. Linkage/ReferralD. AdvocacyE. Crisis PlanF. IEP EvaluationG. Monitoring

10/31/2014 2

F.

Notes:• Cannot exclusively use “F” for all TCM

Notes• If “G” is chosen it must be in reference to

a previously billed activity. (A-F)

Time In

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

10/31/2014 2

F. 3:15 pm

• Must be documented in the following format hh:mm am/pm• Must be presented in chronological order

Time Out

3:40 pm

10/31/2014 2

F. 3:15 pm

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

• Must be documented in the following format hh:mm am/pm• Must be presented in chronological order

Total Minutes

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

3:40 pm

10/31/2014 2

F. 3:15 pm

25

QUIZ: How many units may be billed for this service?

DO YOU REMEMBER?

TCM Note

EXAMPLE SCENARIO: I spent 25 minutes on 10/31 compiling behavior notes in preparation for an IEP meeting associated to a recent behavior incident.

3:40 pm

10/31/2014 2

F. 3:15 pm

25

Compiled behavior documentation in preparation for an IEP meeting to discuss further revision of the students Behavior Plan

The note should consist of the following parts;

1 Action Performed 2 Why Performed 3 Outcome Achieved

Signature and Credentials

3:40 pm

10/31/2014 2

F. 3:15 pm

25

Compiled behavior documentation in preparation for an IEP meeting to discuss further revision of the students Behavior Plan

You must sign each note with your credentials

You may use a digital image file or traditional signature

Date

3:40 pm

10/31/2014 2

F. 3:15 pm

25

Compiled behavior documentation in preparation for an IEP meeting to discuss further revision of the students Behavior Plan

11/08/2014

• The date of each note should fall in a logical and sequential order• The date should follow the traditional mm/dd/yyyy format

Additional Supports

Technical Assistance

BREAK TIME15 Minutes

General IEP TopicsRequired Forms and Procedures

Meeting Preparation

Meeting Notice

Draft IEP

In Lieu of Documentation

Timeline Adherence

Supporting Documentation

Behavior Plans

Individualized Education Program

Attendees

ESY

Considerations

Placement

LRE Considerations

Statewide Testing Accommodations

PWN

What is FERPA

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.

Pertains to all educational documentation associated to a specific individual. Permanent Records IEP Records Teacher Notes Discipline Files Emails/Texts Etc.

Parent and Student Rights

Right to inspect and review records upon request

Right to request correction of inaccurate data

Right to expect confidentiality in the handling and transmission of records

School Responsibilities School officials with legitimate educational

interest;

Other schools to which a student is transferring;

Specified officials for audit or evaluation purposes;

Appropriate parties in connection with financial aid to a student;

Organizations conducting certain studies for or on behalf of the school;

Accrediting organizations;

To comply with a judicial order or lawfully issued subpoena;

Appropriate officials in cases of health and safety emergencies; and

State and local authorities, within a juvenile justice system, pursuant to specific State law.

Schools must have written permission from the parent or eligible student in order to release any information from a student's education record. However, FERPA allows schools to disclose those records, without consent, to the following parties or under the following conditions (34 CFR § 99.31):

ReviewPolicy 2419

Medicaid

General IEP Review

Confidentiality (FERPA)

Report to Breakout by 1:00 pm

Enjoy Your Lunch