SCHOOL DISTRICT ADMINISTRATIVECLAIMING (SDAC)

SDAC District-level Management Team

Meeting

SDAC DISTRICT-LEVEL MANAGEMENT TEAM

Meeting Agenda1. MO HealthNet Agreement and Tenets of the

SDAC program 2. Importance of the SDAC Program to Children

and the District 3. Quarterly Data Reporting Requirements4. Role of the District’s Information Technology

Department 5. Assignments for Each Data Reporting

Requirement 6. Record Retention for Audit File

SDAC DISTRICT-LEVELMANAGEMENT TEAM

Purpose: To aid the District in setting realistic goals and

benchmarks reflecting high expectations in relation to the MO HealthNet process and compliant, timely reporting of data.

To provide consistent communication and coordination of the School District Administrative Claiming (SDAC) process.

To develop and monitor compliant practice in every step of the SDAC process from data submission to form completion to claim calculation.

To establish an effective SDAC management process, supporting district staff in implementing the program.

WHAT IS SCHOOL DISTRICT ADMINISTRATIVECLAIMING? SDAC is a federal program under Medicaid that

allows a school to become an “administrative arm” of the MO HealthNet Division (MHD).

“The purpose of administrative claiming is to: Encourage the development of a framework of

activities that result in each MO HealthNet participant having information and assistance to access needed health care services from a qualified provider.”

(MO HealthNet SDAC Manual, Section 4)

Note: MO HealthNet Division is Missouri’s Medicaid Division

WHAT IS MY DISTRICT’S COMMITMENT TOSDAC? “School districts interested in participating in

administrative claiming must begin with policy [Board of Education] and executive leadership [Superintendent or designee] identifying the scope and depth of the health care role which is desirable for the district to play.”

(MHD SDAC Manual Section 5.1)

ROLE OF DISTRICT AND COMMUNITY

The District and community members must determine the District’s commitment to health and wellness of students. Continuum of Commitment :

Our district is very active in all areas of student health promotion and provides access to primary and preventative health care, when needed. We regularly interact with community providers for the purpose of coordinating student health care.

CONTINUUM OF COMMITMENT(CONTINUED)

Our district views parents as having the primary role. We interact with community providers on an “as needed” basis for individual students.

Our district considers parents to be the primary health care managers—we contact them on an emergency basis only.

(MHD SDAC Manual, Section 5.1)

CORE PRINCIPLES OF SDAC

Connect uninsured children with insurance benefits through MO HealthNet Division.

Link children with appropriate healthcare:Preventive healthcareTreatment for identified healthcare issues

Coordination, follow-up and monitoring. Plan for efficient delivery of healthcare

within the school and community.

WHO IS COVERED BY MO HEALTHNET? Children in families who are eligible for cash

assistance under Temporary Assistance to Needy Families (TANF), and Supplemental Security Income.

Children for whom adoption assistance or foster care payments are made.

Certain other low-income children may be eligible.

Children with certain disabilities.

EXAMPLES OF MO HEALTHNETCOVERED SERVICES Primary, preventive,

and acute services Hospital Services -

Inpatient and Outpatient

Nursing Services Dental Services Immunizations Physical,

Occupational and Speech Therapy

Hearing Services Home Health

Lab & X-ray Prescription Drugs Physician Services Medical Supplies and

Equipment Behavioral Services

(Out-patient counseling & in-patient psychiatric)

Check Up’s, Sports Physicals

Substance Abuse Treatment

Vision Services, glasses

POSITIVE OUTCOMES FOR SCHOOLS

Two-Fold Return for Schools:1) Children come healthy and ready to learn.2) Schools get reimbursed for eligibility outreach, coordination, and referral activities conducted as an extension of MHD.

KEY FACTORS (DATA REQUIREMENTS) OF THE SDAC CLAIM AND INFORMATION SOURCES

Personnel Roster

RMS Form Completion Cost File Medicaid Eligibility

Rate (MEV Rate) Provider Participation

Rate Quarterly Certification

of Expenditures

Human Resources and Department Directors

SDAC Coordinator CFO or Bookkeeper Student Information

Systems Personnel SDAC Coordinator

Financial Officer

Quarterly Data Reporting Requirements Information Sources

WHO’S ELIGIBLE TO BE ON THEPERSONNEL ROSTER?“Appropriate staff will be chosen by each school district based upon function and duties, not on job title.” Examples of staff to be included in the district sample pool are as follows: Employees who refer, coordinate and monitor the

delivery of health care services; Any employee involved in linking the child and family

to an ongoing health care delivery system; and Any employee involved in building and sustaining

state and local partnerships for the delivery of medical and dental services.

(SDAC Manual 5.4C )

COST DATA/PPR CHECKLIST Each quarter, actual costs of salary and benefits are

reported for each person on the Personnel Roster . For persons who are partially funded with federal

funds, all federal dollars have been backed out of the reported salary/fringe amounts.

For positions that are split funded, no costs paid through function codes 2320-2329 have been reported.

A Quarterly Certification of Expenditures, signed by the Superintendent or CFO, is submitted to MSBA at the same time as the cost file.

Referral information is documented and submitted on the Provider Participation Rate (PPR) tab quarterly.

CRITICAL INFORMATION FOR IT DEPARTMENT

DO NOT block the www.therapylog.com website. Trust the email address info@therapylog.com (Alerts and

issues with submitted data is sent from this email.) Send Grid is our email client for all outbound mail. Server Name: email.therapylog.com IP Address: 174.36.32.208 Please note the IP address may change but the name of

the server (email.therapylog.com) shouldn't. Ensure email addresses for participants are unique and

accurate. (If not, contact an MSBA rep.)

ASSIGN REPORTING RESPONSIBILITIES TODISTRICT STAFF

Personnel Roster

RMS Form Completion Cost File Medicaid Eligibility

Rate (MEV Rate) Provider Participation

Rate Quarterly Certification

of Expenditures

Quarterly Data Reporting Requirements

Person Responsible in the District for the Data Collection

RETAIN SDAC RECORDS

Keep Master and Quarterly Files for Five (5) Years Signed copy of the SDAC Interagency Agreement

(IAA) with MHD. Signed copy of Quarterly Certifications of

Expenditures Completed quarterly invoice.* A copy of the District Payment Schedule

documenting SDAC payment from MHD* (may be downloaded from vendor payment web site.)

*INDICATES THAT RECORD CAN BE MAINTAINED ELECTRONICALLY.

RETAIN SDAC RECORDS

Copy of the Personnel Roster for each quarter.* Copy of cost file detailing salaries, benefits, and

PPR.* Certified expenditures are separately identified and

supported in the district accounting system. Documentation of any federal revenues removed from

costs for specific individuals on the personnel roster. Referral tracking by source. (Number of referrals by

source not required.)

*INDICATES THAT RECORD MAY BE MAINTAINED ELECTRONICALLY.

RETAIN SDAC RECORDS

Copy of any RMS forms.*Copy of the Student Roster file used to

determine the Medicaid Eligibility Rate (MEV) for your district for the year. *

Copy of the MEV rate calculated by MHD. *Verification of DESE calculated indirect cost

rate.*

*INDICATES THAT RECORD MAY BE MAINTAINED ELECTRONICALLY.

RETAIN SDAC RECORDS

Copies of all training materials given to staff.* Sign-In Attendance Sheets documenting the date,

names of attendees and instructors for each in-district training session.

For MSBA on-line training, a record of on-online training given for that quarter.*

*INDICATES THAT RECORD MAY BE MAINTAINED ELECTRONICALLY.

COORDINATE SDAC AUDITRECORD RETENTION

Make decisions and document responsibilities: Where will the comprehensive SDAC audit file

be maintained? Who is responsible for ensure that at the end

of each school year the audit record is complete for all four (4) quarters of that year?

Who will be responsible for collecting and forwarding, as appropriate, the data/documents to the person maintaining the comprehensive audit record?

Note: Itemized components of the audit record can be found on slides 17-20 above.

SDAC CONTACT INFORMATION

District SDAC Coordinator Name: Title: Email Address: Work phone: Cell phone:

MSBA Medicaid Consortium: Dr. Kim Ratcliffe, Assoc. Executive Director

Ratcliffe@msbanet.org 800-221-MSBA Ext. 362