Slide 2 The School Board of Broward County, Florida Slide 3 Why
Were You Selected ? You are probably wondering why you have been
asked to complete a Random Moment Sample (RMS) form. The School
Board of Broward County participates in a program called the
Medicaid Certified School Match program. The Administrative
Outreach Claiming portion of this program reimburses the school
district for helping students and their families access health and
therapy services. This program has been a significant revenue
source for the District and allows for enhancements to Student
Support and Exceptional Student Education services in Broward
schools. To learn more about this program please visit our website
at:
http://www.broward.k12.fl.us/studentsupport/Operations/medicaid.htm
Slide 4 The district uses a software product to randomly select
staff and randomly assign moments to be sampled. The software
generates the printed Random Moment Sample forms that you receive.
How Was Your Name Selected ? Your name was randomly selected based
on your Florida Department of Education Job Title and its
description. Your name can be randomly selected more than once a
quarter and more than once a year. Slide 5 If you have received a
letter directing you to watch this presentation, you will soon
receive a survey form that you are required to complete. Data
gathered from the Random Moment Sample form is used for potential
reimbursement from activities that our district staff perform. The
school system is required to remit all participant forms at the end
of each quarter. Be sure to indicate exactly what you were doing at
your moment in time, regardless of the activity. These forms are
permanently retained and read by state and federal auditors. Please
word your response in a professional manner. Slide 6 HOW TO STATE
AN ACTIVITY Lets go over the instructions and review a few
examples. When you document your activity, you do not need to use
the entire space. Describe your activities for just the one minute
you were assigned. Please do not document multiple tasks. Your
statement should reflect who you were with, what you were doing,
and why you were performing the activity. Remember the terms who,
what, and why ! Please use the spaces below to describe the
activity in which you were involved at the exact moment of your
random sample time. It will be necessary for you to be as specific
as possible when writing your response. Document exactly what
issues, ideas, or services were being conveyed at that time as it
relates to the academics, behavioral, administrative or medical
concern. Review the example sentences on the back of this form to
help you illustrate how to accurately record a detailed account of
your sample moment. The instructions for this section read as
follows: Slide 7 TWO SECTIONS TO THE RMS FORM Section 1 the
Activity portion, and Section 2 the Signature and Date portion.
There are two major sections of this form that you will need to
complete. These consist of... You are being asked to complete the
survey form by writing a short response describing your activities
during one specific moment in time (example: June 3, 2014 @ 8:32
a.m.). You will receive the actual form, along with detailed
instructions, approximately three days prior to your assigned date
of documentation. It is mandatory that you complete your form and
return it to the ESE & Support Services Medicaid/504 Department
immediately after completion. IMPORTANT REMINDERS Slide 8 EXAMPLES
The sentence... I was in an IEP Meeting. is too vague. A more
specific response is... I was in a meeting explaining an ESE
students annual goals to the students parent. Notice that in the
example the name of the committee, such as IEP, was replaced with
specific details. It is not enough to say you were writing or
discussing goals. It is important that we know who you were with
and what was being discussed (or being done) and for what purpose,
so that the form may be coded properly. We need to know if the
topic was focused on academic, behavioral, administrative, or
medical concerns. Here is another example... I was talking to a
teacher about a students progress in therapy. While we were
talking, another students mother called and we discussed his
classroom behavior. I suggested he receive a hearing evaluation. I
then went to lunch. This statement reflects too many activities.
Think about what you actually did during your moment in time. If
you were multi-tasking, what task would you continue doing if you
could only work on one? A better response is... I was talking to a
teacher about a students progress in therapy. While it is important
to refrain from giving too much information, it is also important
to refrain from giving too little information. For instance... I
was driving in my car.... is too vague. Do tell us where you were
going to and from. I was driving back to work from a training
session on how to use behavior modification techniques in the
classroom with students diagnosed as hyperactive. Slide 9 SECTON 1
- ACTIVITY PORTION WHO ? WHAT ? WHY ? The response written in the
Activity portion of the form should answer the following 3
questions: (Who - students parents and teachers) ( What -
discussing the students difficulty with gross motor skills) (Why -
to determine if an evaluation for OT/PT is needed) Who were you
with? What were you doing? Why were you doing this? Slide 10 Keep
In Mind... If at your selected moment you were not scheduled to
work or you were at lunch, please indicate that in the area below
and proceed to complete the rest of the form. No further
description is required if at lunch or not scheduled to work. If
you make an error while completing the form, please cross out the
error and initial, and date the change you are making and continue
to complete the form. Slide 11 JOB TITLE When indicating your Job
Title, it is important to write your Job Title exactly as it
appears at the top of the form. This Job Title reflects the Florida
Department of Education Job Title that corresponds with your Job
Description and may not be the same as the School Board of Broward
County Job Title that you are familiar with. For example,
Behavioral Specialists and Support Facilitators can expect to see
Teacher, Varying Exceptionalities as their Job Title on their form.
* If the Job Title on the form is not descriptive of your position,
please contact our office as soon as possible at 754-321-3400.
Slide 12 SECTION 2: SIGN AND DATE WITH CORRECT JOB TITLE Once you
have answered section 1 and review the important reminders, please
be sure to complete the bottom of the form by Signing your Name,
Indicating your Job Title, and Dating the Form. Now you are ready
to complete the Signature and Date portion of the form. Slide 13
FINISHING UP Please remember that completing and dating the form
prior to your assigned date will invalidate the form. Please be
sure to provide us with your work telephone number (including Area
Code). Slide 14 MAILING AND CONTACT INFORMATION As soon as you have
completed the Random Moment Sample form, please return it to our
office using the pre-addressed label provided with the form. Thank
you for your time and cooperation with this program. Our address is
: ESE & Support Services Medicaid/504 Dept. Arthur Ashe 2 nd
Floor, Attn: Nanci English. If you do not receive your Random
Moment Sample form via pony within two days of your assigned date,
please contact our office at: 754-321-3400. Slide 15 Deneen
Gorassini - Medicaid Coordinator Lisa-Ann Clarke - Medicaid
Accountant Nanci English - Customer Service Analyst
