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Wednesday, October 14, 2009

7 am – 8:15 am

New Member "Crewbie" Breakfast

Hosted by:
Anysia Drumheller
Chair Membership Committee

Welcome to NAME! If this is your first time attending the NAME annual conference then this is the breakfast session for you. NAME Organization information will be shared. Come sit down for breakfast, meet members of the Board of Directors of NAME, meet other members and learn about the organization that “bridges Medicaid and education to promote the integrity of school-based health services”. New members are invited and all NAME members are welcome to attend. Join this ‘party wave’ and get to know NAME a little better.

Opening Keynote
9:15 am – 10:15 am

"The Tides of Change"

Carolyn Ingram
New Mexico Medical Assistance division Director
Vice Chair, National Association of State Medicaid Directors

From her role as New Mexico’s Medicaid Director, where she facilitated the development of the School Based Services Program, to her being chosen recently as one of only six Medicaid Directors in the country to participate in the Center for Health Care Strategies 12-month Medicaid Leadership Institute—Carolyn Ingram seems to be where the action is on health care issues. She is uniquely positioned to share the perspectives of a State Medicaid Director, and can also provide a national view as Vice President of the National Association of State Medicaid Directors (NASMD). Director Ingram has been active in the national health care reform discussions; supported the moratoria set by Congress on the CMS proposed regulations that would have hurt SBS programs nationwide; and understands the limitations of a struggling economy. NAME members will hear for themselves how much in common we have with this leader in the field of publicly-financed health care. Time permitting, Director Ingram will take questions from the audience.

Panel Discussion
10:30 am – 12:15 pm

"Surf’s Up - National News, Perspectives and Updates"

Facilitated by:
Amy Edwards

Toby Douglas
California State Medicaid Director

Carolyn Ingram
New Mexico Medical Assistance Division Director and
Vice Chair of the National Association of State Medicaid Directors

Greg Morris
Executive Director

Stan Rosenstein
Principal Advisor
Health Management Associates

John DiCecco
Former Director
Community Partnership
Los Angeles Unified School District

This distinguished panel of experts brings diverse perspectives, yet they are all focused in their work to some degree, on bringing together the Medicaid and education systems for children and youth with disabilities. The panel will begin by addressing general questions posed to them ahead of time related to major issues confronting School Based Services programs across the country. The discussion should be provocative and will likely touch on national health reform, health systems, changing roles that schools play in childrens’ lives, and other areas within Special Education and Medicaid. There will be time during this session for a question and answer dialogue with the audience.

NAME Nuggets
1:30 pm – 3:30 pm

"Surf the Epic" – Building Commitment

Chuck Muirhead, CA

Bring your board shorts and sunscreen. This motivational Nugget will help LEA's build commitment rather than compliance in their school based Medicaid programs. How can we "lead from within" to influence and get people motivated to participate, when the sentiment is "one more thing the district wants me to do?" The presented concepts will be applicable in any other program or work scenario.

"Kickin’ Out" a Flu Vaccine Demonstration Project

Jennifer Kasper, MA
Holly Oldham, MA

In order to implement the recommendations of the Advisory Committee on Immunization Practices (ACIP) related to administration of the influenza vaccine to 1 million school-age children in Massachusetts every year, vaccinations will not only be delivered in the medical home, but will also need to be delivered at non-traditional sites. School-based or schoollocated clinics are one possible venue, because that is where the target population is. A major barrier to implementing a school-based flu vaccination program is the lack of mechanisms for reimbursement to schools and/or local health departments for both the costs of the vaccine and the costs of administering the vaccine. The Massachusetts Department of Public Health (MDPH) will use a portion of the ARRA (stimulus) funding intended for its Immunization Program, to fund a demonstration project that will address the reimbursement issue. The project expects to solve these challenges: insurers reluctant to reimburse schools or local health departments for vaccines delivered outside of the medical home; the lack of billing expertise, capacity and infrastructure within schools and local health departments to implement such a program.

NAME Web Update

Cathy Bennett, CA

NAME LEA Representative, Cathy Bennett, will provide an overview of the new NAME website and how our members will be able to access a wave of information.

Riding the "Combo-Swells" at the Local Level

Catherine Jackson, RI

With her responsibilities as Medicaid coordinator for the Smithfield Public School Department in Rhode Island, Cathy is responsible to diligently seek the maximum reimbursement for health related services through the guidelines set out by the RI Medicaid agency. When staffers in a district try to understand the ‘big, complicated’ SBS program and processes, it is somewhat daunting. If an LEA Medicaid coordinator is able to learn the program’s limitations and potential, managing the entire program becomes easier. In this session you will learn how to create a lexicon of terms and acronyms that bridge both the Medicaid and IDEA worlds so clinicians and staff will better understand SBS, which can influence practices to insure the maximum potential for compliant documentation and reporting. Learn how to become proficient in the nomenclature, develop protocols for your clinical providers and use these tools to impact the viability and efficiency of your district’s Medicaid SBS program.

A "Bottom Turn" At Bayside Community Center

(Handout 2, Handout 3)

Rose Ceballos, CA

Listen first hand to the story of how Bayside Community Center and other community supports created a path for Rose Ceballos as a child. This path was so firm and strong that it led her back to Bayside, as an adult, to be one of its program managers. Yes, the work we do does make a difference!

NAME Nuggets
1:30 pm –3:30 pm

School Based Services Hangin’ in a Consortium

Bryan Pullen, IL

Using the Peoria Medicaid Consortium as the model, the audience will have an overall understanding of what a Consortium is, how it works, and will gain knowledge of the benefits and pitfalls for LEA's to participate in a Consortium.

How to be Heard….How to Nurture Change

John Hill, IN

Be part of the “ground swell”. During the past year, NAME and her collaborative partners met with both the Centers for Medicare and Medicaid Services (CMS) and the Office of Special Education Programs (OSEP). In this open dialogue you will hear what was discussed in those meetings as well as gain a new understanding about the power of credibility, collaboration and data.

A Surfside Chat With the President and President-Elect

Amy Edwards, VA
Michelle Lyons-Brown, AK

There are not many chances during the year for most members of NAME to get to know the Board of Directors or officers of the organization. Take advantage of this opportunity to meet and chat casually with the Current President and President-Elect of NAME. Learn what major issues occurred this past year, what issues they view as important in the future, and activities in which they expect NAME will be involved in the coming year. This is also your chance to express your priorities, concerns, preferences, and suggestions for ways NAME can improve its member services for you.

3:45 pm – 5:15 pm

Medi-Cal LEA Billing: Catching the In-House Wave

(Handout 1, Handout 2)

Cathy Bennett, CA
Margie Bobe, CA

Are you an LEA ? Does your LEA provide direct services to their students? Have you ever wondered how an “in-house” LEA billing process operates? Join two California LEA's while they share their experience of having successful in-house LEA direct School Bases Services billing programs.

The Invisible transformation:
How Medicaid Reimbursement is Transitioning to a New Paradigm

Lisa Carnes, IL
Isamu Fairbanks, IL
Rick Jacobs, IL
Andrew Joseph, IL
Cathy Rutherford, TX

Over the past several years, CMS has been systematically transforming Medicaid in schools by transitioning states into a new paradigm for Medicaid Administrative Claiming (MAC) and Direct Service claiming that creates both challenges and opportunities for states to improve compliance and accountability in their claiming programs. Join the “Dawn Patrol” to get ahead of the wave to better understand the goals, challenges and lessons learned from states who are transforming their School-Based Services Medicaid programs into the new paradigm and obtaining CMS approval for planning, training, developing strategies for achieving time study compliance and the integration of MAC and Direct Service rate setting, cost reconciliation and claiming. The rescission of CMS-2287 and increasing financial demands of the economic downturn represent a new high water mark mandating that every possible dollar of funding be claimed—and retained by LEAs.

Become a "Swami" with Medicaid Outreach in Schools

Debbie Geer, CA
Tonja Kutz, CA
Marty Mares, CA

Schools have a unique opportunity to bring families and health care together. Providing outreach within schools is a vital activity. Not only does it provide families with much needed services and resources but it also builds a positive mainstay for the schools in their community. This session will share Medicaid outreach techniques for schools in rural areas.

"Goin’ Off" Medicaid Data to Verify Applications for School Meals

(Presentation 2, Handout 1, Handout 2)

Sheku G. Kamara, VA
Christopher Logan, MA
John Todd, IN

Direct verification uses information collected by the Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program), Medicaid, and other means-tested programs to verify eligibility of children who have applied for free and reduced-price meals under the National School Lunch Program (NSLP). School districts are required to verify a sample of NSLP applications. With direct verification, NSLP applications may be verified without contacting households! This saves time for both districts and households. Direct verification with Medicaid’s eligibility database (MMIS) can also provide a platform for determining the eligibility of other children/students for the School Based Services Program. This presentation will be based on information gathered by Abt Associates, Inc. in a study for the USDA Food and Nutrition Service (FNS).

Thursday, October 15, 2009

8:30 am – 10:30 am

Medicaid and Education Annual Federal Update

(OSEP Presentation, Handout)

Sharon Brown
Centers for Medicare and Medicaid Services (CMS) Central Office

Mary Cieslicki
Centers for Medicare and Medicaid Services Central Office

Jean Close
Centers for Medicare and Medicaid Services Central Office

Mary Louise Dirrigl
Office of Special Education & Rehabilitation Services (OSERS)

Melissa Harris
Centers for Medicare and Medicaid Services Central Office

Deb Morrow
Office of Special Education Programs (OSEP)

Susan Ruiz
CMS San Francisco Regional IX Office

Jennifer Sheehy
Office of Special Education & Rehabilitation Services

Judi Wallace
Centers for Medicare and Medicaid Services Central Office

It is becoming a tradition at the NAME Annual Conference to have CMS staff provide an update from their various specialty areas that have relevance to School Based Services. This year, not only will there be a panel of CMS staff, but they will be joined by representatives of the federal Department of Education/ Office of Special Education & Rehabilitation Services (OSERS) and the Office of Special Education Programs (OSEP). These federal agencies have begun a dialogue about the School Based Services Program and each will provide insight from their agency’s perspective.

Breakout Sessions
10:45 am – 12:15 pm

Related Service Providers: "Axed or Amped"?

(Handout 1, Handout 2)

Lauren Holahan, NC
Laurie Ray, NC

Related service providers are the linchpin in effective fee-for-service Medicaid School Based Programs, and yet, the relationship between these practitioners and the Program coordinators and administrators is often challenging to navigate. This course will take participants inside the minds of school-based therapists and suggest strategies for working effectively with them. Following a discussion of the myths and realities about clinicians (e.g., personality trends, work habits, communication styles) it will explore policy, program, and personal interaction guidelines so you can improve the morale and increase compliance with reporting deadlines and documentation requirements of Medicaid

Advocacy for Medicaid in Education at the National Level

Sue Hamblin, CA
Margie Rollins, CA

An overview of the advocacy for Medicaid in Education process at the national level from researching to traveling to Washington, D.C. and meeting with representatives to the "thank-you" recognition and follow-up after returning from the meetings.

Don’t Be a "Wax Bum": Finding and Keeping Students Medicaid Eligible

Donna Bader, NM
Christie Husbands, NM
Angela Medrano, NM

See how a new policy enabled districts in New Mexico to increase their Medicaid reimbursement by adding and keeping students enrolled in Medicaid. It has been estimated that 50,000 of New Mexico’s children eligible for Medicaid are not enrolled. In an effort to address this issue, the Human Services Department (HSD) inserted language in the Governmental Services Agreement (GSA) that requires all districts to initiate a Medicaid Outreach Plan to identify and enroll children in Medicaid. This break-out session compares and highlights the issues faced by the largest school district in the state and one of the smaller school districts when instituting this new policy.

"Lock In" Your Team:
the Role of the School Nurse in Special Education

Janet Lowe, MN

Learn how the school nurse can benefit students with special needs as well as how to maximize the skills of the school nurse as part of the IEP team. This session reviews IDEA citations for the school nurse as a related service provider and outlines the involvement of the nurse in the special education process

12:15 pm – 1:20 pm

"Health Care Reform: A Look at the Impact on Children"

Facilitated by:
Greg Morris, MI

Melinda Hollinshead, AZ
Rick Jacobs, IL
Constance LaFlamme, CA
Michelle Lyons-Brown, AK
Paul Swoboda, MA

This panel, composed of state officials and consultants from the private sector, will provide insights into the probable impact of national health care reform on children’s health care. The role of schools as providers of health care to both Medicaid and non-Medicaid populations will be an important part of the panel’s discussion. The panel will work within two overarching themes: the absence of support for critical children’s health issues in the federal reform legislation and the role of schools as health care providers.

Breakout Sessions
1:30 pm – 3 pm

"Pulling Off" Cost Based Rates

Kathleen Cummins Merry, MI

Michigan’s Medicaid School Based Services Program underwent significant changes in their Direct Services/Fee-For-Service component resulting from a simple request to amend the Medicaid State Plan and add reimbursement for LPN services. As happened in many states in the past few years, one seemingly minor amendment request resulted in the federal CMS requiring a complete overhaul of the entire SBS Program, including coverages, time studies and reimbursement methodology. This presentation will briefly describe the steps leading to approval of the SBS State Plan Amendment. We will then focus on the role school districts played in working with the Medicaid agency to further refine, roll out and implement these major changes in its first year.

Ethical "Point Breaks" for Medicaid School Based Services

(Handout 1, Handout 2)

Lauren Holahan, NC
Laurie Ray, NC

This course will provide a review of the IDEA law and regulations for related services pertinent to Medicaid school-based services programs. Areas of ethical consideration will be discussed from the perspectives of both school-based clinicians providing the direct services, as well as from that of the Medicaid coordinators and administrators. A lively discussion based on the experiences of the audience is anticipated.

School Based Clinic Outcomes

Donna A. Stephens, IN

Examine how Learning Well, Inc., a not-for-profit organization, provides school-based health care services in 85 school-based clinics in Indianapolis, IN. This school year, over 27,000 students will be served. The services are provided through a unique collaboration of 34 healthcare, school and community partnerships.

Future Implications for Health Information Technology in Schools

Lawrence Charny, NY

The Obama administration is pushing for expanded use of technology to document, share and store health information. While it may be “redonculous” to consider for a school setting, we need to anticipate the implications this would have if we integrate a student’s IEP and health care/medical information

3:15 pm – 5 pm

Improving Educational Outcomes for Students with Fetal Alcohol Spectrum Disorder

Kay Dole, MN

Hear “full on” how staff from Minneapolis Public Schools Special Education Department, the University of Minnesota Fetal Alcohol Spectrum Disorder (FASD) Clinic and the Minnesota Organization on FASD worked together to find more effective ways to improve educational outcomes for children with FASD. This collaborative project developed an innovative intervention model that focuses on prioritizing educational needs for students identified with FASD, educating district staff about the impact of FASD on learning and behavior while also partnering with families to craft an educational program appropriate to the needs of their children.

Positive Behavior Support: Building a "Peelin’"

Rachel Freeman, KS
Michelle Lyons-Brown, AK

Alaska is in its second year of an ambitious Statewide Planning Initiative to implement a statewide/organization-wide Positive Behavioral Support (PBS) system in a range of intervention levels. PBS is an evidence-based system of behavioral modification that reinforces desirable behaviors in positive way while changing challenging behaviors and preventing them from becoming problems. Medicaid dollars have helped build and sustain this through a partnership with the University of Alaska, statewide agencies, school districts and community agencies. Included in the blueprint, modeled after the University of Kansas program, is a standardized training academy for PBS facilitators to certify them for Medicaid billing and overall program evaluation. This project pioneers innovative partnerships and strengthens the roles of schools and families in the community care of youth and supports the Medicaid State Plan. This presentation will also share innovative administrative claiming and program evaluation financing mechanisms, along with the training academy structure, the role of the University of Alaska, the interagency consortium, and how the state will save money while more services are available to Medicaid eligible children.

Cost Based Rates "Covered"

Bryan Hawkom, MA
Anita Lamb, NC

In this session, you will hear about the history of the school based Medicaid program and the general design of reimbursement methodologies across the country. That will be contrasted with the current requirement by the federal government for cost based rates. We will describe these new requirements and provide an overview of a workable process to use to develop and get approval for a Medicaid State Plan Amendment, while providing some best practices to implement this new system. And finally, there will be a brief discussion of the “North Carolina perspective” in which you will hear the perspective from the largest district, Charlotte Mecklenburg schools on the entire process.

5:15 pm – 7:15 pm

Surviving an Audit Without Wiping Out

Lindy Summers-Bair, CA

Medical Consultant for the California Department of Health Care Services, describes common school based services audit findings and provides guidance for proper documentation for claiming direct billing services.

Friday, October 16, 2009

General Sessions
8am – 9am

"Working the Waves"

Mary Kusler
Assistant Director, Advocacy and Policy
American Association of School Administrators

Mary Kusler has been monitoring the events on Capitol Hill on behalf of the American Association of School Administrators. Medicaid school-based services issues have been and continue to be on her watch list. As Ms. Kusler stated earlier this summer, “We still have work to do”. She was a key player in the nationwide coalition that successfully persuaded Congress to pass the moratorium postponing or withdrawing regulations that would have hurt public schools. Ms. Kusler will discuss the events of the past year, look forward to the upcoming year and remind us how important it is to keep a watch on events. Ms. Kusler stated she looks forward to a dialogue with the audience, and will save plenty of time that portion of her session.

9:10am – 10:30am

"Forecasting the Surf"

Stan Rosenstein
Principal Advisor
Health Management Associates

Stan Rosenstein will combine his knowledge of Medicaid, health care reform, health care delivery systems and finance, and provide us with his observations and suggestions for next steps each of us can take. Mr. Rosenstein will also take a look at issues that are more local and specific to Medicaid in the Schools programs, including recent Medicaid SBS audit reports, as well as the impact of state budget crises on schools and Medicaid services. This session will leave you with a sense of the big picture but also provide new insights about the importance of the work being done across the country for individual children with disabilities.

11 am – 12 pm

Annual Membership Meeting

Committee Reports, Election of Board Representatives and Officers, Adoption of 2010 Budget Passing of the Gavel, President Amy Edwards Address by Incoming President Michelle Lyons-Brown, (AK)