Understanding Special Education Funding The School-Based ACCESS Program (SBAP)

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Understanding Special Education Funding The
School-Based ACCESS Program (SBAP)
Presented by
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Federal and State Medicaid Program
In 1988, Congress enacted legislation to
encourage state and local education agencies
across the nation to access federal Medicaid
reimbursement for health-related services for
disabled children. PDE launched the SBAP in
1991-92 as an avenue for schools to receive
federal funding through Medicaid.
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Overview

• SBAP allows the following school entities to
  receive federal Medicaid funds for providing IEP
  health-related services to Medical Assistance
  (MA) special-education students

• School Districts
• Intermediate Units
• MAWAs

• Charter Schools
• Approved Private Schools

Federal Medicaid Assistance Percentage 54.39
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SBAP is a partnership
Local Education Agency
LEA
Billing Agent
Leader
PDE
DPW
Department of Public Welfare
Pennsylvania Department of Education
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Eligible Services

• Assistive Devices
• Audiology
• IEP Development
• Nursing (RN LPN)
• Occupational Therapy
• Orientation and Mobility
• Personal Care Assistant
• Physical Therapy
• Physician

• Psychiatry
• Psychology
• Social Work
• Speech/Language
• Teacher of Hearing Impaired
• Special Transportation
• Vision (limited)

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SBAP Reimbursement Totals
In the 2003-2004 school year, LEAs received 70
million
In the 2004-2005 school year, LEAs received 90
million
In the 2005-2006 school year, LEAs received 110
million
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Reimbursement Rate Factors

• The amount of reimbursement generated can vary
  greatly based on

• Special education population
• MA population
• Health-related services provided by LEA and
  contracted staff
• Number of qualified providers
• Level of program oversight

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Requirements for Success

• Oversight by someone who will ensure the
  programs integrity

• Track service provider billings
• Timely claims submissions to Leader
• Perform self-audits
• Monitor students for MA eligibility
• Outreach to families not enrolled in MA
• Give service providers positive feedback

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Whats My Role in SBAP?
1. Determine which service providers are eligible
to participate in SBAP.
a. Salaries for service providers or contracted
providers must be partially or fully funded by
state and/or local dollars. b. Providers must
meet SBAP credential requirements.
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Whats My Role in SBAP?

1. Complete the Cost Calculation Worksheet

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Whats My Role in SBAP?
3. Review your account balance monthly provided
by Leader.
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Whats My Role in SBAP?

• 4. Review guidelines for allowable expenditures
  prior to applying for funds withdrawal.

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Whats My Role in SBAP?
5. Apply for funds withdrawal at least
bi-annually (for actual or projected expenses)
using either
a. A PDE 352 Form (school-age withdrawal) b. A
PDE 352M Form (EI withdrawal)
Submit LEA cover letter describing the programs,
services, or products to be acquired. Do not send
copies of purchase orders.
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Whats My Role in SBAP?
PDE 352 Form (for school-age withdrawals)
All requests must be for a minimum of 1,000.
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How Funds Have Been Spent
SBAP funds have been used by LEAs for

• Assistive devices to help disabled children
  function to their full capacity in both the home
  and classroom settings.
• Hiring additional special education staff.

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How Funds Have Been Spent

• Purchasing small buses to transport students with
  special needs.
• Updating special education classrooms with new
  computers and printers.
• Funding field trips for special education
  students.
• Making capital improvements (require prior
  approval).

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SBAP Funds Flow
It helps to understand how the SBAP funds flow in
this process

• LEA submits SBAP transactions to Leader.
• Leader processes transactions nightly and submits
  weekly MA claims file to DPW.
• PDE Comptrollers Office receives check from DPW.

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SBAP Funds Flow

• PDE posts payment to LEAs restricted account.
• LEA submits funds request to PDE by completing
  Withdrawal Form.
• Upon approval, PDE transfers funds to the LEAs
  account.
• Monthly, Leader reconciles that correct fund
  amounts were transferred to the correct LEA.
• On average, reimbursement funds are disbursed
  within 8 weeks from time of request.

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New Challenges facing LEAs...
Federal audits of states have prompted

• Medicaid cutbacks targeting school-based programs
• Costing methodologies that would considerably
  decrease amount of reimbursement

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New Challenges...continued
Federal OSEP regulations...

• Require states to obtain written parental consent
  prior to billing Medicaid

State audits have prompted...

• More stringent and detailed documentation

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Service Offerings

• As the statewide SBAP vendor, Leader provides the
  following services

• Web sites to record service provider logs and/or
  service billing data
• Call center (800 number)
• Phone and teleconferencing
• On-site and regional trainings
• Custom-report generation
• Program analysis

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Contact Information

• Your SBAP Account Manager
• Phone [phone]
• E-mail sbap_at_leaderservices.com

Your SBAP Liaison Name Roni Russell E-mail
rrussell_at_pattan.net
Please e-mail us your comments at sbapfeedback_at_le
aderservices.com