F ederal Financial Participation (FFP)

1. Federal Financial Participation (FFP) • Comprehensive Perinatal Services Program (CPSP)Annual Meeting • November 7, 2012 Jonathan Alspektor, BSBA State of California Contract Manager

2. Objectives for this Presentation • FFP Definition and Objectives • FFP Requirements • FFP Reimbursement • FFP Decision Tree • FFP Secondary Documentation

3. What is FFP? Federal Financial Participation (FFP) is a Title XIX (Medicaid) program that allows states to receive partial reimbursement for activities that meet FFP objectives.

4. What is FFP? FFP has two programs: 1.) Targeted Case Management – TCM 2.) Medi-Cal Administrative Activities – MAA • MAA FFP reimburses for activities that primarily involve linking clients to Medi-Cal services and/or coverage. • MCAH FFP is a MAA program.

5. FFP Requirements Qualified Perinatal Services Coordinator (PSC) must: • Be a Skilled Professional Medical Personnel (SPMP) and must meet Federal SPMP requirements not State or County. • Complete SPMP Questionnaire • Complete activities that meet at least one of the two FFP Objectives .

6. FFP Requirements Qualified Perinatal Services Coordinator (PSC) must: • Time Study • Adhere to current MCAH Policy & Procedure position requirements

7. FFP Personnel There are two FFP personnel classifications: 1.) Skilled Professional Medical Personnel (SPMP) • Education and training at the professional level • Nurses, physicians, Registered Dieticians, etc. 2.) Non-Skilled Professional Medical Personnel (Non-SPMP) • All other personnel

8. SPMP Requirements • All SPMPs must complete the SPMP Questionnaire • Determines SPMP or Non-SPMP • Complete once and keep on file for audit purposes. Double-click on image to show full screen example

9. FFP Objectives 1.) To assist individuals eligible for Medi-Cal to enroll in the Medi-Cal program and/or 2.) To assist individuals on Medi-Cal to access Medi-Cal providers, care and services.

10. FFP Time Study Staff claiming FFP reimbursement must keep record of 100% of their time and activities for all programs (including non-MCAH programs) for a minimum of one month each quarter. The “start and stop” time of all activities are required on each time study at a maximum of 30 minute increments. Double-click image to show full screen example

11. FFP Reimbursement • 50/50 Non-Enhanced Matching (Non-SPMP) $1 spent = .50 cents reimbursed • 75/25 Enhanced Matching (SPMP) $1 spent = .75 cents reimbursed

12. FFP Reimbursement Medi-Cal Factor (MCF%)- Medi-Cal paid births as a percentage of live births in each county. Comprehensive Perinatal Services Program (CPSP) is a Medi-Cal program serving only Medi-Cal providers and clients. • PSCs can claim up to 95% of their matchable activities.

13. FFP Decision Tree • Determines if an activity can be matched • Determines the codes than can be claimed for an activity Double-click image to show full screen example

14. SPMP FFP Codes Enhanced (75/25 Matching) 2: Administrative Medical Case Management (Short Term Only) 3: SPMP Intra/Interagency Coordination, Collaboration and Administration 6: SPMP Training 8: Program Planning and Policy Development 9: Quality Management

15. Non-SPMP FFP Codes Non-Enhanced (50/50 Matching) 1: Outreach 4: Intra/Interagency Collaboration and Coordination 5: Program Specific Administration 7: Non-SPMP Training

16. Other FFP Codes • 10: Non-Program Specific General Administration • 11: Other MCAH Scope of Work Activities that are not matched • 12: Paid Time Off

17. Function code examples FUNCTION CODE 1 Outreach Examples: Informing potential client about the services offered by a CPSP provider Describing range of services, how to access them, and the benefits of preventative health care.

18. Function code examples FUNCTION CODE 2 (SPMP) SPMP Administration Medical Case Management Examples: Consulting with a Medi-Cal provider in regards to the client’s or the infant’s health needs. Assisting Medi-Cal client in contacting their physician for clarification on a specific medical condition such as gestational diabetes and its effect on her pregnancy.

19. Function code examples FUNCTION CODE 3 (SPMP) SPMP Intra/Interagency Coordination, Collaboration, & Administration Examples: Meeting with Dental providers to develop strategies to increase access to dental services for pregnant women. Community Action and Planning strategy meetings

20. Function code examples FUNCTION CODE 4 Non-SPMP Intra/Interagency Collaborationand Coordination Examples: PSC provides assistance to a CPSP Provider with a technical question related to the program i.e. Billing for services to Medi-Cal.

21. Function code examples FUNCTION CODE 5 Program Specific Administration Examples: Reviewing reports, documents, and/or legislation for potential impacts to the CPSP programs. Coordinate logistics for outreach services from various programs to prevent duplication of services and encourage optimal use of resources for Medi-Cal clients.

22. Function code examples FUNCTION CODE 6 (SPMP) SPMP Training Examples: Develop, conduct, or participate in training for CPSP physicians, nurse practitioners, and office nurses to increase access to Medi-Cal services. Using skilled medical expertise to deliver professional training to health care providers that will improve quality of care.

23. Function code examples FUNCTION CODE 7 NON-SPMP Training Examples: Participate in training on data sources, data management and preparation for analysis to improve access to care for Medi-Cal clients. Attending an FFP training

24. Function code examples FUNCTION CODE 8 (SPMP) SPMP Program Planning and Policy Development Examples: Identify, recruit, and provide program support for new providers to expand access for CPSP clients. Assisting providers with CPSP clinical requirements and implementation.

25. Function code examples FUNCTION CODE 9 (SPMP) Quality Management bySkilled Professional Medical Personnel Examples: Developing training materials for CPSP providers for quality assurance monitoring. Reviewing CPSP provider arrangements to assure continuous provision of required consultant services.

26. Function code examples FUNCTION CODE 10 Non-Program Specific General Administration Examples: Agency related activities, such as, fire drills. Staff attend agency meetings and non-program related trainings such as HIPAA, Safety Training, Sexual Harassment.

27. Function code examples FUNCTION CODE 11 Other Activities (Included in MCAH SOW) Examples: Attending Child Abuse Prevention Council meetings. Smoking cessation training.

28. Function code examples FUNCTION CODE 12 Paid Time Off Examples: Paid time off for a Holiday, sick leave, vacation, or jury duty

29. Federal Financial Participation (FFP)Secondary Documentation Purpose: • The information and data that substantiates and supports reimbursable activities claimed on the Time Study. • Ensures Program Integrity • Informs Auditor

30. Federal Financial Participation (FFP)Secondary Documentation Documentation Requirements: • Requirement of All FFP Staff • Evidence of FFP Activities Performed • Provides Audit Trail • Accessible and Available • Records Must Be Retained

31. Federal Financial Participation (FFP)Secondary Documentation Example – SPMP Program Planning And Policy Development – Function Code 8 Good • 5/21/09 from 12:00-2:00 (when) – Attended the South Bay Prenatal Access Task Group meeting (where). The membership, doctors and nurses (who), discussed and made plans (what) to increase access to prenatal care clinics (why). • Other relevant details might include the meeting agenda and participant list Poor • Met with the South Bay Prenatal Access Task Group about access to prenatal care clinics

32. Federal Financial Participation (FFP)Secondary Documentation Supporting Documents: • Job specifications • Duty statements • Organizational chart • Scope of Work

33. Federal Financial Participation (FFP)Secondary Documentation Guidelines and Suggestions: • No standardized form but must provide evidence • Notes should be detailed and specific • Attach other types of documentation, such as, agendas, day planner, flyers, client notes, etc.

34. Federal Financial Participation (FFP)Secondary Documentation Secondary Documentation can be anything an agency chooses, but it should include the following elements: • Date • Time Spent • Activity • Program

35. Federal Financial Participation (FFP)Secondary Documentation Secondary Documentation can be anything an agency chooses, but it should include the following elements: • Identify the client/Program/Event for which the activity was performed • Function Code

36. Federal Financial Participation (FFP)Secondary Documentation REMEMBER • Secondary documentation must support time study • If not supported, FFP activities cannot be reimbursed

37. resources MCAH Business Partners http://www.cdph.ca.gov/services/funding/mcah/Pages/default.aspx

38. Questions?