Texas Medicaid to Schools Program Random Moment Time Study (RMTS)

1. Texas Medicaid to Schools Program Random Moment Time Study (RMTS)

2. What is RMTS? A federally accepted statistically valid random sampling technique that determines what portion of the selected group of participant’s workload is spent performing Medicaid reimbursable activities. The program is run 3 quarters a school year. Each district is responsible for supplying the state with a list of employed professionals that could provide direct services to students at any given point in time during a quarter. Participant Responsibilities If a participant/professional is selected for a random moment, the participant must follow the instructions provided in an email from Fairbanks to which they will login to a specified website and respond to three to four questions.

3. Random Moment Time Study • Process per quarter • District Administrators submit employed professionals to MSB/Fairbanks • Random professionals selected for a random moment are notified via email • Professionals selected respond to random moment within 5-7 business days • State coders review responses and determine if direct “medical” services were being provided

4. 3 Questions • You will be asked to answer three questions to identify what you were doing during your random moment in time. Describe your activities for just the one minute you were assigned. Please do not document multiple tasks. • Were you providing personal care Services? / Was the service defined on the student’s or student(s) IEP(s)? • 1. Who was with you? • 2. What were you doing? • 3. Why were you performing the activity? • Choose from the list of pre-defined answers • or • If the pre-defined answers do not apply, describe your answer in detail in the text box supplied with each question.

5. Direct Medical or Educational Service • Direct Medical Includes: • Activities that do require human intervention to accomplish the tasks the student would normally do for themselves if they did not have a disability or chronic medical condition, such as: • Hands on assistance • Supervision • Cueing • Medical services that require a skilled, trained professional • Psychological services • Counseling services • OT, PT, Speech, etc. and evaluations

6. Direct Medical or Educational Service • Educational Services Include: • Reading/English/Language Arts • Writing • Mathematics • Science • Social studies • Physical education • Electives • And activities that do not require human intervention to accomplish the task the student would normally do for themselves if they did not have a disability or chronic medical condition

7. Is Monitoring a Direct Medical Service? • Monitoring is a Direct Medical Service when: • The student just received medication as indicated on his/her IEP. The participant is monitoring the student for a reaction. • This activity is related to the Direct Medical Service of providing the medication, which is a nursing or delegated nursing task • Student’s IEP requires that he/she receive continuous monitoring due to a behavior problem • This activity is a Direct Medical Service because a personal care service is being provided • The teacher’s aide is monitoring a student in a wheelchair to ensure they do not slide down in their wheelchair. • This activity is a Direct Medical Service because a personal care service is being provided

8. Is Monitoring a Direct Medical Service? • Monitoring is not a Direct Medical Service when: • General monitoring of students in a cafeteria to ensure all students’ behaviors are in accordance with school policy • This activity is not a Direct Medical Service because it is just general supervision of students which is an educationally related service

9. Personal Care Service • Within the category of Direct Medical Services, the most frequently misunderstood service is personal care services • Personal care services are provided to assist a child with a disability or chronic condition benefit from educational services • Personal care services include a range of human assistance provided to students to accomplish tasks the student would normally do for themselves if they did not have a disability • A student may be physically capable of eating lunch but be unable to independently eat in the cafeteria because of functional, cognitive, or behavioral impairments • Personal care services may be provided by a wide range of school personnel • Teacher Aides Bus Aides/Monitors • Health Care Aides Orientation/Mobility Specialists • Instructional Aides Teachers • Bilingual Aides Clerks

10. Personal Care Activity Examples • Eating/feeding • Dressing • Meal preparation • Transferring • Respiratory assistance • Ambulation • Toileting • Mobility • Maintaining continence • Positioning • Personal hygiene • Redirection for behavior • Bathing • Assistance with self • Grooming • Administering medication

11. Random Moment Time Study • Who was with you? • If you do not select a pre-defined answer, it will be necessary for you to describe who was with you during the moment, such as a student, a parent, a co-worker, or indicate that you were alone, if appropriate. • “I was with Jane Doe.” is too specific. Do not use proper names. “I was talking on the phone with a student’s parent”includes an appropriate level of detail. • It is important that we know who was with you, so that the response may be coded properly.

12. Random Moment Time Study 2. What were you doing? If you do not select a pre-defined answer, it will be necessary to be as specific as possible when writing your response. Document exactly what issues, ideas, or services were being conveyed at that time. “I was in a meeting.” is too vague. “I was in a meeting explaining a special education student’s annual goals to the student’s parent.”includes an appropriate level of detail. It is important that we know what was being discussed (or being done) so that the response may be coded properly. We need to know if the topic was focused on academic, behavioral, administrative, or medical concerns.

13. Random Moment Time Study 3. Why were you performing the activity? If you do not select a pre-defined answer, it will be necessary for you to describe why you were performing the activity. Be as specific as possible when writing your response. “It is a requirement of my job.” is too vague. “I was in a meeting to provide information to a parent about an evaluation/assessment for health related services.”includes an appropriate level of detail. It is important that we know why the activity was performed so that the response may be coded properly. We need to know if the topic was focused on academic, behavioral, administrative, or medical concerns.

14. Reminders! • Do not use Acronyms in your response • Do not put a specific name • Indicate if the service/activity is anywhere in the student’s IEP. If you are not sure, please contact your Special Education Department for clarification. • Appreciate and understand what the Medicaid to Schools Program recognizes as a “medical” service/activity or an educational service/activity. • You will have 5-7 school days to complete your assigned moment. Email reminders are sent if moments are not completed. It is extremely important that you complete your moment as soon as possible!

15. Training Complete! If you have any questions please contact your local administration or Fairbanks for technical support. Hotline: 888-321-1225 Email: info@fairbanksllc.com Watch video on insufficient responses go to www.msbconnect.com/Resources/Regulations/Texas