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

Understanding Special Education Funding The School-Based ACCESS Program (SBAP). Presented by:. Federal and State Medicaid Program.

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

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  1. Understanding Special Education FundingThe School-Based ACCESS Program (SBAP) Presented by:

  2. 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.

  3. 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%

  4. SBAP is a partnership Local Education Agency LEA BillingAgent Leader PDE DPW Pennsylvania Department of Education Department of Public Welfare

  5. Eligible Services • Psychiatry • Psychology • Social Work • Speech/Language • Teacher of Hearing Impaired • Special Transportation • Vision (limited) • Assistive Devices • Audiology • IEP Development • Nursing (RN & LPN) • Occupational Therapy • Orientation and Mobility • Personal Care Assistant • Physical Therapy • Physician

  6. 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

  7. 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

  8. Requirements for Success • Oversight by someone who will ensure the program’s 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

  9. What’s 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.

  10. What’s My Role in SBAP? • Complete the Cost Calculation Worksheet

  11. What’s My Role in SBAP? 3. Review your account balance monthly provided by Leader.

  12. What’s My Role in SBAP? 4. Review guidelines for allowable expenditures prior to applying for funds withdrawal.

  13. What’s 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.

  14. What’s My Role in SBAP? PDE 352 Form (for school-age withdrawals) All requests must be for a minimum of $1,000.

  15. 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.

  16. 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).

  17. 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 Comptroller’s Office receives check from DPW.

  18. SBAP Funds Flow • PDE posts payment to LEA’s restricted account. • LEA submits funds request to PDE by completing Withdrawal Form. • Upon approval, PDE transfers funds to the LEA’s 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.

  19. 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

  20. 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

  21. 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

  22. Contact Information Your SBAP Account Manager Phone: (800) 360-8511 E-mail: sbap@leaderservices.com Your SBAP Liaison Name: Roni Russell E-mail: rrussell@pattan.net Please e-mail us your comments at: sbapfeedback@leaderservices.com

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