Replacing Silos with Technology: Sharing Data Across Medicaid and Education

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Replacing Silos with TechnologySharing Data
Across Medicaid and Education
September 26, 2003
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Contact Information
Roberta Puffer rpuffer_at_dc.com 847-753-8558 Stev
e Koruna stkoruna_at_dc.com 847-753-8515
Please feel free to contact us with any questions
you may have about the following presentation, or
for further information regarding our solutions
and services for school based Medicaid
reimbursement
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Agenda

• Challenges facing Education and Medicaid agencies
• An approach for data sharing across organizations
• Data and sharing strategies and benefits
• Data sharing success stories
• Conclusions
• Questions

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Challenges Facing Medicaid and Education Agencies
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Program and policy challenges

• Implementations are unique from state to state
• State flexibility
• CMS regional oversight
• Schools and states are challenged to keep pace
  with complex and changing regulations
• CMS Guidelines and ongoing program changes
• Multiple interpretations of Federal policy
• Schools need ready access to considerable subject
  matter expertise to participate effectively
• Staffing and funding shortfalls at both agencies
  exist there are insufficient funds to pay for
  necessary program administration
• Coordination challenges with related programs,
  such as No Child Left Behind and proposed IDEA
  reauthorization

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Interagency coordination and communication
challenges

• Where Education and Medicaid both play an active
  role, challenges surrounding coordination of
  roles can emerge
• Conflicting priorities
• Communication protocols
• Specialized expertise
• When the program is lead by only one of the
  agencies - Medicaid or Education - ,
  communication challenges may occur
• LEAs are not a natural constituent of CMS or
  Medicaid
• The sheer volume and complexity of program
  information to be communicated and maintained
  leads to a host of training issues at all levels

CMS
State Medicaid Agency
State Education Agency
Local Education Agency
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Data collection and management challenges
Direct Service Reimbursement Documentation
Data Uses
Student Information
DS or MAC Participation
Special Ed. Status
Financial Data
Common Data Requirements
Medicaid Eligibility
Staff Credentials
Service Documentation.
Transportation Data
Data Sources
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Data collection and management challenges
Special Education Documentation
Data Uses
Student Information
Special Ed. Status
Common Data Requirements
Staff Credentials
Service Documentation.
Transportation Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management Systems
Financial System
State Medicaid System (s)
Data Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)
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Data collection and management challenges
Special Education Documentation
Direct Service Reimbursement Documentation
Data Uses
Student Information
DS or MAC Participation
Special Ed. Status
Financial Data
Common Data Requirements
Medicaid Eligibility
Staff Credentials
Service Documentation.
Transportation Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management Systems
Financial System
State Medicaid System (s)
Data Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)
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Data collection and management challenges
Special Education Documentation
MAC Documentation
Direct Service Reimbursement Documentation
State/Federal Reporting
Data Uses
Activities performed
Student Information
DS or MAC Participation
Special Ed. Status
Financial Data
Common Data Requirements
Medicaid Eligibility
Staff Credentials
Service Documentation.
Transportation Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management Systems
Financial System
State Medicaid System (s)
Data Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)
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Data challenges created by silos