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Federal Financial Participation Training

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Federal Financial Participation Training Brought to you by the Good Folks at MCH Agenda The FFP User s Guide Everything you want to know about Federal ... – PowerPoint PPT presentation

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Title: Federal Financial Participation Training


1
Federal Financial Participation Training
  • Brought to you by the Good Folks at MCH

2
Agenda
  • The FFP Users Guide
  • Everything you want to know about Federal
    Financial Participation
  • Documentation
  • Got Questions????

3
FFP Users Guide
  • Provides FFP rules requirements
  • Users Friendly
  • Handy Reference Tool
  • Contains Frequently Asked Questions
  • Keep your notes on FFP and
  • Its free!

4
Purpose
FFP Time Study
Page 6-7
5
Background
  • Identify low or no income women and children that
    had no means or access to health care.
  • Link women and children of need to care,
    providers and/or services to ensure safe and
    healthy pregnancy, birth and growth.

6
FFP Objectives
  • To assist individuals eligible for MediCal to
    enroll in the MediCal program and/or
  • To assist individuals on MediCal to access
    MediCal services.

Page 6
7
FFP Requirements
  • The program (MCH, BIH, /or AFLP/ASPPP) has been
    approved by MCH to use FFP.
  • FFP allowed activities are performed.
  • Staff performing certain FFP activities meets FFP
    professional qualifications.
  • All activities performed by staff are documented
    via quarterly time studies secondary
    documentation.
  • There are qualifying funds to draw down match
    (non-federal funds i.e. local county/city
    funds).
  • The proportion of the program target population,
    which is Medi-Cal eligible.

Page 8
8
Reimbursement Program Staff Activity - Time
  • Program Approved FFP program
  • (MCAH, AFLP, ASPPP, BIH)
  • Staff SPMP or Non-SPMP
  • Activity Must meet the FFP Objectives
  • All activities may be MCAH claimable but not all
    are FFP matchable.
  • Time The start and stop time.

9
Reimbursement
  • For every local/agency dollar spent on
    ProgramStaffActivityTime
  • Title 19 - FFP will match a dollar or three
    dollars depending the staff activity.
  • x
  • MediCal Factor
  • Title 19/FFP Reimbursement total dollars
    to your program.

10
Personnel Classifications
  • Skilled Professional Medical Personnel
  • SPMP
  • Non-Skilled Professional Medical Personnel
  • Non-SPMP

11
Skilled Professional Medical Personnel
  • SPMP are defined as physician, dentist,
    nurses, and other specialized personnel who have
    professional education and training in the field
    of medical practice and who are in an
    employer-employee relationship with the Medicaid
    program. It does not include other non-medical
    health professionals such as public program
    administrators, medical analysts, lobbyists,
    senior managers, or administrators of public
    assistance programs or the Medicaid program.
  • 42 CFR 432.2

12
SPMP Qualifying Enhanced Activities
  • Enhanced , matching rate of 75 is available for
    SPMP and directly supporting clerical staff if
    the following criteria are met
  • Activities are directly related to the
    administration of the Medicaid program.
    Excluding medical assistance.
  • Activities must only be by a qualified SPMP.
  • SPMP in a position that have duties
    responsibilities that require those professional
    medical knowledge skills.
  • Identified as an employee and/or contractor on
    the budget.
  • Supporting staff such as secretarial,
    stenographic, file/records clerk and copying
    staff who provide clerical services that are
    directly necessary for the completion of the
    professional medical responsibilities and
    function of the SPMP. SPMP staff must directly
    supervise the supporting staff and evaluate the
    performance of the staffs work
  • 42 CFR 432.50 (d)

13
Non-Skilled Professional Medical Personnel
All other program staff that perform activities
that are an integral part in meeting the program
goals and objectives.
14
FFP Components
  • MediCal Factor
  • Population wide, publicly available, or
    documented statistics.
  • Direct documentation of MediCal beneficiary
    number.

Time Study
  • Primary documentation of FFP
  • Determine billable to MCH
  • Monitor Activities
  • Documents ALL activities
  • Secondary documentation required

Page 13
15
The FFP Time Study Rules
1. Everyone matching must Time Study. 2. Time
Study all activities including non-MCAH
programs. 3. Must Time Study for at least one
month per quarter. 4. Secondary Documentation is
required. 5. Approved Time Study Form. 6. Time
Study daily is a Good Thing. 7. Time Study must
be reviewed approved by a supervisor.
16
The FFP Time Study Rules
8. Maintenance storage of Time Study sheets
secondary documentation is required for three
years. 9.Absences for greater than 2 weeks.
Exception can be made with the MCAH Branch
permission. 10. Prep travel time for an
activity is coded the same as the activity. 11.
Paid time off. 12. Lunch Its your time! No
coding. 13. Breaks! Absorbed into the activity.
Page 16-18
17
Function Codes/FFP Activities
  1. Outreach
  2. SPMP Administration Case Management
  3. SPMP Intra/Inter Agency Coordination,
    Collaboration Administration
  4. Non-SPMP Intra/Inter Agency Coordination,
    Collaboration Administration
  5. Program Specific Administration
  6. SPMP Training
  7. Non-SPMP Training
  8. SPMP Program Planning Policy Development
  9. Quality Management by SPMP
  10. Non-Program Specific General Administration
  11. Other Activities
  12. Paid Time-Off

18
Function Code 1 Outreach Non-Enhanced Activity
  • This function is to be used by all staff when
    performing activities that inform MediCal
    eligible or potentially eligible individuals, as
    well as other clients, about health services
    covered by MediCal and how to access the health
    programs. Activities include a combination of
    oral and written informing methods which describe
    the range of services available through the
    MediCal program and the benefits of preventive or
    remedial health care offered by the MediCal
    program.
  • This code is also used by Non-SPMP for
    Administrative Case Management.

Page 21
19
Function 2 SPMP Administrative Medical Case
Management Enhanced Activity
  • This function is to be used only by skilled
    professional medical personnel when participating
    in medical reviews assessing the necessity for
    and types of medical care associated with medical
    case management and case coordination activities
    required by individual MediCal beneficiaries.

Page 22
20
Function Code 3 SPMP Intra/Interagency
Coordination, Collaboration, Administration Enha
nced Activity
  • This function is to be used only by skilled
    professional medical personnel when performing
    collaborative activities that involve planning
    and resource development with other agencies
    which will improve the cost effectiveness of the
    health care delivery system and improve
    availability of medical services.

Page 23
21
Function Code 4 Non-SPMP Intra/Interagency
Collaboration Coordination Non-Enhanced
Activity
  • This function is to be used by non-SPMP staff
    when performing activities that are related to
    program planning functions, including
    collaborative and intra/interagency coordination
    activities.

Page 24
22
Function Code 5 Program Specific
Administration Non-Enhanced Activity
  • This function is to be used by all staff when
    performing activities that are related to program
    specific administration which are identifiable
    and direct charged to the program. Office
    related general task.

Page 25
23
Function Code 6 SPMP Training Enhanced Activity
  • This function is to be used only when training is
    provided for or by skilled professional medical
    personnel and only when the training activities
    directly relate to the SPMPs performance of
    specifically allowable SPMP administrative
    activities.

Page 26
24
Function Code 7 Non-SPMP Training Non-Enhanced
Activity
  • This function is to be used by all staff when
    training relates to non-SPMP allowable
    administrative activities and to the medical care
    of clients.

Page 27
25
Function Code 8 SPMP Program Planning Policy
Development Enhanced Activity
  • This function is to be used by only by skilled
    professional medical personnel and only when
    performing program planning and policy
    development activities. The SPMPs tasks must
    officially involve program planning and policy
    development, and those tasks must be identified
    in the employees job description/duty statement.

Page 28
26
Function Code 9 Quality Management by
SPMP Enhanced Activity
  • This function is to be used by only by skilled
    professional medical personnel and only when
    performing quality management activities such as
    monitoring the authorization for medical services
    (utilization review) process, ongoing program
    assessment and evaluation, and the development of
    standards and protocols.

Page 29
27
Function Code 10 Non-Program Specific General
Administration Allocated-Share of cost by all
programs
  • This function is to be used by all staff when
    performing non-program specific administrative
    activities that relate to multiple functions or
    to no specific, identifiable functions due to the
    general nature of the activities.

Page 30
28
Function Code 11 Other Activities Other
programs/funds or activities not matchable with
FFP Funds
  • This function is to be used by all staff to
    record time performing activities which are not
    specific to the administration of the MediCal
    program.
  • Exceptions

Page 31
29
Function Code 11- Exceptions
  • Any activity that does meet the FFP objectives.
  • Any activity on behalf of a non-MCAH program.
  • These type of activities are considered FFP
    exceptions. These activities may be MCAH
    claimable but are not FFP matchable or Function
    Code 11.

30
Function Code 11 examples
  • Fetal Infant Mortality Review FIMR
  • Parenting
  • Day Care
  • SIDs
  • Transportation
  • Translation
  • Routine Developmental Testing (i.e.Denver)
  • Nutrition
  • Many more..
  • May be OK
  • Any direct clinical services.
  • Anticipatory Guidance/Activities
  • Social Activities
  • Childhood Safety
  • Domestic Violence
  • Job Development
  • School related activities
  • Housing need activities

31
Function Code 12 Paid Time Off Allocated -
Share of cost by all programs
  • This function is to be used by all staff to
    record usage of paid leave, holiday, vacation,
    sick leave and so on.

Page 32
32
Secondary Documentation
  • Basic Documentation
  • Requirements
  • Guidelines
  • Styles
  • Dos and Dont
  • Secondary Documentation
  • Privacy Confidentiality

33
Secondary Documentation
  • If it wasnt documented is wasnt done.
  • Definition The recording of information/data,
    action and/or outcome for future reference.
  • Why document?
  • Job requirement
  • Professional responsibility
  • Legal protection
  • Evaluation

34
Secondary Documentation
  • Supports the information on the Time Study.
  • Provides sufficient information to distinguish
    different activities and programs.
  • Link client specific activities to a case file.
  • Documentation should support the Function Code
    chosen.
  • Clearly identifies the clients or entity for
    which the activity or services is provided (i.e.
    MediCal number).
  • Identifies the program for which the activity is
    performed.

35
Secondary Documentation Requirements
  • Standard Format
  • 1/2 hour increments i.e. 830 - 900
  • Common abbreviations i.e. HV-Home Visit
  • Document as you go is best!
  • Complete weekly
  • Meet and discuss FFP questions/issues.
  • Staple all documents together i.e. agenda
  • Remember the KISS principle.

Page 19
36
Secondary Documentation Examples
  • Lets take a few minutes and look at the
    following documentation examples.
  • Can you tell which ones are OK?
  • Can you make suggestions on how to improve them?

37
Secondary Documentation Examples
  • 800 AM 930 AM HV L Simpson Prenatal F/U
    to pre-term labor
  • 1000 AM 200 PM Dental Task Force Quarterly
    meeting.
  • 1100 AM 1130 AM T/C S Evans specialist
    referral appt.
  • 130 PM 330 PM Work on Outreach presentation.
  • 430 PM 500 PM HV reminder calls for tomorrow
    3 clients.
  • 100 PM 500 PM CTO

38
Secondary Documentation Examples
  • 1000 AM 1100 AM HV T Hall review child safety
    specialist referral.
  • 200 PM 530 PM Assisted M Reams into Womens
    Shelter.
  • 100 PM 500 PM Attended Breast feeding
    workshop.
  • 900 AM 1100 AM Attend Bioterrorism training
  • 900 AM 1000 AM Staff meeting.
  • 200 PM 400 PM Dental Appt.

39
Secondary Documentation Guidelines
  • Legible
  • Concise
  • Accurate
  • Complete
  • Organized
  • Timely

40
Types of Record Documentation
  • APIE Assessment Plan Implementation
    Evaluation
  • CBE - Charting by exception
  • SOAP Subjective , Objective, Assessment and
    Plan
  • Computerized client records
  • Focus Charting
  • PIE Problem Intervention Evaluation
  • Flow Charting

41
Dos and Donts
  • Do use only black or blue ink.
  • Do write legibly(Legibly).
  • Do chart to date (i.e. 02/14/03) and time (i.e.
    200 pm or 1400).
  • Do write clear concise and simple sentences (i.e.
    See Jane run.)
  • Do correct errors by a simple cross through
    your initials by correction (i.e. changed drsg. x
    2 3 cac).

42
Dos and Donts
  • Dont use pencil.
  • Dont use white out.
  • Dont use Liquid Paper/Dryline.
  • Dont scratch out errors.

43
Privacy Confidentiality Time Studies/Secondary
Documentation/Clients Records
  • Definitions
  • Rules and requirements
  • Know your organization rules requirements.
  • Professional (i.e. Licensure)
  • HIPPA Federal protection.
  • State regulatory requirements

44
Time Study Readiness
  • Attend Time Study Training
  • Discuss Review the Time Study process in your
    office
  • Create FFP Cheat Sheets
  • Gather all the necessary materials.
  • Review Information
  • Ready Set go!

45
Got Questions? Send your questions to Your
program consultant and contract manager.
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