LGAconf 2019 New LGA Coordinator Orientation Presented by

LGAconf 2019 New LGA Coordinator Orientation Presented by: Ann Joly, LGA Coordinator, Sonoma County Monica Lemelle, LGA Coordinator, San Luis Obispo County

DISCLAIMER: The information provided is for informational purposes only and is not intended to substitute for obtaining CMAA and TCM information from your Local Government Agency (LGA) coordinator and/or California Department of Health Care Services. Presentation of the information is not intended to create and constitute a vendor-client relationship. All participants to this conference are advised not to act upon this information without seeking the service of your LGA Coordinator and/or California Department of Health Care Services. Any advice contained in the conference materials or from presenters in this conference is not intended to be used for the purpose of meeting compliance under Federal and/or State laws and regulations. The views and opinions of the presenters and materials expressed herein do not necessarily state or reflect those of California Department of Health Care Services or LGA. While we use reasonable efforts to furnish accurate and up-to-date information, we do not warrant that any information contained in or made available through this conference is accurate, complete, reliable, current or error free. We assume no liability or responsibility for the accuracy, completeness or usefulness of any information disclosed in the presentation and conference materials.

CMAA Website https: //www. dhcs. ca. gov/provgovpart/P ages/CMAA. aspx

TCM Website https: //www. dhcs. ca. gov/provgovpart/Pages/T CM. aspx

So… You Are an LGA Coordinator! Now What? Take a deep breath – you are NOT alone – the Consortium is here to help! First things First: Signature Authority Request: https: //www. dhcs. ca. gov/formsandpubs/Documents/ACLSS%20 PPLs/2016/PPL_16006_Attachment. pdf CMAA Coordinator Change Form https: //www. dhcs. ca. gov/provgovpart/Pages/CMAA_Forms. aspx **Both of these forms are at end of presentation

Agenda 1. Overview of MAA/TCM Programs 2. Role of the MAA/TCM Coordinator 3. LGA Consortium & Other Resources

Medicaid federal system of health insurance Department of Healthcare Services (DHCS) designated “single State agency” responsible for oversight of Medi-Cal program Local Government Agencies (LGA) designated local entity (usually a county or charter city) responsible for administering the Medi-Cal program

What do all of these letters MEAN? ? ? CMS = Center for Medi-Cal Services (Federal) DHCS = Department of Health Care Services (State) LGA = Local Government Agency (counties) MAA = Medi-Cal Administrative Activities TCM = Targeted Case Management CCUG = Comprehensive Claiming Grid CUFG = Claiming Unit Function Grid CBO = Community Based Organization LPE = Local Public Entity (ex. First 5) A & I = Audits & Investigations CPE = Certified Public Expenditure

Important Concept #1: Federal Financial Participation (FFP) is Participation a broad term for programs that the federal government is willing to share in the costs – or “participate. ” Why is it important? You can’t use the same work or the same matching funds for two different FFP programs! Doubledipping is BAAAD.

Important Concept #2: Certified Public Expenditures (CPEs) are local public funds that were used for actual costs of providing eligible services and/or activities. Why is it important? MAA is a REIMBURSEMENT program the services and activities must already be paid for with non-federal funds that have not been used for

CMAA MHMAA TCM SMAA

Role of the MAA/TCM Coordinator

Role of the MAA/TCM Coordinator Monitoring Coordination of Program Required Documents Technical Training and Assistance Program Policy and Compliance Information Flow

Monitoring & Coordination of Program Required Documents • • • CMAA/TCM Contracts and/or MOUs CMAA Claiming Plan Documents CPE Documents Time Survey Documents Invoice Documents ** Audit File Reference Guide at end of presentation

Technical Training & Assistance § Attend annual statewide or regional MAA/TCM training sessions ü Preparing cost reports ü Preparing invoices ü How to time survey – review of Activity Codes ü Cost pools § Identify areas of training needs within your LGA claiming units and/or employees who may be under-claiming § Conduct local trainings in a timely manner ü Before the start of every fiscal year ü As soon as new employees are hired on

Training Requirements • LGA Coordinator MUST “attend” annual DHCS Time Study Training • All Time Study participants must be trained annually • All new Time Study participants must be trained prior to Time Studying Some Good Ideas • Train employees who do similar activities together • Match up actual staff activities to Time Study Activity Codes • Create Training Reference Guides for each staff position (See example at end of presentation)

Program Policy & Compliance Ensure that MAA and TCM policies and program requirements are met and understood by all participating claiming units. Monitor and implement all Policy and Procedure Letters (PPLs) from DHCS Attend and participate at LGA Consortium quarterly meetings, work groups and conference calls.

Information Flow Receive and review all MAA/TCM related correspondence and forward to appropriate programs/staff in a timely manner. Facilitate relationships and network with participating programs and staff, DHCS, the LGA Consortium and your fellow coordinators!

DOCUMENT! TRACK! ü Current CUFGs, CCUGs – signed by both LGA and DHCS Analyst ü Roster with staff names matching job classifications in Claiming Unit Function Grid ü Duty Statements (signed in BLUE ink) ü ü Documentation of Skilled Professional Medical Personnel (SPMP) certification (license check through www. breeze. ca. gov) – signed in BLUE ink ü Direct Charge forms ü Invoice Log – amounts, submission dates, invoices, date paid ü Time Study Training Logs

Important Deadlines – MARK YOUR CALENDARS! CMAA: • • • Signature Authority Request form: due as soon as you start DHCS LGA MAA/TCM Coordinator Change of Information form: due as soon as you start Time Study training by either the Alternate or the current/most recent Coordinator: ASAP Invoices: due no later than 15 months after the end of the quarter claiming Amendment documents for Claiming Plan due: before the beginning of the quarter affected Contract with DHCS to participate in MAA/TCM: usually renewed every 3 years, comes from DHCS • Host County Agreement: usually renewed annually, comes from Host County • Host County Participation Fee: invoiced from Host County • CWA is released (as a PPL) TCM: • Provider Participation Agreement (PPA) • Annual Participation Prerequisite (APP) – March 29 • TCM Annual Cost Report (November 1) • Invoices: due to DHCS within 12 months of the encounter date

Get Your MONEY as Soon as You Can!!! Keep your Fiscal Department close – make friends with them! Give them an Invoice Due Schedule at the beginning of each year and remind them! CMAA invoices are due 15 months after the end of the Quarter – but why wait? ? ? TCM invoices are due within 12 months of the encounter date, but why wait? ? ? Keep an eye out for PPLs releasing invoice and other templates – not always current on the DHCS website!

LGA Consortium and Other Resources Made up of LGA Coordinators throughout the State Works to identify system-wide issues of health policy & administration related to MAA/TCM. Meets with DHCS to discuss, advise and recommend policy positions and management strategies to address the identified issues. Provides a place (Quarterly Meetings and online workgroups) for LGA coordinators to collaborate with each other on common concerns.

LGA Consultant - Patrick Sutton psutton@optimasservices. com • Provides support to Consortium, Regional Groups, Task/Workgroups. • Provides technical assistance to LGAs as needed and/or requested. • Assists LGAs to comply with program requirements, optimize potential funding and minimize audit risks. • Helps to keep us all from jumping off a cliff or sailing into the sunset.

Handy Websites – Bookmark these! https: //www. dhcs. ca. gov/provgovpart/Pages/CMAA. aspx https: //www. dhcs. ca. gov/provgovpart/Pages/TCM. aspx https: //leginfo. legislature. ca. gov/faces/codes. xhtml https: //www. medicaid. gov/ https: //www. breeze. ca. gov/datamart/main. Menu. do; jsessionid=YIjt. SW ZTj 0 D 4 Ghc. Ty. PSEae. SGPc. GFd 8 zza. Mj 17153. dca-fp-98 -o-01 http: //www. maa-tcm. com/index (LGA Consortium site)