Volume 37, December 2019                                                                                                           
In This Issue
Stakeholder Meeting

9:00 a.m. - 12:00 p.m .
Location: Department of Health Care Policy & Financing
*Building and Room TBD

Quarterly Cost Report

October-December 2019 (OD19) Quarterly Financials open

Quarterly Financials Refresher Training

OD19 Quarterly Financials certifications due

Random Moment Time Study (RMTS)
January-March 2020 (JM20) Staff Pool List (SPL) and calendar certification due

April-June 2020 (AJ20) SPL and calendar open
Welcome to the December 2019 edition of the School Health Services Newsletter!

Our newsletter is a Department of Health Care Policy & Financing (the Department) publication which provides information on the School Health Services (SHS) Program. The Colorado SHS Program is administered by the Department in collaboration with the Colorado Department of Education. Providers participating in the program may receive federal matching funds for amounts spent in providing health services through the public schools to students who are receiving Medicaid benefits.

Please feel free to share SHS News with your colleagues .   
Thank you for your interest!
Save The Date-
2020 Mid Year Refresher  Training 
The School Health Services mid-year refresher trainings are right around the corner.
All training sessions will occur from 8:30 a.m. - 12:30 p.m. with sign-in beginning promptly at 8:15 a.m. Registration links and information can be found on the Department website.
The dates and locations are as follows:
January 28, 2020
Rifle Public Library
207 East Avenue
Rifle, CO 81650
Colorado Springs
January 29, 2020
Penrose House
1661 Mesa Avenue
Colorado Springs, CO 80906

Denver Metro
January 30, 2020
Aurora Public Schools
15771 East 1st Avenue
Aurora, CO 80011

January 31, 2020
Durango Public Library
1900 East 3rd Avenue
Durango, CO 81301

Colorado Department Of Education News
The Annual Report to the Colorado Department of Education (CDE) is due January 17, 2020. The report outlines how the district's Health First Colorado reimbursement was spent in the previous school year. The link to the Annual Report Formsite is listed below. If you used the report last year, you can use the same login and password to access the report. If you are a new user, follow the directions to create an account. Once logged in you will have the ability to enter data and save it if you get pulled away to address another issue.

Tips for Submission:
  • Do not use commas when entering numbers
  • Use the mouse or tab key to move from box to box
  • You only need to enter data in the categories in which you had expenditures.
  • Only press the submit button when you have completed the report and want to send it.  
The Annual Report Formsite is a work in progress and suggestions as to how it can be more user-friendly are always welcome. Please contact Jill Mathews with comments or questions at 303-866-6978.
Free Care Corner
On September 27, 2019, the Department of Health Care Policy & Financing (Department) released public and tribal notices regarding the expansion of Free Care services. To view these notices in their entirety, please go the Department's Communication page which displays publications and public notices: The Department and Public Consulting Group (PCG) have been working together to revise and submit the State Plan Amendment (SPA) for approval to the Centers for Medicare and Medicaid Services (CMS). Upon approval and implementation of the SPA, the School Health Services (SHS) program stands to receive additional reimbursement for expanded coverage of medical services. The illustrated timeline below represents the anticipated work over the next year and a half.
As we look forward to expanding the documentation of services allowed for additional plans of care, training of time study participants should be a key focus for districts. Most districts will have two types of providers to train with the expansion of services: current providers, and new providers. Current providers may be more difficult to educate because they will need to be trained on the changes and differences of the new time study as opposed to new providers who will be experiencing the time study for the first time. New Random Moment Time Study (RMTS) questions will be developed to capture standalone plans of care for students receiving services in addition to the Individualized Education Program (IEP) the SHS program is currently limited to. Standalone plans of care must establish medical necessity by a qualified medical provider. Examples of standalone care plans are listed below:
  • 504 Plans
  • Behavior Plans
  • Safety Plans
  • Health Plans
The standalone plans of care are not limited to the list above. Other standalone plans may exist and meet the requirement to establish medical necessity. It is important to keep in mind that providers should log or document all services rendered.

Frequently Asked Questions (FAQs) specific to the subject of Free Care have been published on the Department's SHS home page for easy reference.  These FAQs will continue to be updated with new questions from districts/BOCES and community stakeholders during future meetings and in-person trainings.

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Stakeholder Meeting Update
The most recent stakeholder meeting was hosted by the Department on October 17, 2019. The meeting topic was Free Care and all regions were represented by their stakeholders either in person or by telephone. Since the SPA revisions include additional plans of care establishing medical necessity by a qualified provider, Julie Wilkin from Jefferson County presented a PowerPoint which included several templates of standalone plans her district has identified and utilized. These plans are listed below:
  • State asthma
  • State allergy/anaphylaxis
  • Catherization
  • Adrenal insufficiency
  • Diabetes
  • G-tub feeds/G-buttons
  • Seizure
  • Diapering/Toiling
  • Trach support
  • Generic plan - multiple health conditions
Organizing these plans of care, as well as educating service providers about them, will be essential to the successful implementation of Free Care.
Stakeholders will have an opportunity to attend an additional meeting this school year. Traditionally, the Department facilitates three meetings a year but with the implementation of Free Care an additional meeting will be held in May 2020.

Expanded Care, Health Care Plans and Scope - Duration - Frequency
By Julie Wilken, Jefferson County Public School District (Jeffco)

In fall 2020, Jeffco plans to begin implementing Expanded Care for the School Health Services Program. Expanded Care will include plans for Health First Colorado eligible students in addition to Health First Colorado eligible students with IEPs. All plans (IEP, IFSP, Health Care Plans, Behavior Plans, 504 plans, etc.) must contain Scope, Duration, and Frequency. All plans including service records must be maintained and accessible for all delivered and billed Medicaid services.
Jeffco has already started planning and training nurses for this program by adjusting our health care plan templates. We have added a box to each health care plan containing the ICD-10 code for the service task being delivered as well as explaining the Scope, Duration, and Frequency of the service(s) being provided to the student.

Scope - explains the needed service for that student.
Duration - explains the amount of time per instance for the related service.
Frequency - is described as how many times does it need to be done per day, or is the service as needed?
Success of Expanded Care is dependent on training all providers on the right documentation for delivered and billed services. Don't wait, start training now!
National Alliance for Medicaid in Education (NAME) Coordinator Update
By Marlee Hart, NAME At-Large- Local Education Agency Representative and  District Coordinator for Montezuma-Cortez, Archuleta and Dolores School Districts 

At the beginning of October, delegates from Colorado joined those from 47 other states at the 17 th annual National Alliance for Medicaid in Education (NAME) Conference in Albuquerque, New Mexico. Attendees participated in targeted discussion groups, break-out sessions, and practitioner panels centered on Medicaid in education.
Free Care was a primary target of many sessions and workgroups, which was timely in light of the push across the nation to include non-IEP services in our reimbursement programs. States that have successfully expanded their programs brought insight on overcoming challenges to the discussion, while states considering or are already in the process of expanding could share their concerns and questions with the group. There's something for everyone at NAME, with other presentation topics included Office of Inspector General (OIG) audits, service documentation, and strategic partner collaboration. Shout out to Sarah Blumenthal, Judith Weaver, and Hattie Pinkston of Colorado for presenting a session on our fantastic state and district program flyers!
In addition to the takeaways from the sessions mentioned above, by the end of the conference the following became clear: SHS in Colorado is unique in a most positive way. Our program funding is directed straight to our students. LEA's have a voice at the table through our stakeholder program. Our SHS partners support each other and are accessible, and there is open communication between districts, vendors, and state agencies. The sheer size of the Colorado delegation (24!) at NAME 2019 is further proof of a widespread drive from all partners to learn all they can to make our reimbursement program the best it can be.
It's not too early to start making plans for NAME 2020, which will be held in Columbus, Ohio! NAME is a fantastic opportunity to not only learn more about Medicaid in education, but also to build partnerships with your colleagues in other states. While we may all experience the SHS program in different ways, we can learn from each other and build a better appreciation of what's right in Colorado. Please visit the NAME website for 2020 conference information.