Jessica Vaughn: OUR MEDICAID UPDATE WORKSHOP IS NOW CALLED TO ORDER. I'LL TURN THIS OVER TO SUPERINTENDENT AYRES. Van Ayres: THANK YOU, MADAM CHAIR. BOARD MEMBERS THIS MORNING, THIS IS A WORKSHOP THAT WAS REQUESTED BY THE BOARD. AND THIS IS A MEDICAID UPDATE. THIS WILL BE DONE THROUGH OUR FINANCE OFFICE. AGAIN, THIS IS A REQUESTED WORKSHOP BY OUR BOARD ON UPDATES AROUND MEDICAID. SO WHAT THIS WORKSHOP WILL LOOK LIKE IS WE'LL SPEND THE FIRST 15, 20 MINUTES JUST KIND OF PROVIDING AN OVERVIEW OF MEDICAID. AFTER THAT, WE'LL MOVE INTO SOME DISCUSSION AROUND THAT. OF COURSE, LIKE ALL OF OUR WORKSHOPS, TO PROVIDE SOME DIRECTION AROUND THIS TO MYSELF AND MR. LEWIS, OUR CHIEF FINANCIAL OFFICER. I'LL TURN THIS OVER AT THIS POINT TO MR. LEWIS, OUR CFO, WHO WILL INTRODUCE HIS TEAM. Jamie Lewis: THANK YOU, BOARD MEMBERS, AND SUPERINTENDENT AYRES, FOR THE OPPORTUNITY FOR FINANCE TO COME TALK TO YOU GUYS ABOUT WHAT IS OUR MEDICAID PROGRAM.
WE'RE GOING TO TAKE THIS NEXT FEW MINUTES TO INTRODUCE WHAT MEDICAID IS HERE AT OUR DISTRICT, WHICH IS A LITTLE BIT DIFFERENT THAN MAYBE WHAT YOU THINK AND THE MULTIPLE PROGRAMS THAT WE HAVE. AND THEN TALK ABOUT SOME CHALLENGES AND SOME OPPORTUNITIES THAT WE HAVE WITH IT. I HAVE A LOT OF MY STAFF HERE THAT CAN ANSWER QUESTIONS LATER ON. BUT I DO WANT TO INTRODUCE OUR -- WHAT I'M CALLING OUR MEDICAID EXPERT, MS. GRACIANI. SHE WILL HELP US WALKING THROUGH THE PRESENTATION AND THEN WE'LL WELCOME QUESTIONS AT THE END. GOOD MORNING, EVERYONE. I APPRECIATE THIS OPPORTUNITY. I'M EXTREMELY HAPPY TO BE ABLE TO PRESENT TO YOU AND TELL YOU ABOUT OUR MEDICAID PROGRAM. MY EXPERIENCE I THINK IS IMPORTANT BECAUSE I WORKED FOR BROWARD COUNTY SCHOOLS FOR ABOUT 28 YEARS BEFORE I CAME TO HILLSBOROUGH THREE YEARS AGO. SO WHILE WE WERE IN BROWARD THE LAST 20 YEARS, I WORKED WITH THE SCHOOL-BASED MEDICAID.
SO I'VE BEEN IN THIS INDUSTRY FOR MANY, MANY YEARS. SO NOW I'M AT HILLSBOROUGH. AND WE WANT TO PRESENT TO YOU AND LET YOU KNOW ABOUT WHAT'S GOING ON WITH THE BIGGER PICTURE OF MEDICAID, WHAT MEDICAID IS. WE WANT TO TELL YOU ABOUT THE MEDICAID PROGRAM ITSELF THAT WE HAVE WITHIN BROWARD -- EXCUSE ME, HILLSBOROUGH SCHOOLS. AND ALSO THE POLICY CHANGES THAT ARE GOING TO IMPACT US AS WELL AS WHAT ARE OUR NEXT STEPS? WHAT ARE WE GOING TO DO TO MAKE THIS PROGRAM SUCCESSFUL? ALSO, WHAT TYPE OF SUPPORT THAT WE NEED FROM THE BOARD. WHAT IS MEDICAID? IT IS A LOW-COST OR FREE HEALTH INSURANCE FOR FAMILIES AND CHILDREN. IT COVERS ALL MEDICALLY NECESSARY SERVICES, ALMOST 40% OF THE USE A STUDENTS, U.S. POPULATION ARE COVERED BY EITHER MEDICAID OR CHIP, WHICH IS CHILDREN HEALTH INSURANCE PROGRAM. MEDICAID IS THE FOURTH LARGEST FUNDING STREAM FOR SCHOOLS.
EVERYONE CAN HEAR ME OKAY? OKAY. ALSO, MEDICAID SUPPORTS ABOUT $7.5 BILLION AS MONEY FOR SCHOOL-BASED SERVICES FOR THE SCHOOL DISTRICTS ACROSS THE UNITED STATES. WHAT IS MEDICAID? SO WE HAVE MEDICAID IN SCHOOLS NOW. SO MEDICAID IN SCHOOLS, ACCORDING TO THE CENTERS FOR MEDICARE OR MEDICAID, THAT'S CMS. ACCORDING TO CMS, SCHOOL DISTRICTS HAVE A UNIQUE OPPORTUNITY TO BE ABLE TO ACCESS STUDENTS. SO THIS IS THE BEST PLACE FOR US TO HAVE THESE MEDICAID PROGRAMS. WE'RE ABLE TO ENROLL OUR STUDENTS IN MEDICAID. WE'RE ABLE TO PROVIDE SERVICES FOR THEM. AND WE'RE ABLE TO HAVE THEM -- GIVE THEM ACCESS TO THOSE SERVICES. SO CONGRESS APPROVED THIS AND ALSO THEN THE FLORIDA LEGISLATURE ALSO ENACTED SOME RULES AROUND IT. SO WE HAVE TWO MEDICAID PROGRAMS HERE IN HILLSBOROUGH COUNTY SCHOOLS. SO THOSE TWO MEDICAID PROGRAMS ARE THE MEDICAID CERTIFIED SCHOOL MATCH PROGRAM. SO THAT IS THE PROGRAM WHERE IF I'M A SPEECH PATHOLOGIST AND I SEE JOHNNY FOR 30 MINUTES, I PROVIDE JOHNNY HIS SPEECH THERAPY.
I DOCUMENT THOSE SERVICES, AND THEN OUR DEPARTMENT TAKES OVER AND SUBMITS THOSE SERVICES. SO THAT'S ONE PROGRAM THAT EVERYBODY IS PRETTY FAMILIAR WITH. THE OTHER PROGRAM THAT WE RUN HERE IN HILLSBOROUGH COUNTY IS A TIME SAMPLE. SO WHAT WE DO -- AM I ON THE WRONG SLIDE? THE MEDICAID SCHOOL DISTRICT, WE HAVE THE ESTACK PROGRAM. WE FOCUS ON OUTREACH TO STUDENTS AND HELP THEM GET THEIR SCHOOL-BASED HEALTH SERVICES. IT'S A SHARED PARTNERSHIP, THIS MEDICAID PROGRAM IS A SHARED PARTNERSHIP BETWEEN THE FEDERAL AND STATE GOVERNMENT. AND HOW -- WHAT DOES THAT PARTNERSHIP LOOK LIKE? WE HAVE A STATE PLAN. SO THE STATE PLAN DETAILS EVERYTHING THAT WE'RE ALLOWED TO DO. SO WITH THAT STATE PLAN, IF YOU EVER WANT TO MAKE CHANGES TO THAT, AND WHEN I SAY YOU, I MEAN THE STATE OF FLORIDA. IF THEY EVER WANT TO CHANGE THAT STATE PLAN, THEN THEY HAVE TO DO A SUBMIT A SPA.
IT'S A STATE PLAN AMENDMENT. CURRENTLY, IT TAKES 15 TO 18 MONTHS TO GET A SPA APPROVED. THAT'S IMPORTANT THAT YOU'LL HEAR LATER IN THE PRESENTATION ABOUT THE SPA. WHERE DO WE START? WE START WITH ENROLLING STUDENTS IN MEDICAID. HOW DO WE DO THAT AS A SCHOOL DISTRICT? SO THE SCHOOL DISTRICT HAS A MEMORANDUM OF AGREEMENT WITH THE FAMILY HEALTH CARE FOUNDATION, AND WE'VE HAD THAT AGREEMENT FOR AT LEAST THE LAST TEN YEARS THAT I CAN TELL. SO WE WORK WITH THE HAPPILY HEALTH CARE FOUNDATION TO -- WORK WITH THE FAMILY HEALTH CARE FOUNDATION TO GET THE STUDENTS ENROLLED AND WE ALSO WORK WITH OTHER DEPARTMENTS WITHIN THE SCHOOL DISTRICT. WE ARE WORKING WITH FACE FOR THE COMMUNITY, WE'RE WORKING WITH THE ESE DEPARTMENT. WE'RE WORKING WITH THE FINANCE STUDENT SERVICES. SO THIS ISN'T JUST A ONE-DEPARTMENT PROGRAM. IT INTERFACES WITH MANY, MANY, MANY OTHER DEPARTMENTS WITHIN THE SCHOOL DISTRICT.
WE HAVE THIS MEMORANDUM OF AGREEMENT WITH THE FAMILY HEALTH CARE FOUNDATION. WHAT DO THEY PROVIDE FOR US? WELL, THEY HAVE ALL THE KNOWLEDGE. THEY KNOW HOW TO ENROLL STUDENTS IN MEDICAID. THEY ARE ABLE TO EDUCATE AND EDUCATE OUR PARENTS AND OUR FAMILIES. THEY HAVE TOOL KITS AND MEDIA TOOL KITS TO BE ABLE TO BRING OUT TO THE SCHOOLS. THEY GO TO OUR OPEN HOUSES. THEY HAVE BAY CARE NAVIGATORS WHICH ARE MOBILE MEDICAL BUS. SO THEY ARE ABLE TO GO TO ALL THE SEVEN SITES FOR THE CHILDREN'S BOARD AND ENROLL THESE STUDENTS. THEY SCREEN THEM AND THEN THEY ENROLL THEM. IF THEY DON'T ENROLL THEM IN MEDICAID OR CHIP, CHILDREN'S HEALTH INSURANCE PROGRAM, THEN THEY'LL FIND A LOW-COST HEALTH INSURANCE THAT THEY CAN AFFORD THAT WILL MEET THE FAMILIES' NEEDS. SO WE PARTNER WITH THEM AS WELL AS OTHER DEPARTMENTS WITHIN THE SCHOOL DISTRICT. WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR STUDENTS?
SO THEY HAVE TO BE A U.S. CITIZEN, QUALIFIED IMMIGRATION STATUS. YOUR INCOME, THEY LOOK AT HOW MUCH MONEY YOU MAKE OR DON'T MAKE. IF YOU ARE A PREGNANT WOMAN, THEY PAY FOR THE SERVICES IF YOU QUALIFY OF HAVING THAT BABY. ALSO, WE HAVE FAMILIES THAT HAVE A LOT OF HIGH MEDICAL EXPENSES, AND THEY CAN APPLY FOR A MEDICAID WAIVER. SO THOSE ARE THE QUALIFICATIONS TO BECOME MEDICAID ELIGIBLE. AND WE'LL GO A LITTLE MORE INTO THAT IN A BIT. BUT IN HILLSBOROUGH COUNTY SCHOOLS, I ESTIMATE THAT WE HAVE ABOUT 8,000 MEDICAID ELIGIBLE STUDENTS RECEIVING SERVICES. SO WE CAN HAVE MEDICAID ELIGIBLE STUDENTS IN THE DISTRICT BUT AREN'T RECEIVING SERVICES, SO THERE'S NO REIMBURSEMENT. THAT'S WHERE THE 8,000 NUMBER COMES FROM, BECAUSE THEY ARE RECEIVING. AND THAT'S ESE ONLY AT THIS POINT. SO IMMIGRATION STATUS, I'LL GO OVER THIS REAL QUICK. IT IS THE QUALIFIED IMMIGRATION STATUS YOU HAVE TO HAVE.
I THOUGHT IT WAS IMPORTANT FOR YOU TO KNOW THAT WE ALSO HAVE PROGRAMS FOR CHILDREN UNDER 19 FOR EMERGENCY MEDICAL SERVICES. AND THE CHILDREN, REGARDLESS OF THE IMMIGRATION STATUS, MAY BE ELIGIBLE FOR CHIP UNDER THE AFFORDABLE CARE ACT WHICH PROVIDES SERVICES TO COMPREHENSIVE HEALTH CARE SERVICES. WE'LL TAKE A LOOK AT THE INCOME LIMITS TO SHOCK YOU A BIT. THE FIRST SLIDE TELLS YOU ABOUT AGE GROUPS. I'LL GO TO THE SECOND SLIDE TO SAVE TIME AND LOOK AT THE ANNUAL INCOME GUIDELINES. IF YOU LOOK AT A FAMILY OF FOUR, THEY CAN'T MAKE MORE THAN $42,760. THEY MAKE $42,761, THEY ARE NO LONGER ON MEDICAID. MAYBE THEY CAN GET CHIP, BUT THEY DON'T QUALIFY FOR MEDICAID. THERE ARE OTHER REQUIREMENTS AS WELL. IT'S NOT STRICTLY INCOME. SO THAT WAS JUST SO YOU HAD A LITTLE BIT OF INFORMATION ON THAT. WHY ARE WE UNIQUE? WHY IS THE SCHOOL-BASED MEDICAID PROGRAM DIFFERENT FROM THE COMMUNITY PROVIDER?
WELL, THERE'S AT LEAST TWO REASONS. ONE OF THEM IS THAT WE GET PAID DIFFERENTLY? WE GET REIMBURSED DIFFERENTLY THAN SAY A HOSPITAL OR A DOCTOR'S OFFICE. WE GET REIMBURSED THROUGH TIME SAMPLES. WE ASK, WHAT ACTIVITY WERE YOU ENGAGED IN AT A SPECIFIC MOMENT IN TIME? FOR EXAMPLE, ON APRIL 11 AT 2:11 P.M., WHAT WERE YOU DOING AT THAT MOMENT? THAT CAN BRING IN A SIGNIFICANT AMOUNT OF REIMBURSEMENT TO THE DISTRICT. AND THEN THE SECOND PROGRAM IS DIRECT SERVICES. SO IT'S THE SAME THING YOU'RE USED TO SEEING. I'M A SPEECH PATHOLOGIST. I SEE JOHNNY FOR 30 MINUTES. I DOCUMENT IT. HE'S MEDICAID ELIGIBLE. I HAVE PARENTAL CONSENT AND SOME OTHER COMPLIANCE CHECKS WE HAVE TO DO, AND WE SUBMIT IT AND CAN GET REIMBURSED FOR THAT. TWO PROGRAMS IN THE HILLSBOROUGH COUNTY SCHOOL DISTRICT. THEN THE SECOND OTHER DIFFERENCE IS CONSENT. WE NEED PARENTAL CONSENT TO BE ABLE TO BILL FOR THOSE SERVICES AND ALSO TO RELEASE INFORMATION TO THE ENTITY, THE MEDICAID ENTITY.
LET'S GET INTO DETAILS. SCHOOL DISTRICT ADMINISTRATIVE CLAIMING, THAT'S PROGRAM NUMBER ONE. LIKE I SAID WE RUN TWO MEDICAID PROGRAMS. THE FIRST PROGRAM IS THE ESTAC, SCHOOL DISTRICT ADMINISTRATIVE CLAIMING OR RANDOM MOMENT TIME SAMPLE. RMS OR RMTS. IT'S A MOMENT. RANDOM IN TIME, 2:10 P.M. WHAT DO WE GET REIMBURSED FOR? WE GET REIMBURSED FOR SEEKING OUT, IDENTIFYING, REFERRING, MONITORING, TRAINING, AND LEARNING. SO THESE ARE THE THINGS, THE ACTIVITIES THAT WE'RE TRYING TO CAPTURE FROM OUR STAFF MEMBERS OF WHAT YOU WERE DOING AT YOUR MOMENT IN TIME. IF YOU ARE DOING ONE OF THESE ACTIVITIES ON THE SHEET, THEN WE CAN GET REIMBURSED FOR THOSE ACTIVITIES. LET'S DIG A LITTLE BIT DEEPER INTO THE PROGRAM. WHAT HAPPENS? WE HAVE FOUR QUARTERS, AND WE SAMPLE OUR PARTICIPANTS, MEANING WE SURVEY THEM, EVERY QUARTER. HOW MANY PEOPLE? THERE'S ABOUT A POOL OF BETWEEN 3,000 TO 3500 DEPENDING ON THE QUARTER ARE IN THE SAMPLE POOL.
OUT OF THOSE PEOPLE EVERY QUARTER, WE SELECT ABOUT 80 TO 90 DEPENDING ON STATS. WE PARTICIPATE IN THE DOE PROGRAM SO THEY REALLY DO MOST OF THAT PART OF IT. IT'S ABOUT 80 TO 90 SURVEYS THAT WE DO EVERY SINGLE QUARTER. AND WE ASK THE STAFF THREE QUESTIONS. ARE YOU READY FOR THIS? WHO ARE YOU WITH? WHAT ARE YOU DOING? AND WHY ARE YOU DOING IT? THREE QUESTIONS. A SIGNIFICANT AMOUNT OF MONEY. SO STAFF MEMBERS ARE NOT TOLD THE DATE AND THE TIME OF THEIR TIME SAMPLE UNTIL THE DAY THEY ARE SAMPLED. THAT WILL CHANGE IN 2026. YOU'LL HEAR ME TALK ABOUT THAT IN A MINUTE. THAT WILL CHANGE TO, THEY'LL GET TWO DAYS' NOTICE. SO WE CAN TELL THEM TWO DAYS IN ADVANCE THAT YOUR MOMENT IS GOING TO BE APRIL THE 5th AT 2 P.M. RIGHT NOW, THEY GET A NOTIFICATION AT 4 A.M.
IN THEIR E-MAIL, AND WE ASK THEM SEVEN DAYS IN ADVANCE TO LOOK AT YOUR E-MAIL EVERY MORNING AND WAIT FOR THAT MOMENT. THEN THEY'LL KNOW WHEN THEIR MOMENT IS. THEY'LL GET THE E-MAIL THAT SAYS YOUR MOMENT IS TODAY, IT'S AT 2:00, AND IT WILL GIVE THEM THE INSTRUCTIONS ON WHAT THEY HAVE TO DO. SO THE STAFF MEMBERS THAT PARTICIPATE IN THIS PROGRAM, THEY CANNOT BE 100% FEDERALLY FUNDED. AND THEN ONCE THEY REPLY TO THE SURVEYS, THE MEDICAID TEAM CODES THE SURVEYS BASED ON THE GUIDE THAT WE HAVE AND BASED ON THE CODES WE GET REIMBURSED. AND THE CURRENT PARTICIPATION RATE WE HAVE TO GET BACK 75%, ALTHOUGH OUR GOAL IS 95 TO 100, WE ALWAYS WANT EVERY SINGLE ONE BACK, BUT IN 2026, THEY WILL BE CHANGING THAT TO 85% PARTICIPATION. AND ALSO THEY HAVE TO RETURN THEIR FORMS IN TWO DAYS, TODAY IT'S SEVEN DAYS.
IT WILL BE A BIGGER CHALLENGE COME 2026 TO GET THOSE TIME SAMPLES BACK. SO WHO ARE WE SAMPLING? WHO PARTICIPATES IN THESE PROGRAMS? ON THE RIGHT SIDE -- ON THE LEFT SIDE OF THE SCREEN, YOU SEE YOUR DIRECT SERVICE PROVIDERS AND ON THE RIGHT SIDE YOU SEE LIKE ESE TEACHERS, ESE SPECIALISTS, PRINCIPALS, THIS WHOLE GROUP IS INCLUDED IN THE TIME SAMPLE. IT'S ABOUT 3,000 TO 3500 STAFF MEMBERS EVERY QUARTER, WHOEVER IS IN THOSE ROLES FOR THAT QUARTER. SO THAT WAS THE SDAC PROGRAM. THAT WAS PROGRAM NUMBER 1. IT IS A TIME SAMPLE. THREE QUESTIONS. WE CODE IT. WE GET REIMBURSED. WISH IT WAS THAT SIMPLE. SCHOOL MEDICAID PROGRAM NUMBER TWO. SO THIS PROGRAM IS A FEE FOR SERVICE PROGRAM. MANY OF YOU HAVE HEARD THAT TERMINOLOGY, FEE FOR SERVICE. WE PROVIDE A SERVICE. WE CHARGE A FEE. SO WHAT ARE THE REQUIREMENTS OF THIS PROGRAM?
SO WE HAVE TO HAVE PARENTAL CONSENT. THERE HAS TO BE SOME TYPE OF A PLAN. A TREATMENT PLAN, IEP PLAN, A HEALTH CARE PLAN, POSITIVE BEHAVIOR INTERVENTION PLAN. THERE HAS TO BE A PLAN FOR US TO GET REIMBURSED BECAUSE, OF COURSE, MEDICAID, THE NEXT REQUIREMENT IS THEY WANT DOCUMENTATION. SO WE HAVE TO HAVE THOSE THINGS AS A BACKUP FOR DOCUMENTATION. WE ALSO HAVE TO HAVE APPROVED PROVIDER. SO OUR SPEECH PATHOLOGIST, THEY HAVE TO HAVE CERTAIN CREDENTIALS, PSYCHOLOGIST, THEY HAVE TO HAVE CERTAIN CREDENTIALS IN ORDER TO PARTICIPATE IN THESE PROGRAMS. ANOTHER PART OF THIS FEE FOR SERVICE PROGRAM IS THE DIRECT SERVICES TO STUDENTS, RIGHT? SO WHAT ARE THOSE CATEGORIES THAT WE GET REIMBURSED FOR DIRECT SERVICES? WE GET REIMBURSED FOR MENTAL HEALTH SERVICES. THERE ARE SERVICES WE PROVIDE FOR COUNSELING ARE ALL THE EVALUATIONS THAT WE DO. WE GET REIMBURSED FOR NURSING SERVICES, MEDICATION SERVICES, THERAPIES WE GET REIMBURSED FOR SPEECH LANGUAGE, OTPT, AND ALSO, BELIEVE IT OR NOT, WE GET REIMBURSED FOR TRANSPORTING STUDENTS TO SCHOOL AND HOME FROM SCHOOL.
NOBODY THINKS MEDICAID HAS ANYTHING TO DO WITH TRANSPORTATION IN THE SCHOOL DISTRICT, BUT WE DO. AND OUR TRANSPORTATION DEPARTMENT IS DOING A PHENOMENAL JOB CAPTURING THOSE RIDES ON THE BUS. SO WE TRANSPORT A STUDENT TO SCHOOL AND THEY HAVE A SERVICE THAT DAY, THE NURSING SERVICE, AND WE TRANSPORTED THEM HOME, WE GET TO BILL THEM FOR TWO SERVICES, FOR THE RIDE HOME AND THE RIDE TO SCHOOL. SO IT'S IMPORTANT THAT THOSE SERVICES ARE IN THE SYSTEM AND DOCUMENTED BECAUSE WE NOT ONLY LOSE THE SERVICE, BUT WE WOULD LOSE THE TRANSPORTATION REIMBURSEMENT AS WELL. WHICH STAFF MEMBERS PARTICIPATE IN THIS PROGRAM? SO YOU'LL SEE IT WAS JUST THAT ONE SLIDE, BUT THESE ARE THE PEOPLE THAT HAVE A DOE CERTIFICATION OR A LICENSE. AND IT ALSO INCLUDES CONTRACTED STAFF. I WANT TO MENTION THAT, BECAUSE WE HAVE QUITE A FEW SPEECH LANGUAGE PATHOLOGISTS THAT ARE CONTRACTED.
HOWEVER, THEY ARE REQUIRED TO DO THE SAME THING AS OUR SCHOOL DISTRICT EMPLOYEES REGARDING THE MEDICAID PROGRAM. SO OUR FEE FOR SERVICE RATE SCHEDULE. SO WHAT DO WE GET REIMBURSED? HOW MUCH IS IT? THE STATE MEDICAID AGENCY REIMBURSES SCHOOL DISTRICT BASED ON A FEE SCHEDULE. THESE ARE RATES FROM LIKE 1997 OUT OF THE 2005 MEDICAID HANDBOOK. AND THE FEE SCHEDULE LISTS TYPES OF SERVICES. FOR EXAMPLE, WE CAN GET REIMBURSED A FEE FOR PSYCH EVALUATION THAT WE DO FOR OUR STUDENTS. SO THAT'S HOW WE GET REIMBURSED BASED ON THE FEE SCHEDULE FOR THIS PROGRAM. SO THE NEXT SLIDE IS CERTIFICATION OF PUBLIC EXPENDITURES. I'M GOING TO READ IT TO YOU, BUT THIS IS REALLY IMPORTANT THAT YOU UNDERSTAND THIS BECAUSE THIS HAS BEEN A CHALLENGE FOR US, AND THIS IS WHERE WE ARE OUT OF COMPLIANCE. SO WHAT IS THE CERTIFICATION OF PUBLIC EXPENDITURES? EVERY TIME I SUBMIT A CLAIM, WE HAVE TO SIGN THIS FORM.
AND WHAT DOES THE FORM SAY? IT SAYS THE SCHOOL DISTRICT HAS EXPENDED THE STATE SHARE OF PUBLIC, NONFEDERAL FUNDS NEEDED TO MATCH THE FEDERAL SHARE OF MEDICAL CLAIMS BILLED TO THE STATE MEDICAID AGENCY FOR SCHOOL DISTRICT SERVICES PROVIDED TO AND ON BEHALF OF ELIGIBLE MEDICAID STUDENTS WITH EACH QUARTER'S CLAIM. WHAT DOES THAT MEAN? BASICALLY IT MEANS WE GET REIMBURSED FOR WHAT OUR COSTS ARE. IF IT COSTS US $10 TO TRANSPORT ONE ESE KID TO SCHOOL, THAT'S OUR COST AND HOW WE SHOULD BE REIMBURSED, NOT ON A FEE SCHEDULE. THIS HAS BEEN -- WELL, LET'S GO TO THE NEXT SLIDE. WE HAVE BEEN OUT OF COMPLIANCE ALONG WITH THESE OTHER STATES AS WELL. WE DID SOME RESEARCH, AND IN 2022, THE HEALTHY SCHOOLS PROMISING FUTURES WHO IS A PARTNER OF OURS, WHO REALLY ADVOCATES FOR SCHOOL-BASED HEALTH SERVICES, THEY DID A SURVEY, AND THERE'S FIVE DISTRICTS.
OR STATES AND FLORIDA IS STILL OUT OF COMPLIANCE. IN 2014 IS WHEN WE WENT OUT OF COMPLIANCE. SINCE THEN, WE HAVE NOT BEEN PAID THE WAY THAT WE SHOULD BE BEING REIMBURSED. SO HERE'S SOME RECENT EVENTS. GIVES YOU SOME DATES, HOW WE GOT TO THIS PLACE WHERE WE ARE THAT WE ARE OUT OF COMPLIANCE. AND IT'S UNDER THE CODE OF FEDERAL -- CODE OF FEDERAL REGULATIONS. WHAT DOES IT SAY? WHY ARE WE OUT OF COMPLIANCE? BECAUSE WE RECEIVED A LETTER IN 2020 FROM THE FEDERAL GOVERNMENT TO THE STATE GOVERNMENT SAYING THE SCHOOL DISTRICTS MAY NOT BE PAID FROM A FEE SCHEDULE AND USE THIS AS A CERTIFICATION OF COSTS. SO THAT WAS THE CPE. PER BETH KIDDER, DEPUTY SECRETARY FOR MEDICAID IN 2020. NOW, WE HAVE SOME TALKING POINTS IN THE BACK THAT WE DIDN'T WANT TO TAKE THE TIME TO GO OVER ALL OF THAT BUT WE DID CREATE A ONE-PAGER FOR YOU AS A RESOURCE TO UNDERSTAND A LITTLE BIT MORE IN-DEPTH OF WHAT IS HAPPENING.
SO IN 2019, AHCA, THE AGENCY FOR HEALTH CARE ADMINISTRATION, WHO IS OUR STATE MEDICAID AGENCY, THEY SUBMITTED A SPA, AND CMS APPROVED THE SPA TO ADD NON-ESE STUDENTS. WE'RE NOW ABLE SINCE 2020 TO BE ABLE TO CAPTURE SERVICES THAT WE PROVIDE TO STUDENTS THAT ARE GEN ED THAT ARE MEDICAID ELIGIBLE THAT ARE RECEIVING SERVICES. SO THAT'S BEEN SINCE 2020. I CAN TELL YOU THAT FLORIDA IS WAY BEHIND IN ALL THE OTHER SCHOOL DISTRICTS IN CREATING THIS INFRASTRUCTURE TO BE ABLE TO DOCUMENT AND GET REIMBURSED FOR THAT. IN 2019, WE SUBMITTED THE SPA, THE STATE DID FOR NON-IEP SERVICES AND ALSO TO INCLUDE CHARTER SCHOOLS AND PRIVATE SCHOOLS IN MEDICAID -- IN THE MEDICAID PROGRAMS. IN 2020, THE GOVERNOR SIGNED IT INTO LAW, AND THEN ALSO IN 2020 IS WHEN WE RECEIVED THAT LETTER THAT I SPOKE ABOUT, THE COMPANION LETTER THAT WAS SENT TO BETH KIDDER.