2011-2012 Annual Report for CDE Guidelines
COLORADO DEPARTMENT OF EDUCATION
Annual Report for CDE Guidelines
2011-2012
Part I: Summary of Expenditures...... 2
Part I: Section 1Funds budgeted and expended...... 2
Part I: Section 2 Certification of data and contact information...... 2
Part II: Expenditure Reports...... 2
Part II-A-1: Administrative Expenditure Report...... 2
Part II-B: 2010-11CDE Description of Expenditures…………………………………….3-6
Part III: Subcontractor Report …………………………………………………………………4
Submission instructions……………………………………………………………………...6
Reports are dueFriday,May 24, 2013
Email one copy to:
Email or Mail oneoriginal signature page to:
Colorado Department of Education
201 E. Colfax Ave. Room 305
Denver, CO. 80203
Attention: Jill Mathews
The Annual Report is a requirement of your contract with the Department of Health Care Policy and Financing (HCPF).CDE has provided forms to make it easy for districts to provide HCPF with the information as to how Medicaid reimbursement has been used by the districts.
The deadline for submitting the report is May 24, 2013
Part I: Summary of Expenditures
The Summary of Expenditures section 1, list the funds budgeted andthe amounts expended.Section 2 requires the signature of the finance officer, who certifies these funds were used to pay for appropriate services. These sections are outlined in more detail below.
Part I – Section 1
Section 1-A:enter the funds budgeted for Administration and Health Services for 2011-12 in the appropriate cell
Section 1-B:enter totalfunds expended for administration and health service in2011-12 in the appropriate cell
The details of these expenditures will be described in the Expenditure Reports in Part II A and B of this report.
The cells labeled “total” will calculate automatically.Please check for accuracy.
Part I –Section 2 Certification of data and contact information
Please enter the district contact information, including name, email address and phone number.
This should be the person to contact if there are questions or revisions to be made to the report.
Part II: Expenditure Reports
Part II-A: Administrative Expenditure Report
This part of the Annual Report describes administrative expenditures related to managing the Medicaid School Health Services Program in your district or BOCES. This includes costs related to processing claims, provider training, payments to billing agents, costs related to LSP development, program management, administrative personnel and supplies,etc.
Use tab key to move through the fields. Dollar signs and 00 will enter when you tab
Part II-A-1:enter the description of administrative expenditures (2011-2012 school year)andthe cost. Please provide a brief description and cost in the appropriate column. Examples of the level of description needed are: CSMC or Centennial Education Solutions, administrative personnel salaries, provider trainings, office supplies, conferences or workshop registration fees,etc.
The cells labeled “total” will calculate automatically. Please check for accuracy.
Part II-B: Expenditures by CDE Category
For purposes of reporting, CDE breaks down expenditures by the categories listed in this section of the Annual Report. You may be combining different types of services into one category, so you may need to list more than one unit of service for a single category. A description of the categories is below. Some health services listed in the LSP may cover different categories. If it is not practical to separate the expenditures by category, use your best judgment as to how to categorize the service or contact CDE with questions. For example, a nurse may provide services that include hearing and vision screenings, dental screenings, and health education. The services delivered, though, would best be categorized as Nursing Services. Even though a health assistant may provide insurance outreach as part of her duties, her services would best be characterized as “Health Assistant/Clinic Aide.” See CDE category definitions beginning on page 5.
Health Service Category- Select the appropriate category and tab to select next field:
Units of Service – The number of Units of Service reflects the quantitative data gathered as part of your monitoring plan that describes the amount of service actually delivered to students. Examples include; # of hours of service providers spent deliveringhealth services to students, # of pieces of equipment purchased, # of referrals made, etc. Please indicate both the quantity of service and the type of service (example: 300 hours, 27 referrals, 15 vouchers, etc.).
Total Expenditure–enter the amount of funds that were used to deliver the service.
The cells labeled “total” will calculate automatically. Please check for accuracy.
Unduplicated Number of Students – enter the unduplicated number of students who received the service.For direct services, you must indicate only the number of individual students who actually benefited from a service, not the general population of students who could have received the service. Please indicate here if this number is an estimate.
For an indirect service, you may enter the number of students indirectly affected by the service. Please note in the description if a service is indirect. Examples of indirect services include staff trainings, professional development, publications, computers and computer software, and other materials, equipment, or supplies not provided to a specific student.
Examples of services:
Service / Service delivered / Which students to count?Mental Health / Referrals to MH clinic for treatment / Count students who are referred and receive treatment at the clinic.
Vision Screening / Vision screening for 4th and 6th grades (non-mandated). / Count the number of 4th and 6th grade students screened.
Insurance Outreach / Information sent out to every family in the district. / All students may be included in the count.
Insurance Outreach / Bilingual outreach services available to all students. / Only count students who actually benefited from the service.
Staff Training (indirect) / First aid training to elementary teachers. / Count only the number of students in classrooms of teachers receiving training. Indicate that this is an indirect service.
Health Tech / 1-on-1 health aides for 3 severe needs students. / Count the 3 students who received the service.
Nursing / Additional 1 day (6 hours) per week of nursing services. / Count the number of students served through the extended services. You could also report the percentage of students this equates to, based on the percentage of overall hours these extra hours represent.
Nursing / Additional full time nurse for elementary school. / Count the number of unduplicated students who received services from this nurse.
Assistive Technology / Purchase positioning and access equipment. / Count the number of students who used this equipment.
Part III, Subcontractor Report
A subcontractor is any individual or organization not employed by the district or BOCES who is delivering services described in the Local Services Plan. In accordance with state purchasing law, districts and BOCES are required to report on the performance and monitoring of subcontractors. For each subcontractor, please enter the name of the subcontractor, the amount paid to the subcontractor, and a brief narrative that describes:
- How the subcontractor was chosen
- The health services that were provided
- How the subcontractor’s performance was monitored
- Any problems that arose
- Any corrective actions taken and results of those actions
Please include any administrative subcontractors, such as claiming agents in this section.
CDE Category Definitions
Assistance/Emergency Funds – Many districts have set up assistance or emergency funds to help low income students access basic health-related services. This may include vouchers for prescriptions and co-payments and assistance with purchasing glasses, hearing aids, hygiene items, or any other health related materials.
Assistive Technology – This category includes assistive technology purchased for generalized use by multiple students.
Audiology – This category includes services delivered by an Audiologist in addition to Audiology services delivered by other personnel (screenings, re-screenings, referrals, etc.). It may also include assessment tools and screening equipment used to deliver Audiology services.
Case Management – This includes services such as care coordination, assessments, referrals, and other health-related case management services.
Dental – This may include screenings and referrals, subcontracted dental services, or vouchers for dental care and follow-up.
Health Assistant/Clinic Aide – This category may include direct health services, entering immunization data, clinic aides, or administrative services that allow providers to deliver more direct health services to students. These activities would be non-delegated.
Health Education – Health education includes health instruction and materials or curriculum related to this instruction.
Intensive Health Tech – This category includesdelegated nursing servicesin addition to district provided services delivered by a paraprofessional or health tech.
Insurance Outreach - CHP+ & Medicaid – This includes insurance outreach activities and may include bi-lingual outreach services. This category may overlap with Parent/Family Services. Districts and BOCES should use their best judgment about whether or not to report insurance outreach separately.
Materials/Equipment/Supplies – This broad category includes all health-related materials, equipment and supplies. You may combine and include all health-related goods in this category or include it under other categories. For example, you could include Speech Language assessment toolkits in the Speech Language category or an audiometer in the Audiology category.
Mental Health – Mental health services include psychology, social work, counseling, behavior therapy, and other mental health services. It may also include assessment tools or curriculum used to deliver mental health services.
Motor Therapy – Motor therapy is a generalized category that includes occupational and physical therapy services. It should be used when these services are combined or undifferentiated.
Nursing Services – Nursing services are those delivered by a licensed registered nurse. Delegated nursing services should be included as Health Assistant/Clinic Aide or Intensive Health Tech.
Nutrition – This category would include any health-oriented feeding programs such as offering breakfast to low income students. It also could include health education that focuses solely on nutrition.
Occupational Therapy – This category includes occupational therapy includes services delivered by an occupational therapist, COTA, or other person. It may also include assessment tools or equipment used to deliver this therapy.
Orientation & Mobility – This category includes orientation and mobility services and may also include tools or equipment used to deliver this therapy.
Parent/Family Services – This category includes family support and referral services, parenting training and services, bi-lingual liaisons, and other services delivered to families of students. Districts may include insurance outreach as a family service when it is part of a broader health-oriented outreach program.
Physical Therapy – Physical therapy includes services delivered by a physical therapist, physical therapy assistant, or other person. It may also include assessment tools or equipment used to deliver this therapy.
Professional Development – This category includes staff development and training. It could also include health-oriented materials such as books and computer software used for staff development.
Physician Services – Physician services include any services or subcontracted services delivered by a physician.
Screenings and Assessments – This category includes any non-mandated screenings or assessments. You may wish to categorize these under type of screening (count vision screenings under the Vision category), or you may wish to categorize all screening types under this category.
Speech Language – This category includes services delivered by a Speech Language Pathologist in addition to speech language services delivered by other personnel. It may also include assessment tools and screening equipment used to deliver speech language services.
Transportation – This category includes special transportation services in addition to district provided services. These services could include personnel or special equipment.
Vision - This category includes screenings, re-screenings, referrals, follow-up care, etc.). It may also include screening equipment or other materials related to the delivery of vision services.
Email the Annual Reportto:
Email or Mail one original signature page to:
Colorado Department of Education
201 E. Colfax, Suite 305, Denver, CO 80203
Attention: Jill Mathews
Due date is Friday, May 23, 2013