1. School Administrative Claiming Guide as a Resource to Fund School Mental Health Programs and Alternative Billing Strategies in School Mental Health
Elizabeth Trevino, Comal, TX (2007)
Matt Yancey, Cobb County, GA (2008)
John Cornelison, CM
Beth Freeman and Kelly Wells, TAS
February 27, 2012
Mental Health Affinity Group – Spotlight Series

2. Speakers Matt Yancey, PD John Cornelison, CM Lizzie Trevino, PD
Kelly Introduces speakers – Lizzie and Matt send short bio

3. School Medicaid Claiming Guide
A copy should be located in the Special Education Office or Finance Department in your school district.
You can also contact a representative in the Office of Exceptional Children and your State Department of Education.
Google State Department of Education and link to Office of Exceptional Children (Contacts), search “Medicaid Administrative Claiming Guide”
Beth introduces topic

4. Different Medicaid Standards
Mental Health
Education
Individual Therapy
Psychological Education Assessment
Group Therapy
Nursing Services
Family Therapy
Occupational Therapy
Diagnostic Assessment
Speech Therapy
Crisis Intervention
Educational Counseling
Case Management
School Social Work
Medical Assessment / Treatment
Psychologist Time Limited Counseling / Treatment

5. Determining Medicaid Reimbursable Services
Search state School Medicaid Administrative Claiming (SMAC) Guide on various websites:
Health and Human Services
State Department of Education
Office of Exceptional Children
Review guide to determine services that are Medicaid reimbursable under IDEA and/or other school-based services

6. Determining Funding Resources
Meet with school district finance office to discuss SMAC guide, reimbursement services, approved providers, current district funding, and potential future reimbursement requests.

7. Ask Questions
What does the district bill under IDEA? Are these Tier 2 (targeted) or Tier 3 (indicated) services?
What is the district not billing? Are there avenues of funding overlooked?
Does your district bill or contract with a billing agency?
Do you and/or district staff need to
advocate for additional funding
reimbursements within your district?

8. Using the SMAC Guide Elizabeth Trevino, Project Director
Comal Independent School District, Texas
Beth Introduces Lizzie

9. SS/HS Keystone School Mental Health Program
Comal ISD
SS/HS Keystone School Mental Health Program

10. CISD-District Information
589 Square Miles
5 Counties (Comal, Bexar, Hays, Kendall, Guadalupe)
Cities of - Canyon Lake, New Braunfels, Bulverde, Garden Ridge, Smithson Valley, some of San Antonio
17,000+ students
16 Elementary Campuses
5 Middle School Campuses
4 High School Campuses
1 Alternative School Campus

11. Keystone Program Overview
Olweus Bullying Prevention Program- All Elementary School
(10 – 16)
LifeSkills Training Program- All Middle Schools
(5 with CISD Grant Staff)
Security Camera’s- Middle and High Schools
Facilities Monitor (CISD Grant Staff)
Parents as Teachers- Teen Parents
Re-Integration Counseling / Case-Management with Juvenile Probation Students
GED / ESL Classes
DARE – 5th Grade
School-Based Mental Health Assessments / Counseling
Case-Management Services (2 CISD Grant Staff)

12. Keystone Program MH Service Delivery
Referral received by Case-Managers
Intake Assessment / Parental Consent
Staffing - weekly
Assignment to Counselor / MH Assessment
Weekly School-Based Mental Health Begins
Follow-up and Coordination with Case- Managers
Closure – Goals/Meet with Therapist
On-going Coordination with Case-Manager

13. Keystone School MH Program
Overview: Keystone MH
Contract w/MHMR – 3 LPC’s
Yr 1-$168,098, Yr 2-$198,480, Yr 3-$198,939,
Yr 4-$138,000
Contract w/Connections- 2 MH Specialist
Yr 1-$55,802, Yr 2-$83,065, Yr 3-$87,360, Yr 4-$75,000,
Yr 5-$32,000)
Contract w/Stogner & Associates–3 Staff(2- LPC, 1- LCSW) Yr 4 - $56,000, & NCE - $27,075
Contract w/Individual LPC-Independent Contractors
NCE($950-$1070 Month or $10,165 yr)
2 CISD Case-Managers
Annual Comparison
Year Served 123 students = $281,545.00
Year Served 205 students = $197,075.00
NCE - Served students = $82,825.00

14. Keystone Program Students Served M/H
Year 1 ( ) MHMR Connections Stogner
82 (260)
Year 2 ( )
123
Year 3 ( )
151
Year 4 ( )
205 (375+)

15. Keystone Mental Health - Sustainability
Hired Part-Time Medicaid Biller – January 2011
Worked with Stogner & Associates to begin billing Medicaid
Modeled after our Juvenile Probation Contract
Contract for Non-Cost to cover 5 hours non- billable per week, or 20 month

16. Getting Started – Tips / Suggestions
Begin partnerships with the 80/20 rule
Credentialing Process
Know who are the Medicaid providers & their rules
What campuses have the highest Medicaid eligible
Get a copy of the Medicaid Card
Service Limits per Provider
Re-Authorization Process
Progress / Case Notes
Time limits for billing
Hospital Systems to partner with
Crisis Situations / Suicide

17. Keystone Mental Health Goals
SHARS or MAC for students in Special Ed and Case-Management Services
Connections Therapists to begin billing
Addition of School Psychologist – billing
Establish a Billable School-Based Clinic

18. Alternative Strategies to Fund School Mental Health
Matt Yancey, Project Director
John Cornelison, Clinical Manager
Cobb County School District, Georgia
Kelly Introduces Matt

19. Cobb County, GA Service Area
26th largest school district in the nation and 2nd largest in Georgia.
Over 106,000 students in a diverse, constantly changing suburban environment
SFAS targeted area: 38,000 students/35 schools (6 high schools, 8 middle schools and 21 elementary schools)
56 % Caucasian, 27% African- American, 9% Latino and 8% other
26% economically disadvantaged/participate in free and reduced lunch program
Nine Title I schools

20. Play Therapy Rooms
18 targeted schools have created play therapy rooms.
Rooms utilized by SFAS mental staff, school counselors, school social workers and other community mental health professionals.
MOU between SFAS and the school.
Georgia State University Play Therapy Institute.
Over 1100 sessions have been provided since 2008/2009 school year.

21. School Board Policy
There was not a policy in place regarding school-based mental health services.
New board policy created to allow community-based practitioners access to students in schools.
Coalition of 85 community providers who now have access to clients on campus.

22. Working with Private Mental Health Providers
Current partners (i.e. Community Services Board and CCSD) can not sustain/absorb positions.
Working with community MH partners to hire SFAS clinical staff within their agency when grant ends to continue provision of school- based mental health programming in Cobb County schools.
Private agencies have billing infrastructure in place.

23. Graduate Interns
SFAS works with Kennesaw State University and Richmont Graduate University to obtain interns in the SMH program
Project provides supervisors for these internships through the school MH staff and private/public agencies.
Kennesaw State University ‘s MSW program exploring concentration in play therapy.

24. State Level Advocacy
Currently working with state level leaders and a recently formed state CMT comprised of the departments of education, health/human services and juvenile justice.
Schools may use the School Medicaid Administrative Claiming Guide for LCSWs to bill for Special Education services for students in Cobb County Schools and in other Georgia school districts.  The school districts in Georgia have not used this resource for billing Medicaid in the past even though it is allowed. 

25. Contact Information
Matt Yancey Beth Freeman, TAS
Project Director
Cobb County School District, GA
Elizabeth Trevino Kelly Wells, TAS
Project Director
Comal Independent School District, TX
Beth summarizes webinar, and how to contact speakers/TAS’s for follow up after webinar

26. Mental Health Interest Group March 19, 2012 2-3:30 p. m
Mental Health Interest Group March 19, :30 p.m. EST Topic: Teaming up to Service Students: SMH Services integrated through Student Intervention Teams, District Funding & Community Providers
Kelly – Save the Date for the next MH Interest Group