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Place holder for photograph. Please remove from master page if not needed. Replacing Silos with Technology: Sharing Data Across Medicaid and Education September 26, 2003 Contact Information Roberta Puffer [email protected] 847-753-8558 Place holder for photograph. Please remove from master page if not needed. Steve Koruna [email protected] 847-753-8515 Please feel free to contact us with any questions you may have about the following presentation, or for further information regarding our solutions and services for school based Medicaid reimbursement Agenda Challenges facing Education and Medicaid agencies An approach for data sharing across organizations Data and sharing strategies and benefits Data sharing success stories Conclusions Questions 2003 Deloitte Consulting 3 Challenges Facing Medicaid and Education Agencies Place holder for photograph. Please remove from master page if not needed. Program and policy challenges Implementations are unique from state to state State flexibility

CMS regional oversight Schools and states are challenged to keep pace with complex and changing regulations: CMS Guidelines and ongoing program changes Multiple interpretations of Federal policy Schools need ready access to considerable subject matter expertise to participate effectively Staffing and funding shortfalls at both agencies exist; there are insufficient funds to pay for necessary program administration Coordination challenges with related programs, such as No Child Left Behind and proposed IDEA reauthorization 2003 Deloitte Consulting 5 Interagency coordination and communication challenges Where Education and Medicaid both play an active role, challenges surrounding coordination of roles can emerge: CMS State Medicaid Agency State Education Agency Local Education Agency Conflicting priorities Communication protocols Specialized expertise When the program is lead by only one of the agencies - Medicaid or Education - ,

communication challenges may occur LEAs are not a natural constituent of CMS or Medicaid The sheer volume and complexity of program information to be communicated and maintained leads to a host of training issues at all levels 2003 Deloitte Consulting 6 Data collection and management challenges Direct Service Reimbursement Documentation Data Uses Common Data Requirements Data Sources DS or MAC Participation Medicaid Eligibility Administrative Management Systems 2003 Deloitte Consulting Staff Credentials Financial System

Student Information System Student Information Special Ed. Status Financial Data Service Documentation. Transportation Data State Medicaid State Medicaid System (s) State Medicaid System (s) System (s) Special Ed. Solution or Documentation State Education State Education System (s) State Education System (s) System (s)

7 Data collection and management challenges Special Education Documentation Data Uses Student Information Common Data Requirements Data Sources Staff Credentials Administrative Management Systems 2003 Deloitte Consulting Financial System Student Information System Special Ed. Status Service Documentation. Transportation Data

State Medicaid State Medicaid System (s) State Medicaid System (s) System (s) Special Ed. Solution or Documentation State Education State Education System (s) State Education System (s) System (s) 8 Data collection and management challenges Direct Service Reimbursement Documentation Data Uses Common Data Requirements Data Sources DS or MAC

Participation Medicaid Eligibility Administrative Management Systems 2003 Deloitte Consulting Staff Credentials Financial System Student Information System Special Education Documentation Student Information Special Ed. Status Financial Data Service Documentation. Transportation Data State Medicaid State Medicaid System (s)

State Medicaid System (s) System (s) Special Ed. Solution or Documentation State Education State Education System (s) State Education System (s) System (s) 9 Data collection and management challenges Data Uses MAC Documentation Activities performed Common Data Requirements Data Sources Direct Service Reimbursement Documentation DS or MAC

Participation Medicaid Eligibility Administrative Management Systems 2003 Deloitte Consulting Staff Credentials Financial System Student Information System Special Education Documentation Student Information State/Federal Reporting Special Ed. Status Financial Data Service Documentation. Transportation Data State Medicaid State

Medicaid System (s) State Medicaid System (s) System (s) Special Ed. Solution or Documentation State Education State Education System (s) State Education System (s) System (s) 10 Data challenges created by silos Efficiency Data is collected to support programs, rather than as part of natural processes. Technology involved is also typically program specific. As a result: Effectiveness Management

2003 Deloitte Consulting Schools are incurring costs for multiple technology solutions, MAC and DS vendors, and internal costs to develop state reporting. States incur additional costs to process claims and manage state reporting. A primary benefit of technology is not realized due to lack of integration. Data is not as accurate as it could be, as it is not collected at the source. Inability to effectively reconcile information across programs: MAC and DS DS and Special Education Inability to manage and monitor programs on a proactive basis. Data does not become information until the claim is filed, yet the building blocks to prevent errors existed long before. Inability to measure program outcomes effectively 11

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