Transcript Personal Care in the Schools

Personal Care Services
Medicaid In The Schools
Dana Bennett, RN
Health Services Nurse
Introduction
Personal Care is medically necessary
services authorized by a physician.
It is IEP driven.
Reimbursement is available.
It is designed to assist a student
with their physical dependency needs
related to activities of daily living.
Activities Of Daily Living
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Bathing
Bladder and bowel requirements
Dressing
Eating
Incidental housekeeping
Personal hygiene
Shopping
Laundry
Mobility/Ambulation
Services That Are
Covered
• The student must have a physical
dependency need preventing or
substantially impairing their ability to
do these things for themselves.
Tasks associated with
ADL’s
 Eating
 Example: puree food for student , cut
food up, hand over hand assistance.
 Mobility and Ambulation
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Example: assist student form sitting to
standing position, assist with walking,
assist with ROM.
Cont.’d
 Personal hygiene
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Example: assist with brushing teeth,
assist with hand and face washing.
 Bladder and bowel
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Example: assist student to restroom,
assist with clothing.
 Bathing
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Example: assist student with holding
wash cloth.
Cont.’d
 Dressing
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Example: assist student with buttons, assist
with putting on coat.
 Incidental Housekeeping means cleaning of the
floor and furniture only in the area of the service
delivery location occupied by that student.
 Laundry means laundering only items incidental to
the care of that student.
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Example: cleaning soiled clothing.
Cont.’d
Shopping means services to address
the student’s physical dependency
need by assisting the student with
shopping or by shopping for the
student.
Acting as a Medicaid
Provider
Personal Care requires a separate
provider number.
Paraprofessionals must complete a 40
hour curriculum, take a test, and
receive the ADE certification.
The district must employ an RN.
Cont.’d
The RN is responsible for the
services that are provided by the
personal care aide, thus supervision is
a requirement.
Documentation requirements
General Certification
Requirements
• Minimum classroom training is 24 hours.
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Paraprofessional Modules through the
ADE, special education unit.
• Minimum for practical training is 16 hours.
• Training curriculum provided on website
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RN must train
• Certified Nursing Assistants, Certified
Home Health Aides with current valid
credentials are deemed qualified.
Delegation
• Nurse Practice Act
• Delegation Chart
Student Privacy
Requirements
• The Family Educational Rights and
Privacy Act of 1973(FERPA)
• The Health Insurance Portability and
Accountability Act of 1996(HIPAA)
• Confidentiality of student records.
• Need to know basis.
Documentation Log
• Essential for calculating time
• Documentation of specific services
rendered
• Can be coded for services, where
services are provided
• Cumulative daily minutes provided
calculate into billable units.
Billing
• Billed by 15 minute increments from
documentation log)
• Based on prior authorized hours:
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AFMC review
• Quarterly match requirement for district
• EDS
• FFS Electronic Medicaid Billing
• $3.46 per 15 minute unit
Documentation
• Service Log
• Prior Authorization
• Supervision Notes
Prior Authorization
Goes along with the student’s service
plan
Service plan is included in the Prior
Authorization.
Supervision
 RN is required to make supervised visits
with aide and student at a minimum of 2
times per 183 days.
 RN is required to review the aide’s
records, document the review, and if
necessary make changes to the plan which
may include further instruction)
Contact Information
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Medicaid In The Schools
2402 Wildwood, Suite 172
Sherwood, AR. 72120
1-866-280-8300
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Dana Bennett-Health Services Nurse
501-681-6087
[email protected]
http://arksped.k12.ar.us/sections/medicaid.html