School Districts Wait for Vital SMAA Program Information

School districts participating in California’s School-Based Medi-Cal Administrative Activities (SMAA) Program, a federal reimbursement program that provides valuable funds that are reinvested back into the state and school district, continue to wait for information that may be central to their continued participation in the program.

Specifically, California schools are anxiously waiting for updates on the following:

  • Program Manual and Invoice: several program changes have been either implemented or proposed since the original SMAA-RMTS program manual was released in 2014; CMS needs to approve an updated program manual before survey data can be released and invoicing can begin for the first quarters of RMTS which started in January 2015. Many schools are relying on reimbursements from the new RMTS program to help alleviate years of receiving no funding due to the deferral, and the delay in both the new program manual and invoice template threaten to push this relief even further back.
  • Deferral/Pro-Rata PPL: this policy and procedure letter will describe the process by which LEAs who owe money following the interim reimbursement process will be handled; DHCS had previously stated that LEAs would be required to cut a check to cover these losses, but schools pointed out that the recent deferral had left their programs crippled and that requiring payment, as opposed to withholding the amount owed from future reimbursements, would jeopardize their ability to continue participating in the SMAA program.
  • Categorical Funding PPL: LEAs are waiting for clarification on a policy that was originally released by DHCS in October 2015, and later pulled back due to concerns over the applicability of this policy to school districts and the impact it would have on districts’ ability to use state funds from programs like Special Education — a common source of funding for health services and staff — as matching funds for the federal reimbursement program.
  • IEP PPL: DHCS has requested that CMS change their stance on prohibiting the reimbursement of SMAA activities that take place during an IEP meeting; a letter was sent to CMS at the end of February and the state reports that they are still waiting for a response or status on their request.

While these issues have been the cornerstone of discussions with the state Department of Health Care Services (DHCS) at bi-weekly stakeholder calls, these meetings have been plagued by cancellations and a DHCS Management Review process that appears to have stalled progress on most issues by several months (view the Action Item log from the most recent April 20, 2016 meeting).

The next bi-weekly meeting is scheduled for May 18.