Web Resources - ECTA Center



Financial Data Workshop for Part C Coordinators

May 22, 2006

&

Part C Finance Leadership Symposium

August 14 – 16, 2006

WEB RESOURCES

I. Finance Systems

Publications

Hayes C. (2004). Strategic Financing: Making the Most of the State Early Childhood Comprehensive Systems-Building Initiative. In: Halfon N, Rice T, and Inkelas M, eds. Building State Early Childhood Comprehensive Systems Series, No. 5. National Center for Infant and Early Childhood Health Policy.

The Maternal and Child Health Bureau’s (MCHB) State Early Childhood Comprehensive Systems (SECCS) Initiative gives states an opportunity to think more strategically about how early childhood services are delivered and funded. States with SECCS grants do an environmental scan of current financing of early childhood services and potential funding for service expansion and further systems-building efforts before they develop a broad statewide, multi-agency plan for early childhood. This paper presents a framework to help SECCS partners develop a strategic financing approach to meet these requirements. Chapters include: Financing Challenges to Developing Comprehensive Early Childhood Systems; Principles to Guide Early Childhood Investments; Making the Most of SECCS: Strategies for Financing Comprehensive Early Childhood Initiatives; and Keys to Successful Financing. Appendices provide information on federal funding streams, list federal funding sources by functional activity, and highlight a number of other published materials and electronic information sources.

Galinsky, Ellen. (February 2006). The Economic Benefits of High-Quality Early Childhood Programs: What Makes the Difference? Families and Work Institute, Committee for Economic Development.

Contains Key Economic Findings and Background/Probable Causes of the Economic Impact from three often-cited studies of high-quality early education programs that show strong evidence of the economic benefits of early childhood education.

Organizations/Agencies

American Academy of Pediatrics

• Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy. (December 2004). Pediatrics, Vol. 114 (6), pp. 1677-1685.

This policy statement defines culturally effective health care and describes its importance for pediatrics and the health of children. The statement also defines cultural effectiveness, cultural sensitivity, and cultural competence. The statement is based on the conviction that culturally effective health care is vital and a critical social value and that the knowledge and skills necessary for providing culturally effective health care can be taught and acquired through focused curricula throughout the spectrum of lifelong learning, from premedical education and medical school through residency and continuing medical education. The American Academy of Pediatrics also believes that these educational efforts must be supported through health policy and advocacy activities that promote the delivery of culturally effective pediatric care.

• Pediatrician's Role in Early Identification: Developmental Surveillance and Screening of Infants and Young Children. (July 2001). Pediatrics, Vol. 108 (1), pp. 192-195.

This policy statement provides recommendations for pediatricians for screening infants and young children for early identification of children with developmental delays and disabilities and intervening with families.

Center for Health Care Strategies, Inc.

• Current Applications of Predictive Modeling in Medicaid Managed Care

Predictive modeling is a tool to help plans prioritize and anticipate the future medical needs of their members. During this April 5, 2005 CHCS Network Exchange Call, three expert organizations presented national, state, and health plan experiences using predictive modeling. Highlights from the call include an overview given by presenters from Mercer Human Resources Consulting, followed by guest experts from Wisconsin reviewed how predictive modeling is employed by their organizations.

The Commonwealth Fund

The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries.

• Publications on Children’s Health/Development

The Finance Project

The Finance Project is a specialized non-profit research, consulting, technical assistance and training firm for public and private sector leaders nationwide that helps leaders make smart investment decisions, develop sound financing strategies, and build solid partnerships that benefit children, families and communities.

• Publications

In the past decade, The Finance Project has produced a broad array of published resources for public and private sector leaders. These include working papers, strategy briefs, issue notes, and funding guides. Our publications are designed to help those who need to identify successful financing strategies and to develop effective and sustainable programs for children, families, and communities. Many of our publications can be downloaded at no cost.

The Future of Children

• Journal on-line publication

See several past issues including:

Health Insurance for Children (VOLUME 13, NUMBER 1 - SPRING 2003)

Children and Managed Health Care (VOLUME 8, NUMBER 2 - SPRING 1998)

National Association for the Education of Young Children

Resources on Financing Early Childhood Education

To adequately finance an early childhood education system, we need to answer several basic questions. How much will a system of quality early care and education cost? How much are we spending already? What are the various ways that the system can be financed? What can we learn about finance from other systems that can be adapted to reform financing of early childhood care and education? How can we implement a new system? Included is a list of organizations and projects that are working on a variety of ways to support a well financed system.

National Center for Children in Poverty (NCCP)

Mailman School of Public Health at Columbia University.

Website includes innumerable links to reports, policy papers/briefs, family resource simulator tool, and state-level data related to low-income children in the US, as well as information about specific fund sources.

• National Infant & Toddler Child Care Initiative

Administration for Children & Families, US Department of Health & Human Services

• At-A-Glance: Financing Infant & Toddler Child Care

In order to achieve high quality infant and toddler child care, funding needs to come from private and public sources, including parents, employers, civic groups, government, and foundations. Federal, State, and community leaders are challenged to find, allocate, and effectively use funds for early childhood services. They face competing interests and priorities for limited resources. In order to make effective decisions, leaders need to know how funds are currently allocated and whether those allocations support high-quality care across ages and settings. There are key considerations for policy-makers when examining efforts to finance quality infant/toddler child care services. They include:

• Integration of funding for 0-3 services into other early childhood initiatives,

• Strategic and effective use of infant and toddler earmark funds and other investments to meet the developmental needs of infants and toddlers,

• Information for parents about the available supports (tax deductions, credits, subsidies) to help pay for the cost of care by the parent and other caregivers, and

• Development of public/private partnerships to improve services for infants/toddlers and their families.

National Health Law Program: Working for Justice in Health Care for Low Income People

• EPSDT Checklist for Medicaid Managed Care and Children with Special Needs

• National Health Law Program – recent publications to order and/or to download

Zero to Three Policy Center

The Zero to Three Policy Center is a research-based, non-partisan program that brings the voice of babies and toddlers to public policy to promote good health, strong families, and positive early learning experiences.

• The Infant-Toddler Set Aside of the Child Care and Development Block Grant: Improving Quality Child Care for Infants and Toddlers (January 2005)

Fact sheet including policy recommendations, research, ‘fast facts’ and references.

• Restructuring the Federal Child Welfare System: Assuring the Safety, Permanence and Well-Being of Infants and Toddlers in the Child Welfare System

Fact sheet including policy recommendations, research, ‘fast facts’ and references.

II. Funding Sources

Publications

Pera, Mary Kay. (2004). Improving Coordination Between School-Based Health Centers and Medicaid Managed Care. New Mexico Human Services, Department Medical Assistance Division, Center for Health Care Strategies, Inc.

Resource paper on challenges and successes from a New Mexico pilot project.

Organizations/Agencies

Centers for Medicaid & Medicare Services (CMS), U.S. Department of Health & Human Services

• Medicaid at a Glance 2005: A Medicaid Information Source

This document contains descriptions and links to information on eligibility, SCHIP (State Children’s Health Insurance Program), and optional state plan services included under state plans and managed care waivers. It also includes federal poverty level charts and state level Medicaid Services State Plan Chart.

• CMS Medicaid Index to Subjects

This index page links you to information on the Medicaid program. Each link represents a topic. Topic links are grouped by category. Each topic contains from 1 to 20 pages of information. The first page of each topic starts with an Overview. At the bottom of every page, downloads and lists of related links offer you more information.

• Medicaid State Waiver Program Demonstration Projects

The Social Security Act authorizes multiple waiver and demonstration authorities to allow states flexibility in operating Medicaid programs. Each authority has a distinct purpose, and distinct requirements. Use this webpage and links to get additional information about these authorities, or to find out what kinds of waivers and demonstrations have been proposed and/or approved in your state.

• New Freedom Initiative

This initiative is a nationwide effort to remove barriers to community living for people of all ages with disabilities and long-term illnesses. CMS provide some opportunities for funding to assist in implementing systemic changes to better serve individuals with disabilities in the setting of their choosing. Information on these grant programs can be found on this link.

• EPSDT

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaid's comprehensive and preventive child health program for individuals under the age of 21. EPSDT was defined by law as part of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) legislation and includes periodic screening, vision, dental, and hearing services. In addition, Section 1905(r)(5) of the Social Security Act (the Act) requires that any medically necessary health care service listed at Section 1905(a) of the Act be provided to an EPSDT recipient even if the service is not available under the State's Medicaid plan to the rest of the Medicaid population. The EPSDT program consists of two mutually supportive, operational components: (1) assuring the availability and accessibility of required health care resources; and (2) helping Medicaid recipients and their parents or guardians effectively use these resources.

• General information on HIPAA

The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services (HHS) to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data.

• CMS Glossary

This glossary explains terms found on the cms. web site and is available in English and Spanish.

• CMS acronyms

An acronym is a term formed from the initial letter or letters of each of the major parts of a compound term. This list explains acronyms found on the cms. web site and other acronyms that are commonly used.

State Title V CSHCN (Children with Special Health Care Needs) Programs:

Eligibility Criteria and Scope of Services

This directory is organized by state.

Supplemental Security Income (SSI) for Children

FAQs on How does the SSI system work for a child?

State-specific Guides and Forms

Florida Early Steps (formerly the Infants and Toddlers Early Intervention Program)

• FL Program Plan and Operations Guide: Service Delivery

The Infants and Toddlers Early Intervention Program Plan and Operations Guide outlines how state and federal requirements for the Early Intervention Program are implemented and how early intervention services are delivered to families in Florida.

• FL Program Plan and Operations Guide: Service Delivery Appendix

This Appendix to the Service Delivery Section of the Infants and Toddlers Early Intervention Program Plan and Operations Guide includes forms used in Florida’s Early Steps system.

Georgia: Medicaid waiver forms-- Katie Beckett waiver forms (new)

In order for a child to establish Medicaid eligibility under this program, it must be determined that:

• If the child was in a medical institution, he/she would be eligible for medical assistance under the State plan for title XIX;

• The child requires a level of care provided in a hospital, skilled nursing facility, or

intermediate care facility (including care facility for the mentally retarded);

• It is appropriate to provide the care to the child at home; and

• The estimated cost of caring for the child outside of the institution will not exceed the estimated cost of treating the child within the institution.

Illinois Billing Manual

IL Department of Human Services Early Intervention service descriptions, billing codes and rates.

Michigan Medicaid Provider Manual

The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Children's Special Health Care Services, Adult Benefits Waiver, Maternity Outpatient Medical Services (MOMS), and other healthcare programs administered by the Department of Community Health

Minnesota Department of Human Services Individualized Education Program

(IEP) Services: Technical Assistance Guide

The Minnesota Department of Human Services (DHS) Individualized Education Program (IEP) Technical Assistance Guide is designed for schools and districts that provide covered IEP services to eligible children who receive services through an Individualized Education Program (IEP), Individualized Family Service Plan (IFSP), or Individual Interagency Intervention Plan (IIIP). The purpose of this guide is to provide schools/districts with Medicaid policy and billing information for covered IEP services. DHS also provides the Minnesota Health Care Programs (MHCP) Provider Manual. MHCP Provider Manual chapters 1-4 and 9 are particularly helpful for IEP services providers.

New Mexico Family Infant Toddler Program: Healthcare in New Mexico: A Guide

to Funding Services for Families in Early Intervention. A Self-Study Guide for

Service Coordinators

This self-study guide developed by the New Mexico Department of Health is designed for Service Coordinators to assist them in knowing about the eligibility requirements, procedures and resources that can help families access and receive the health care they need for their young child. This guide includes state specific guidance related to the use of resources, supports and services provided by federal, state and local entities that relate to the requirements of Part C. The sections on health insurance, Medicaid, Indian Health Services (IHS), military health benefits Social Security Insurance (SSI) and waivers are particularly helpful.

III. Child and Family Data

Children’s Defense Fund

The State of America’s Children (2005)

Includes September 2005 national data trends on U.S. poverty data; in-depth analyses of the current status of family income, child health, child care and early childhood development, education, child welfare, and youth development; and personal and policy success stories and recommendations. Appendix includes state level.

Kids Count

Publications include a 16th annual KIDS COUNT Data Book that provides a state-by-state statistical portrait of the educational, health, and economic conditions of American children. This year’s essay focuses on "Helping Our Most Vulnerable Families Overcome Barriers to Work and Achieve Financial Success". July 2005.

IV. The Deficit Reduction Act (DRA) of 2005

Johnson K. (2006). Short Take No. 1: The Deficit Reduction Act (DRA) of 2005—

Opportunities and Challenges for ECCS Initiatives. Project Thrive, National Center for Children in Poverty.

Examines the potential impact of the DRA on health access and coverage for young children ages birth to 5 years. The core provisions of the DRA are described in contrast to existing law, and opportunities and threats are discussed. The last section offers recommendations and resources for further study.

Guyer J, Mann C., and Alker J. (March 2006). The Deficit Reduction Act: A

Review of Key Medicaid Provisions Affecting Children and Families. The Center for Children and Families, Georgetown University Health Policy

Institute.

This issue briefly reviews four main Medicaid provisions in the DRA that affect children and families: changes in the Medicaid benefit standards, changes to federal cost sharing and premium standards, the New citizenship documentation requirement and “Healthy Opportunity Account” demonstrations.

Changes in the Medicaid Program: The Deficit Reduction Act (DRA) of 2005. (April 2006). Family Voices.

The Family Voices Policy Team (FVPT) focuses on monitoring federal and state legislation and provides information to help families and family leaders understand and influence the legislative process. The FVPT developed this paper outlying the parameters of the law and the changes states must make to their Medicaid program.

New Requirements for Citizenship Documentation in Medicaid (June 2006). Medicaid and the Uninsured. Kaiser Commission on Medicaid Facts, The Henry J. Kaiser Family Foundation.

This fact sheet provides information on the new requirement and recent CMS guidance, and examines their implications for Medicaid beneficiaries and the states.

WV Income Maintenance Manual. Chapter 4, Verification. Citizenship and Identity Requirements.

Provides a state example of the documents that West Virginia requires for Medicaid beneficiaries to establish U.S. Citizenship and identity.

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