Local Education Agency (LEA)
California law requires that each school district participating in the LEA Medi-Cal Billing Option form a community collaborative group to make decisions on the reinvestment of funds returned to school districts. The Los Angeles Unified School District (LAUSD) LEA Collaborative membership is made up of community and District representatives, including Los Angeles County representatives LAUSD representatives from a variety of employee groups, UTLA, and parents. The Collaborative funds supplemental health and human services for the purpose of supporting academic success. The LEA Collaborative Board meets quarterly and documents its activities by way of a mandated Annual Report submitted to the California Department of Health Care Services (DHCS).2017 LEA Collaborative Board MembersThe LAUSD LEA Collaborative Board has the following voting members:
Patricia A. Armani,
Children Services Administrator (CSA)
Educational AudiologistJamie Miller,Mental Health Clinician II
Associate SuperintendentStacy Barron,Pediatrician
Erika F. Torres,
LEA Collaborative Frequently Asked Questions
- Can Healthy Start sites bill Medi-Cal?
No. The LEA Medi-Cal Billing Option is currently restricted to services provided on IEPs. Healthy Start sites do provide a range of services for all children including those who are Medi-Cal eligible, but these services are not eligible for reimbursement because they are not written on the IEP.
- Do LEA funds carry-over from year to year?
The decision to carry-over LEA funds is made on a yearly basis by Budget Services.
- How are LEA funds allocated?
Each year the LEA Collaborative allocates funds generated by the LEA Medi-Cal Billing Option program to a variety of groups including, Healthy Start, provider groups (audiology, counseling, occupational and physical therapy, nursing, school psychologists, speech therapy), the Division of Special Education and the Division of Student Health and Human Services. Allocation recipients are required to report reinvestment outcomes to the Collaborative during the year the allocation was awarded and prior to the Collaborative decision to allocate funds in successive years.
- Is it appropriate and fair to fund Healthy Start sites when they are not allowed to generate Medi-Cal funds?
The Healthy Start Program was originally established under Gov. Pete Wilson and the CA state legislature (SB620). Subsequently, Gov. Wilson then worked with the legislature to establish the LEA Medi-Cal Billing Option for schools in order to sustain successful Healthy Start and Healthy Start-like programs, as well as other supplemental services and program for students and their families as deemed effective by the local Collaborative. Many Healthy Start sites do assist the Medi-Cal billing program by helping families to enroll in Medi-Cal, and thus contribute to the overall LEA revenues brought back to the District.
- Once an allocation has been made, how is the use of the LEA funds determined?
The LEA Collaborative determines the dollar allocation. District administrators budget the funds keeping within the general state requirements to supplement not supplant district services. The California Provider Participation Agreement does require signatures on an annual basis of field staff, budget personnel and program administrators who have participated in the budget process for their programs.
- What can LEA reimbursement be used for and how are these decisions made?
State regulation establishes broad outlines for the types of supplemental services which can be funded. In addition, the CA Department of Health Services, as well as the Collaborative, further define how the money is allocated. For example, the California Department of Health Services has informed districts that professional conference attendance does not qualify as a supplemental service.
- What constitutes supplanting or supplementing (and what is allowed)?
LEA funds may be used to supplement, but not supplant, District services. Supplementary services are those services over and above those which are funded routinely by the General Fund. Supplanting is the funding of services for special or general education for which the District is responsible.
- What determines central LAUSD Medi-Cal administration costs? What support and services are provided by administration?
An annual budget is developed to make sure the administrative budget can support billing, software, hardware, cost reconciliation, training and supplies. It also supports the District’s participation in the California Department of Health Services LEA Advisory Workgroup. The purpose of this Workgroup is to support the implementation of the Medi-Cal program for school districts, including improvements in the State Plan and the development of policies and trainings regarding school-based Medi-Cal billing.
- What is school-based Medicaid?
In 1989, Congress enabled school districts to claim federal funds for certain health related services they provide to students who have IEPs and who are enrolled in Medicaid. Districts can seek reimbursement from Medicaid for these services as long as the district is a Medicaid provider and meets requirements regarding licensure, certification, and other federal mandates for the Medicaid program.Note: Medicaid is called Medi-Cal in California.
- What is the difference between LEA and SMAA/RMTS?
California established the Local Education Agency (LEA) Medi-Cal Billing Option Program in 1993 and the School Medi-Cal Administrative Activities Program (SMAA) in 1994.The Local Education Agency Medi-Cal Billing Option program is a fee-for- service program which includes direct assessment and services to Medi-Cal eligible children. Claims which capture this direct service require the name of the student, the name of the provider, the date of service, and supporting documentation for the nature and extent of the services.Reimbursements for LEA direct services are returned to the District as General Fund- Restricted funds. Funds are restricted by the oversight of a Collaborative Board as defined in the California state education code.For more information about the LEA Medi-cal billing Option programs see the DHCS website: http://www.dhcs.ca.gov/provgovpart/Pages/LEA.aspxThe School Medi-Cal Administrative Activities (SMAA) Program claims reimbursement for administrative activities, including outreach and enrollment, referral to Medi-Cal services, and other specific administrative activities that improve and support Medi-Cal services to children. The District is required to implement a quarterly time study methodology completed by District personnel in order to claim this revenue. LAUSD uses a time sampling methodology known as Random Moment Time Survey (RMTS).Reimbursements for the SMAA/RMTS program are returned to the District as General Funds.For more information about the SMAA/RMTS program see DHCS website:
- What is the LEA Collaborative?
California requires that each district participating in the LEA Medi-Cal Billing Option program form a community collaborative group to make decisions on the reinvestment of funds returned to school districts. The LAUSD LEA Collaborative membership is made up of community and District representatives, including Los Angeles County representatives, LAUSD representatives from employee groups and UTLA, and a parent. The Collaborative funds supplemental health and human services for the purpose of supporting academic success.
- Why does the total dollar amount available for allocation vary from year to year?
Many variables affect the actual dollar amount the District receives each year. These include the percentage of children in Medi-Cal at any given time and the number of Medi-Cal eligible services that are documented by District services providers which meet the requirements for billing. Revenues can also vary according to regulatory changes made by the state and federal governments.
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