https://www.scdhhs.gov/internet/pdf/manuals/Local%20Education/Manual.pdf
The following policies apply when an LEA relies upon Social Security Act §1903(c) (42 U.S.C. 1396b(c)) as its basis for billing Medicaid:
The South Carolina Department of Health and Human Services (SCDHHS) provides Medicaid reimbursement for medically necessary services provided to Medicaid-eligible individuals in the Local Education Agency (LEA). This includes, but is not limited to, children under the age of 21 who have or are at risk of developing sensory, emotional, behavioral, or social impairments, physical disabilities, medical conditions, intellectual disabilities or related disabilities, or developmental disabilities or delays. Each Local Education Agency (LEA) recognized as such by the South Carolina Department of Education has contracted with SCDHHS to provide Medicaidreimbursable School-Based Services to Medicaid-eligible children with special needs. Individual service providers employed or contracted by an LEA must meet the specified Medicaid provider qualifications.
LEAs and/or subcontractors must meet all applicable Medicaid provider qualifications as well as the applicable state licensure regulations in addition to any specified requirements by the State Department of Education for the provision of Medicaid School-Based Services. The contracted LEA is responsible for ensuring the individuals rendering Medicaid School-Based Services are approved, credentialed, or licensed. LEAs may contract with any qualified provider for SchoolBased Services. The LEA must utilize the subcontract format approved and provided by SCDHHS. This can be found in the applicable appendix of the LEA contract. This format includes the federal and state contractual components that are required to ensure that Medicaid reimbursement is available. There may be additional state and/or federal requirements for approval by SCDHHS. LEAs may include other terms and conditions necessary to
define the responsibilities of both parties.
Social Work 401- Social Work Practice II
Policy Paper
Due Date: October 7, 2015 by midnight via blackboard
Purpose of Assignment: To help understand the policies and procedures that governs clients’ services in your service agency. To understand how policies and procedures influence the interactions between professionals and clients/families. To examine the extent that organizational policies and procedures support or constrain social work values and ethics.
Requirements: Identify an issue or policy that affects at risk families from your current field placement. Policies or issues include:
Eligibility criteria for services
The type of proof required to receive services and benefits(ex: from your agency or the state)
Rules related to access to services
Rules governing clients’ and families’ behavior in residential or instructional settings
Policies around missed appointments or failure to follow through with treatment recommendations ( ex:how are your clients terminated from agency, how do they become non-complaint )
Procedures for developing treatment plans.
Policies about client and family access to records
Policies requiring that the client be given a mental diagnosis or special education label.
Paper Requirements:
Students must prepare a policy paper that should be 4 full pages of text, supported by scholarly information. The paper should not exceed 7 pages (Cover page, abstract, body of work, and reference). The paper must be written in APA format, typed, double spaced, in TNR or Courier New Font, size 12. Student should also provide a copy of the policy found in their agencies policy and procedures manual and/or provide the correct APA citation within work and reference page.
Introduction
a.)Overview and/Background: Identify the agency and funding sources, identify the agency’s mission statement and/or vision/purpose. Identify the issue/and or policy
Body of Paper
a.)Discuss the origin, ideology, and values that appear to have influenced the policy include in the discussion the intended and potential unintended consequences of the policy’s application.
b.)To what extent is the policy and what it expects of clients and their families influenced by societal ideology (e.g., worthy and unworthy poor, social control, compliance)?
c.)What is the image of clients, families and practitioners portrayed by the policy?
d.)What does the policy demand of clients, families and practitioners?
e.)What are client and family reactions to the policy?
-Conclusion
a.)Assess the extent to which the policy and its procedures support or constrain social work values, ethics, and social justice concerns
b.)Does the NASW Code of Ethics offer you any guidelines about the appropriateness of the policy? In what way?
c.)How would you change the policy?
d.)What have you learned about the effects of policy on families and service delivery?
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