Medicaid Messenger
Direct Service Staff Edition
When staff are developing the IEPT/IFSP, or another Plan of Care, and the question comes up with regards to the services provided by a Personal Care Aide that a student qualifies for, ask the team members to consider these questions:
- Is the student's medical condition such that they would benefit from the care provided by a Personal Care Aide?
- Does this student need assistance or cueing with:
- meal and snack feeding,
- exercise to increase lung capacity,
- accessing the toilet, does not include assisting due to potty training capabilities,
- washing face and hands, combing hair, personal appearance,
- dressing themselves following toileting, or for going outdoors,
- moving from one surface to another (to/from a wheelchair, desk, toilet, pool),
- walking, either with some type of walker or other equipment OR on their own (perhaps due to issues with weakness or balance),
- teeth brushing, maintaining hygienic conditions, assistance with female menstrual periods, diaper changes, wiping nose, etc.,
- mobility, such as pushing a wheelchair, assist with a walker; manipulate objects such as turning pages, writing or typing,
- positioning to prevent stiff muscles and pressure points,
- proper skin care in cases of chronic conditions,
- monitoring for seizures and glucose levels,
- accessing the restroom in a timely manner,
- medications the student administers for themselves,
- hands-on redirection for chronic behavior issues that results in disruptive, non-compliant behavior, or the student is not focused on a consistent basis,
- any other categories not listed above, such as walking with a student throughout the day because they may attempt to leave the building or put themselves or others in danger.
If you need additional clarification regarding when to utilize the services of a Personal Care Aide, or have a specific scenario not clearly defined above, please contact the Medicaid Department for guidance.
With less than two weeks of school remaining before the Holiday break, we are asking you to contact your Case Managers, Direct Service Staff and Personal Care Aides and ask them to complete their billing through December 22, 2023.
After the billings are submitted and marked 'Ready to Bill' by your staff, the Medicaid Department must then submit these items to the State for review.
In addition, we will be sending out reports to each LEA and PSA with updates regarding staff member billing status. If you would like to run the report before we provide them to you, please follow these steps:
- Log into MISTAR
- Click: Menu>Programs>Reports>Service Tracker Billing Status
- Click the options you would like to see reported for your practitioners for the date ranges of September 1 through December 22, 2023.
Please reach out to all of your staff members who are billing for the Medicaid services they are providing and ask them to complete their billing before leaving for the Holiday break.
