2001 Public/Private Partnership Awards

MAYOR RICHARD M. DALEY, CITY OF CHICAGO

OUTSTANDING ACHIEVEMENT AWARD

PUBLIC CONSULTING GROUP, INC.
HEALTH SERVICES MANAGEMENT PARTNERSHIP

In 1995, Mayor Richard M. Daley took control of the Chicago Public Schools in response to national criticism of public education in the city of Chicago.  CPS developed multi-faceted reform strategies, including public - private partnerships to reform the entire system.  The collaboration between CPS and Public Consulting Group, Inc. (PCG) is one of the most successful of these partnerships, focused on improving the delivery of health services to over 50,000 children enrolled in special education at CPS.  The overall result is enhancement of educational opportunities for all CPS students.

Over ten years ago, federal funds were made available to reimburse school districts for providing mandated health services to Medicaid-eligible students.  State and federal funds have never fully covered the costs of providing entitled medical services.  Thus, expensive special education services have been disproportionately funded by local dollars.  By working closely with PCG to incorporate state-of-the-art business practices and systems to capture information and thus leverage more Federal funds, CPS was able to re-allocate general funds from special education and medical services to meet the educational needs of the general school population.  CPS’ annual Medicaid reimbursement has increased from $1.5 million in FY94 to $49 million in FY00 and processing costs have decreased from $8 million in FY96 to $2.1 million in FY00. 

CPS’ Office of Specialized Services is now able to do more effective strategic planning, advocacy, and educational leadership.  In 1997, CPS and PCG designed and implemented an innovative Medicaid billing program, the Health Services Management Program (HSMP).  As a result, in addition to revenue enhancement, the quality of special education services has been improved as medical needs were more fully addressed and the delivery of services was streamlined.  By having management reports provided by PCG to senior advisors and made available to school principals on computers, immediate access to information on what services a child needs and receives is available.  One of the many important management tools created by CPS and PCG are monthly reports that allow CPS management to compare health service minutes entitled to a child to the service minutes actually received.  This allowed CPS management staff to promptly identify and rectify service delivery issues.  In addition, PCG and CPS collaborated on Medicaid outreach activities to identify children at risk of needing health care and facilitated access to appropriate Medicaid-covered services for these students.  The success of these efforts was enhanced by CPS’ substantial efforts at enrolling uninsured children into the Children’s Health Insurance Program.

Another asset of the partnership is that the consistency of services is enhanced.  PCG assists with the training of CPS staff in their outreach efforts and in monitoring the health services provided.  In addition, PCG supports a help desk for clinicians with laptops to remedy technical problems and to train them on how to appropriately document services and utilize customized software. 

State and federal laws, rules, and guidelines governing Medicaid billing by school districts are very technical, complicated and confusing.  With the technical, legal and policy expertise of PCG, CPS and PCG have proven to be an effective team in promoting improvements at both the federal and state government levels.  PCG and CPS have successfully negotiated with Illinois Department of Public Aid and the Illinois State Board of Education to more expansively claim revenue and obtain reimbursement rates more commensurate with actual cost of CPS health services. 

The success of CPS’s HSMP has placed CPS and PCG at the forefront nationally on the school-based Medicaid reimbursement issue.  According to a review of comparable school district programs, the Council of Great City Schools reported that CPS “operates one of the most comprehensive and successful Medicaid cost recovery systems in the country”.  The HSMP is a state-of-the-art model that can be replicated in school districts across the country.  PCG is now recognized as having unique expertise through working directly with CPS. PCG is continuing to expand the model created with CPS to include the development of a web-based application for documenting health services and for developing Individualized Education Plans required for children in special education programs. School districts across the country, both large and small, can benefit from this type of partnership.