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2001 Public/Private Partnership Awards MAYOR RICHARD M. DALEY, CITY OF CHICAGO OUTSTANDING ACHIEVEMENT
AWARD PUBLIC CONSULTING GROUP, INC. 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. |