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From: Jamie Gustafson <jamie.sdac@gmail.com>
Date: Fri, 10 Oct 2025 09:20:40 -0700
Message-ID: <CAF0G3_Ro_GLRQVL+O_R2uu=e2Ka3EvsU+CQGOd3Zfe54QQJXUQ@mail.gmail.com>
Subject: Please complete TODAY: MO SDAC Program Q4-25 Random Moment Sampling
 (RMS) Survey
To: LuptonA@delasallecenter.org
Cc: "Nan (Kansas City International Academy) Dong" <nan@ed-ops.com>
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Name: Andge Lupton
School District: DeLaSalle Charter School
SDAC Coordinator: Linda Kirkpatrick
SDAC Category: Special Education Teacher
Random Moment: 12:01 PM on 10/07/2025

You have been selected on behalf of your school district to participate in
a Random Moment Sampling (RMS) survey for the School District
Administrative Claiming (SDAC) program. To participate in the survey, you
will need to respond to three questions online. Your participation is
required, should take no more than a few minutes to complete and will be
reported back to your school district.

*Related Medicaid Activity that may have occurred during your moment in
time:*












*Examples of SDAC Activities:=E2=80=A2Outreach to children and families to =
access
MO HealthNet when assisting parent/guardian to find community related
counseling or health/medical services.=E2=80=A2Facilitating an application =
for MO
HealthNet programs when assisting parent/guardian to identify documents to
apply for Medicaid or health insurance and services.=E2=80=A2Program planni=
ng,
policy development and interagency coordination related to medical
services when attending in-services for crisis intervention, emergency
procedures, etc.=E2=80=A2Referral, coordination and monitoring of MO
HealthNet services for students that may need therapy services counseling
or if receiving implementation of therapy goals.=E2=80=A2Transportation rel=
ated
activities in support of MO HealthNet services such as transportation to
doctor, health department, counseling, or to receive therapy.=E2=80=A2Trans=
lation
related to MO HealthNet services for non English speaking
parents/guardians.=E2=80=A2Preparing and sharing information regarding medi=
cal and
mental health related services covered by MO HealthNet programs with school
nurse, health care providers, etc.=E2=80=A2Assisting families in the Medica=
id
application process; answering questions such as =E2=80=9CWhat is Medicaid?=
=E2=80=9D or
"How do I apply?" or "Where is the Medicaid office?=E2=80=9D, etc.=E2=80=A2=
Monitoring the
delivery of medical and mental health services performed in the school
district such as Occupational Therapy, Physical Therapy or Speech
Services=E2=80=A2Participating in meetings/discussions to coordinate or rev=
iew a
student=E2=80=99s needs for health and related services such as
Occupational Therapy, Physical Therapy of Speech.=E2=80=A2Attending or cond=
ucting
training for the purpose of improving an individual=E2=80=99s ability to id=
entify,
refer or assess students =E2=80=9Cat risk=E2=80=9D of poor health outcomes.=
*

In order to complete the survey, please login to www.fairbanksllc.com and
select CLIENT LOGIN. You will then need to log in with the information
below and answer three simple questions to report the activity you were
performing at your sampled moment of 12:01 PM on 10/07/2025.

Username: alupton4
Password: sac59lid

If you do not have access to a computer, you can complete the survey by
calling Fairbanks directly at (877) 285-0388. Please call or email
Fairbanks at info@fairbanksllc.com with any questions.

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<div dir=3D"ltr">Name: Andge Lupton<br>School District: DeLaSalle Charter S=
chool<br>SDAC Coordinator: Linda Kirkpatrick<br>SDAC Category: Special Educ=
ation Teacher<br>Random Moment: 12:01 PM on 10/07/2025<br><br>You have been=
 selected on behalf of your school district to participate in a Random Mome=
nt Sampling (RMS) survey for the School District Administrative Claiming (S=
DAC) program. To participate in the survey, you will need to respond to thr=
ee questions online. Your participation is required, should take no more th=
an a few minutes to complete and will be reported back to your school distr=
ict.<div><br></div><div><div class=3D"gmail_default" style=3D"font-family:t=
ahoma,sans-serif"><font color=3D"#ff0000"><b>Related Medicaid Activity that=
 may have occurred during your moment in time:</b></font></div><div class=
=3D"gmail_default" style=3D"font-family:tahoma,sans-serif"><font color=3D"#=
ff0000"><b><br></b></font></div><font color=3D"#ff0000" style=3D"font-famil=
y:tahoma,sans-serif"><b><font size=3D"4"><u>Examples of SDAC Activities:</u=
></font><br>=E2=80=A2Outreach to children and families to access MO HealthN=
et<span class=3D"gmail_default">=C2=A0when assisting parent/guardian=C2=A0t=
o find community=C2=A0related counseling or health/medical services</span>.=
<br>=E2=80=A2Facilitating an application for MO HealthNet programs<span cla=
ss=3D"gmail_default">=C2=A0when assisting parent/guardian=C2=A0to identify =
documents to apply for Medicaid or health insurance and services.</span><br=
>=E2=80=A2Program planning, policy development and interagency coordination=
 related to medical services<span class=3D"gmail_default">=C2=A0when attend=
ing in-services for crisis intervention, emergency procedures, etc</span>.<=
br>=E2=80=A2Referral, coordination and monitoring of MO HealthNet<span clas=
s=3D"gmail_default">=C2=A0</span>services<span class=3D"gmail_default">=C2=
=A0for students that=C2=A0may need=C2=A0therapy services=C2=A0counseling or=
 if receiving implementation of therapy goals</span>.<br>=E2=80=A2Transport=
ation related activities in support of MO HealthNet services<span class=3D"=
gmail_default">=C2=A0such as transportation to doctor, health department, c=
ounseling, or to receive therapy</span>.<br>=E2=80=A2Translation related to=
 MO HealthNet services<span class=3D"gmail_default">=C2=A0for non English s=
peaking parents/guardians</span>.<br>=E2=80=A2Preparing and sharing informa=
tion regarding medical and mental health related services covered by MO Hea=
lthNet<span class=3D"gmail_default">=C2=A0</span>programs<span class=3D"gma=
il_default">=C2=A0with school nurse,=C2=A0health=C2=A0care providers, etc</=
span>.<br>=E2=80=A2Assisting families in the Medicaid application process; =
answering questions such as =E2=80=9CWhat is Medicaid?=E2=80=9D or &quot;Ho=
w do I apply?&quot; or &quot;Where is the Medicaid office?=E2=80=9D, etc.<b=
r>=E2=80=A2Monitoring the delivery of medical and mental health services pe=
rformed in the school district<span class=3D"gmail_default">=C2=A0such as O=
ccupational Therapy, Physical=C2=A0Therapy or Speech Services</span><br>=E2=
=80=A2Participating in meetings/discussions to coordinate or review a stude=
nt=E2=80=99s needs for health and related services<span class=3D"gmail_defa=
ult">=C2=A0such as Occupational=C2=A0Therapy, Physical Therapy of Speech</s=
pan>.<br>=E2=80=A2Attending or conducting training for the purpose of impro=
ving an individual=E2=80=99s ability to identify, refer or assess students =
=E2=80=9Cat risk=E2=80=9D of poor health outcomes.</b></font><br><br>In ord=
er to complete the survey, please login to <a href=3D"http://www.fairbanksl=
lc.com">www.fairbanksllc.com</a> and select CLIENT LOGIN. You will then nee=
d to log in with the information below and answer three simple questions to=
 report the activity you were performing at your sampled moment of 12:01 PM=
 on 10/07/2025.<br><br>Username: alupton4<br>Password: sac59lid<br><br>If y=
ou do not have access to a computer, you can complete the survey by calling=
 Fairbanks directly at (877) 285-0388. Please call or email Fairbanks at <a=
 href=3D"mailto:info@fairbanksllc.com">info@fairbanksllc.com</a> with any q=
uestions.<br><br></div></div>

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