California School Based Medi-Cal Administrative Activities (SMAA)

Region 5 SMAA Program information

Welcome to the Santa Cruz County Office of Education (Region 5 LEC) SMAA Web Site… this site will be used to share information about the SMAA Program in Region 5 (Monterey, San Benito, Santa Clara, and Santa Cruz Counties). If you have specific items that you would like addressed and/or if you have suggestions on ways to improve this site, please contact Tina Reger at (831) 466-5634 (or

Liann Reyes
Deputy Superintendent
Business Services
(831) 466-5602
Rith Mean-Hill
Senior Executive Assistant
(831) 466-5601


The SMAA program allows school districts, county offices of education, and community colleges to be reimbursed federal dollars for costs incurred while performing certain administrative activities related to connecting students/families to health services. Employees’ participate in a “random moment time survey” (RMTS) throughout the school year to identify the percentage of time spent on reimbursable activities.

These activities include:

  • Medi-Cal outreach
  • Facilitating the Medi-Cal application
  • Non-emergency, non-medical transportation of Medi-Cal eligible individuals to Medi-Cal services
  • Contracting for Medi-Cal services
  • Program planning and policy development
  • SMAA coordination and claims administration

The Santa Cruz County Office of Education has been involved in the School Based Medi-Cal Administrative Activities (SMAA) program since 2002. The Santa Cruz County Office of Education is the host entity for the South Bay Area Region (Region 5) Local Educational Consortium (LEC) statewide SMAA program. The South Bay Area Region (Region 5) is based on the California County Superintendent Educational Services Association (CCSESA) regions. Region 5 serves Monterey, San Benito, Santa Clara, and Santa Cruz counties.

The SMAA Program benefits schools in many ways. While the program connects students & families to Medi-Cal covered services, it also brings much needed unrestricted funding into our schools.

Random Moment Time Study (RMTS)

What is Random Moment Time Study (RMTS)?

RMTS is the distribution of a random moment to a Time Study Participant (TSP) every quarter during the regular school year beginning January 1, 2015. In the state of California, school district participation in the School-Based Medi-Cal Administrative Activities (SMAA) program requires completion of this statistically valid way of determining the amount of time and effort a TSP spends performing Medi-Cal school health-related services, Medi-Cal administrative and outreach activities, and other school/education-based activities.

Who can participate in RMTS?

A TSP is someone who routinely performs Medi-Cal school health services prescribed in an IEP and administrative activities that support Medi-Cal school health services.

A TSP cannot be 100% federally funded.

How does RMTS work?

A TSP is randomly selected and assigned a moment in time to create time study sample moments. A moment is one, single-assigned minute. A TSP is required to respond in a timely manner to each and every moment assigned. An assigned moment will expire after five consecutive student attendance days.

When a moment is assigned, a TSP will respond to the initial question, “Were you working,” by selecting one of the following responses.

  • Yes, I was working
  • No, moment was before/after work day
  • No, moment was during a paid time off
  • No, moment was during an unpaid time off

If the TSP responds, “Yes, I was working,” then the TSP is prompted to answer the three following questions to complete documentation of the activity performed.

  1. Who were you with?
  2. What were you doing?
  3. Why were you performing the activity?

Medi-Cal Administrative Activities Links