G1. Why do districts have to participate in the SHARS time study process?

The approved SHARS State Plan language requires that providers submit an annual cost report, with cost reconciliation and cost settlement processes. The State Plan language also requires that providers must participate in the time study in order to bill for SHARS. The results of the time study are the basis for the calculation of the direct services percentage that is used during the cost reporting process to allocate costs down to the Medicaid program.

Participation in the time study means that providers must certify their time study participant list for each quarterly time study by the specified date and must ensure that sampled participants submit responses to sampled moments within seven days of the sampled moment.

G2. How do we determine what staff (including contractors) to include on our participant list to Fairbanks?

  • All staff will be reported into one of two staff pools: 
    • a “Direct Service and Administrative Providers” staff pool or 
    • an “Administrative Services Provider Only” staff pool.
  • Each district must certify that its list of staff being submitted for inclusion in each eligible staff pool are appropriate for participation in the time study and for SHARS or Medical Administrative Claiming (MAC) program. Staff deemed inappropriate during review of time study quarters will be removed from the time study and excluded from SHARS cost report and/or the MAC claim. 
  • A replacement provider can take the place of a person on the certified participant list. If a sampled participant is out on extended leave for more than 51% of the quarter, then a substitute may respond to the moment for the selected employee that is not available. For example, Provider A is on the certified participant list and is replaced temporarily by Provider B during a time study quarter, Provider B may respond in Provider's A place if Provider A is out for more than 51% or the quarter.
  • Vacant positions that are anticipated to be filled during the quarter should be included can the participant list.

Direct Service and Administrative Provider List

Providers of SHARS must be reported in the "Direct Services and Administrative Providers" pool.

No transportation (drivers or mechanics)

Provider Category

SHARS Category of Service

Nurses (RNs, LVNs, LPNs)

Nursing Services

Nurse Practitioners (Advanced Practice Nurses (APNs), Clinical Nurse Specialists and Pediatric Mental Health Nurses)


Nursing Services or Physician Services

Delegated Nursing Services Provider (e.g., clinic aides, home health aides, school health aides, certified nurse aides, certified medication aides)





Licensed Audiologists and Licensed Audiologist Assistants

Audiology and Hearing Services

Psychologists, including LSSPs

Psychological Services - Assessments and/or Treatment Services

Therapists (Occupational, Physical, Speech)

Occupational Therapy; Physical Therapy; Speech and Language Services

Licensed/Certified Therapy Assistants (COTA, LPTA, SLPA)

Occupational Therapy; Physical Therapy; Speech and Language Services

Licensed Marriage & Family Therapists

Counseling Services

Social Workers only LCSWs, unless they provide PCS for which they should be reported under Personal Care Services



Counseling Services

Personal Care Services – e.g., Special Education Teacher; Special Education Teacher's Aide; Bus Aide/Monitor; Orientation & Mobility Specialists; Sign Language Interpreters; Translators




Personal Care Services

Physicians (MDs/DOs), including Psychiatrists


Physician Services

Physician Assistants

Physician Services

Administrative Services Only Provider List (MAC Services)

If providers in any of the following categories provide Personal Care Services or Delegated Nursing Services, they must be reported on the Direct Service and Administrative staff pool.

Administrative staff such as executive directors, program directors, principals, assistant principals, special education directors, and other managers/supervisory staff are not to be included in the time study, unless they provide billable SHARS delegated nursing or personal care services tasks. Likewise, there should be no clerical or administrative support staff included, again, unless they provide billable SHARS delegated nursing or personal care services tasks.

Provider Category

Behavioral Counselor

Outreach Workers

Service Coordinators/Case Managers

Interpreters/Translators/Bilingual Specialists

Pregnancy Education and Parenting Program (PEP)

Orientation & Mobility Specialist (O&M)

Physician Assistant (PA)

  • If these providers bill for Physician Services under SHARS, they must be reported in the Physician category in the Direct Service and Administrative staff pool.

Licensed Bachelors of Social Work (LSW)

Licensed Masters of Social Work (LMSW)

Psychology Intern

G3. Can the same person be designated MAC and SHARS on the RMTS Participant List?

Yes, in order to be claimed on the MAC financials and SHARS cost report (and billable for SHARS to TMHP), the individual would need to be reported under the "Direct Services and Administrative Cost Pool" on the participant list.

G4. We have a contracted Orientation & Mobility Specialist (O&M) as MAC on the PL and we are also billing for the position as direct medical services for PCS. Is this allowed?

If the O&M Specialist was reported on the PL under the Administrative Services Only Cost Pool this is not allowable. If the position was reported under the Direct Services and Administrative Cost Pool this would be allowable.

G5. How often will I need to submit a participant list? Do I need to do a totally new list every time?

The Participant List (PL) can be updated at any time throughout the quarter prior to the time study quarter for which the PL is submitted. The PL should be updated as often as necessary, i.e., as new staff that will be/were included in the time study are hired or leave. If staff does not change in a quarter, the school district does not need to make PL changes. HOWEVER, every federal quarter, even if there have been no staffing changes from the previous quarter, school districts must certify their PL no later than the specified due date.

G6. We have a School Counselor, who is TEA/SBEC certified, that has gone through further training with our local ESC to have a certificate as a Behavior Specialist. Will she be eligible on the PL?

Behavior counselors that are strictly behavior counselors are only allowable as MAC providers and should be listed as Administrative Services Only on the district’s PL. If the behavioral counselor also provides personal care services (PCS) for the district’s SHARS program, he/she can be included on the PL under the Direct Services and Administrative cost pool. In the latter case, the position would be reported as a personal care services provider, not a behavioral counselor.

G7. If I have questions about the time study process, who should I contact?

HHSC Rate Analysis Department, Time Study Unit:

Telephone: (512) 730-7403

E-Mail: TimeStudy@hhsc.state.tx.us

Website: Random Moment Time Study

G8. Who are the MAC contacts?

HHSC Rate Analysis Department, MAC Unit

Telephone: (512) 462-6200

E-Mail: MAC@hhsc.state.tx.us.

Website: Medicaid Administrative Claiming

G9. Who are the SHARS contacts?

HHSC Rate Analysis Department, SHARS Unit

Telephone: (512) 730-7400

E-Mail: RA_SHARS@hhsc.state.tx.us.

Website: School Health and Related Services