Welcomed, Positive Resolutions After Years of Advocacy

It is said that slow and steady wins the race. This adage proved true for longstanding efforts aimed at resolving two issues that had limited the overall Medicaid reimbursement potential for schools in California.

March 25, 2013 – San Francisco, CA – The turn of the New Year has been nothing short of encouraging for those who dedicate their time, resources, and careers to school Medicaid programs, such as the MAA and LEA Billing programs. These programs help to ensure California’s 6.2 million students have access to essential health services and coverage. While regulations for school Medicaid programs are often slow to change, when change does happen it is a welcome affirmation of the hard work and relentless efforts by program advocates of all stripes.

On January 8, 2013, California LEAs recevied confirmation that, as the result of legislation passed in September of 2012, they could begin billing for an expanded range of specialized transportation services beginning with dates of service January 1, 2013. California regulations had previously prevented LEAs from seeking reimbursement for eligible wheelchair or litter van transportation services when those services were provided to students whose disability did not require the child to be physically transported in a wheelchair or in the prone or supine position.

After nearly seven years of advocacy, this new policy entitles California LEAs to reimbursement for the full breadth of eligible transportation services as allowed under the federal definition. (Read Paradigm’s full analysis on the LEA Transportation Billing issue here.) This immediate access to increased reimbursements for specialized transportation will serve to ease the financial stressors that come with providing special education students access to essential health services.

Then, on February 14, 2013, LEAs across the nation received long-awaited relief in the form of new regulations related to obtaining parental consent under the Individuals with Disabilities Education Act (IDEA) for the purpose of accessing public benefits or insurance (i.e., Medicaid) to help pay for eligible services. Previously, this regulation had required LEAs to obtain parental consent each time access to public benefits or insurance was sought. In practice, as documented in a 2009 study conducted by the National Alliance for Medicaid in Education (NAME), compliance with this regulation imposed a considerable administrative and financial burden on schools.

The revised IDEA parental consent regulations, effective March 18, 2013, clarify that LEAs need only obtain a one-time written consent from parents/guardians, coupled with a notification of rights prior to signature and annually thereafter. California LEAs should consult with their internal legal counsel and SELPAs for the most up-to-date guidance on compliance with these new federal regulations. (Read Paradigm’s full analysis of the IDEA Parental Consent issue here, and OSERS’ non-regulatory guidance here.) These new regulations are a win-win for all parties; as OSERS points out, “These final regulations… will make it easier for school districts to access public benefits while still protecting family rights.”

These two policy issues have been “in play” for nearly a decade, with many minds and hands devoted to their positive resolution. Specific to these two policy issues, the effort and leadership exhibited by California’s LEA Ad-Hoc Workgroup (ref: transportation services) and National Alliance for Medicaid in Education (ref: parental consent) cannot go unacknowledged—Paradigm congratulates all those involved in bringing about these changes.

Paradigm clients have been provided additional detail and guidance on implementing these recent policy changes—clients can contact Paradigm directly via email or by phone at (888) 536-0920 with any questions.