Accelify Blog

Trade-off Marks Special Ed Funding (KS)

July 26, 2010

As expected, the Centers for Medicare and Medicaid Services has determined Kansas school districts can no longer seek Medicaid reimbursement for attendant care services for students who have severe physical or emotional disabilities, a decision that will costs those districts about $8.5 million in the upcoming school year.

In confirming the change, the Kansas Health Policy Authority this week also said that CMS has approved a new Medicaid reimbursement method for other services that will result in a net gain of $5 million to $10 million for school districts and special education cooperatives.

However, special education directors r emain concerned and to some extent unconvinced.

Linda Grote, director of special education for USD 308, said the Hutchinson school system will continue providing attendant care services but pay for them out of local funds, as it did until the last school year, when it sought Medicaid reimbursement for the first time.

"We’re not going to reduce services. We can’t," she said.

Attendant care services include tube feeding, helping with medications, toileting, mobility and other services without which some special education students could not attend school.

CMS had ruled that the school districts could not seek Medicaid reimbursement for those services unless the state plan also provided reimbursement for those services in non-school settings as well. Because the cost of doing so would have been prohibitive, the state withdrew attendant care services from its Medicaid plan.

To try to offset the loss of revenue for school districts, KHPA is touting what it says will be a higher rate of reimbursement for other services.

Currently, schools are reimbursed for services such as specialized transportation, nursing services, occupational and physical therapy, speed, language and hearing services on a fee-for-service basis that KHPA says pays less than the actual cost of those services.

Retroactively to July 1, 2009, education organizations will be able to submit end-of-year reports and get additional reimbursement for the difference between the fee-for-service schedule and actual costs. They also will be able to bill for two new services: psychologists and social workers.

However, Grote isn’t counting on any additional revenue for USD 308. She said the district has always kept its costs low and she isn’t convinced that 2009-10 cost-settlement reports to be submitted in September will show that the district has spent more than it received on the fee-for-service schedule. The district also doesn’t provide the psychological and social work services that can now be reimbursed.

KHPA said that because a number of school districts have expressed concern that the loss of funding for attendant care services will create a financial hardship, the organization will discuss the changes at a meeting of the Leadership Conference for Special Education Directors on July 30 in Wichita.