Regional Representative Update
Melinda Hollinshead (AZ), Cathy Bennett (CA), Stacie Martin (KS)
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Positive Growth Happening with Washington State’s School-Based Health Care Services and Medicaid Administrative Claiming Programs
Washington State’s School-Based Health Care Services (SBHS) program could soon be experiencing a positive expansion. The Individuals with Disabilities Education Act (IDEA) Part C services, known as early intervention (birth to age three), is soon to be added to the SBHS program in Washington State. SBHS currently reimburses participating school districts for health-care-related service, but only for children and students ages 3 to 21 under IDEA Part B. The Department of Early Learning (DEL) and Washington’s Health Care Authority (HCA-Medicaid agency) have determined approximately 300 children statewide currently receive Part C services in the school setting but the school districts are not being reimbursed for these services.
Reimbursement for Part C services under the SBHS program would allow schools to draw down additional state and federal monies. Once a Medicaid state plan amendment (SPA) has been submitted and approved by the federal Centers for Medicare and Medicaid Services (CMS), participating school districts will be allowed to retroactively submit claims, effective April 1, 2014. The current plan is that the Washington state Medicaid agency will submit a SPA to CMS by the end of June 2014.
Medicaid reimbursement to schools for Part C services not only requires a Medicaid state plan amendment (SPA), but also revisions to the Washington Administrative Code (WAC), updates to the SBHS Medicaid Provider Guide, and ongoing training for school districts will need to occur. The Washington state Medicaid agency anticipates this preparation process will take approximately one year with no budget impact.
Washington State Charter Schools to Receive Medicaid SBHS Reimbursement
The positive growth at HCA does not stop there with both SBHS and Medicaid Administrative Claiming (MAC) programs. In June 2014, the State’s first charter school (First Place Scholars) prepares to open their doors to any student living in Washington State. First Place Scholars, a social-services agency in Seattle’s Central Area, provides a variety of supports for children who are homeless and those with disabilities. First Place Scholars will become a publicly funded K-5 charter school starting in the Fall 2014, and intends to participate in the Medicaid MAC and SBHS programs.
Charter schools across Washington State that elect to become enrolled as a Medicaid provider and comply with the licensure and billing requirements of a local education agency, will be allowed to contract with HCA for reimbursement of direct health-care-related services for Medicaid eligible children in Special Education and MAC. In Washington State, charter schools are free, privately operated schools that are not bound by many of the rules and regulations that govern traditional public school districts. Under Initiative 1240 approved by the voters in November 2012, they are considered public schools because they receive taxpayer dollars on a per-student basis, like other public school districts in Washington State. Washington State will be the 42nd state to allow public charter schools.