Staff from the Alaska Department of Health (DOH) presented a bill to the legislature that would expand access to school-based services for Medicaid eligible children.
Senate Bill 240 is sponsored by the Senate Rules Committee at the request of Gov. Mike Dunleavy.
DOH Commissioner Heidi Hedberg introduced the bill at a Senate Health and Social Services committee meeting on Tuesday.
“SB 240 supports access to school-based services by removing statutory barriers that limit access to school-based services,” Hedberg said. “This bill provides convenient choices for parents seeking care for their children, supports parent-directed services provided in the school setting, promotes early intervention and promotion, and removes barriers from schools leveraging [a] federal Medicaid match, and increases flexibility for schools to seek Medicaid reimbursement for eligible children.”
Emily Ricci, deputy commissioner for DOH, said school-based health services include speech language therapy, occupational and physical therapy, behavioral health services, and nursing services. The current law bars certain Medicaid-eligible students from being covered for these services in schools.
“State law currently requires that, in order for a service to be Medicaid reimbursable when offered to a student who is Medicaid-eligible, that service [must] be outlined in a student’s Individualized Education Plan (IEP) and that student [must] be disabled,” Ricci said.
The bill would remove the state’s requirement that the services must be outlined under an IEP. That means any Medicaid-eligible student would be able to access the services, regardless of whether the child has a disability or not.
Schools would be able to choose which services they would like to provide. No school would be required to participate in providing additional services.
Six of Alaska’s 54 school districts currently submit claims for Medicaid reimbursement for school-based services. Speech therapy, occupational therapy, and physical therapy make up 96 percent of reimbursed services.
“These are not new services, these are not new eligibility groups. These are similar services being made available in a setting that is already authorized, but being made available to more students.”
— Ricci
Leah Van Kirk, healthcare policy advisor for DOH, discussed some of the benefits the bill would provide to Alaskans.
“Oftentimes, children may not have qualified for the level necessary to receive a service, and so they’ve had to receive services in a community-based setting,” she said. “So this allows schools to make decisions about the services they are able to provide, and includes children that may not have been able to access services previously.”
Van Kirk said having services in schools is important for both the children and their families.
Children spend almost every day in their school, so with the passage of the bill, they would be able to receive care in a setting in which they are comfortable. It also allows parents more flexibility as they do not have to leave work and pull their child out of school to find these services in a community setting.
“This isn’t the answer. It is a part of the answer to provide services to our youth that meet their needs.”
— Van Kirk
Ricci acknowledged the challenges that will come with the bill. One barrier includes the process for schools to seek reimbursement, which can be challenging.
“There are other barriers that the department will have to work with school districts to address and we’re prepared to do that,” Ricci said.
DOH work groups would meet with school districts to work out some of the challenges.
Sen. David Wilson (R-Wasilla), committee chair, asked about the fiscal impact of the bill.
The bill encourages school districts to leverage federal Medicaid matching funds, which would be between 50 and 65 percent of cost. Ricci said the current system already has school districts pre-funding the state’s match for services. But it can be a complicated administrative process.
“We anticipate a slow uptick in utilization of school-based services, partly because we need to work through the administrative challenges,” Ricci said.
Ricci said the bill would result in more of a cost shift within Medicaid rather than a new cost to the system by using these services in a preventative manner before the state has to pay for a higher level of care.
DOH is also applying for a grant that would cover implementation costs and contractual support. The grant also focuses on ensuring that rural communities can participate in the program.
If the grant is not awarded, DOH will still plan to move forward with the bill.
Van Kirk said the grant is an opportunity to explore ways to work more effectively with schools to improve their current process of submitting reimbursement claims.
“Prior to the release of this grant we had already planned on engaging stakeholders, and we had planned on supporting this bill, so we have engaged consultation support to help guide us through this process,” Van Kirk said.
If DOH is awarded the grant, it will receive $2.5 million over three years.
SB 240’s counterpart in the House, HB 343, is scheduled for a hearing in the House Health and Social Services Committee on Thursday.