2018 -- H 7401

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

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A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

     

     Introduced By: Representatives McNamara, Diaz, Ackerman, Carson, and O'Brien

     Date Introduced: February 01, 2018

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 40-8-18 of the General Laws in Chapter 40-8 entitled "Medical

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Assistance" is hereby amended to read as follows:

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     40-8-18. Local education agencies as EPSDT providers.

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     (a) It is the intent of this section to provide reimbursement for early and periodic

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screening, diagnosis and treatment (EPSDT) services through local education agencies for

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children who are eligible for medical assistance. A local education agency's participation as an

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EPSDT provider is voluntary. Further, it is the intent that collaboration among the department of

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human services (DHS), the department of elementary and secondary education and local

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education agencies (LEAs) will result in state and local funds being used to maximize federal

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funding for such EPSDT services.

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     (b) The services available to eligible children under Title XIX of the Social Security Act

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for early and periodic screening, diagnosis and treatment (EPSDT) may be provided by local

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education agencies.

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     (c) (1) Voluntary participation as an EPSDT provider shall require the local education

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agency to provide the state match to obtain federal financial participation for EPSDT services and

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associated administrative costs by certifying to the department of human services that sufficient

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qualifying local funds (local certified match) have been expended for such services and

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administrative costs; provided, however, that a local education agency shall not be required to

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provide local certified match for those EPSDT services for which the department of human

 

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services, or another state agency, agrees to provide the state match to obtain federal financial

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participation for EPSDT services.

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     (2) The local certified match shall be established in the local education agency pursuant

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to federal Title XIX provisions. Failure of the local education agency to provide the local match

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shall result in the penalties described in subsection (f).

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     (3) The department of human services shall pay the local education agency from the

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federal matching funds for EPSDT services pursuant to fee schedules established by rules and

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regulations of the department of human services, and for associated administrative costs pursuant

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to administrative cost reimbursement methodologies to be approved by the federal government,

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upon certification of the local match by the local education agency in accordance with federal

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Title XIX provisions. Payments made to the local education agency pursuant to this section shall

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be used solely for educational purposes and shall not be made available to local communities for

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purposes other than education. The local fiscal effort to support education referred to in

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subsection (d) shall not be reduced in response to the availability of these federal financial

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participation funds to the local education agency. These federal financial participation funds must

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supplement, not supplant, local maintained fiscal effort to support education.

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     (4) For the purposes of this subsection, the term "local education agency" shall include

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any city, town, state or regional school district or the school for the deaf or the William M.

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Davies, Jr. career and technical high school, the Metropolitan Career and Technical Center, any

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public charter school established pursuant to chapter 77 of title 16 of the general laws, any

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educational collaborative established pursuant to chapter 3.1 of title 16 of the general laws, or the

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department of children, youth, and families (DCYF).

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     (d) (1) Each community shall maintain local fiscal effort for education. For the purpose

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of this subsection, to "maintain local fiscal effort" means each community shall contribute local

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funds to its school committee in an amount not less than its local contribution for schools in the

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previous fiscal year.

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     (2) Further, state support for education shall not be reduced from the prior fiscal year in

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response to local community participation in the EPSDT program.

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     (e) The department of human services and the department of elementary and secondary

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education shall effect the interagency transfers necessary to comply with the provisions of this

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section. The department of elementary and secondary education and the department of human

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services are authorized to promulgate any and all regulations necessary to implement this section.

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All local school agencies becoming EPSDT providers shall be required to comply with all

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provisions of Title XIX, 42 U.S.C. § 1396 et seq., of the Social Security Act relative to

 

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responsibilities of a Medicaid provider.

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     (f) Failure of the local education agency to establish a local certified match under this law

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sufficient to support its claims for reimbursement of EPSDT services and associated

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administrative costs will result in the withholding of state funds due that community in

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accordance with § 16-7-31 in an amount equal to the federal financial participation funds denied

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by the federal government as a result thereof. The withheld funds will be transferred to the

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department of human services.

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     (g) The department of human services, with the aid of the department of education, shall

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determine which health care related services are eligible for federal Medicaid reimbursement for

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health related services provided by local education agencies to children eligible for early periodic

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screening diagnosis and treatment. The department of human services, with the assistance of the

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department of administration, shall also develop the following resources in furtherance of the goal

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of recouping the maximum amount of administrative costs associated with such services:

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     (1) A time study training manual which outlines how to complete a time study by school

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personnel to enhance recovery of administrative costs; and

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     (2) A claiming manual, which outlines the financial information and claim submission

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requirements that are needed to complete the claim.

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     (h) Services provided by school social workers and certified school psychologists who

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are certified by the department of elementary and secondary education shall be included as health

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care related services eligible for federal Medicaid reimbursement pursuant to this section. These

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school social workers and certified school psychologists shall be eligible to participate in time

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studies as local education agency employees and contractors.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

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     This act would direct that services provided by school social workers and certified school

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psychologists would be included as health care related services eligible for federal Medicaid

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reimbursement.

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     This act would take effect upon passage.

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