Chapter 259
2023 -- H 5010 AS AMENDED
Enacted 06/22/2023

A N   A C T
RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE -- THE PROMOTING ACCESS TO INCREASED MENTAL HEALTH SERVICES FOR ALL STUDENTS ACT

Introduced By: Representatives McNamara, Shallcross Smith, Fenton-Fung, Noret, and Donovan

Date Introduced: January 06, 2023

It is enacted by the General Assembly as follows:
     SECTION 1. Section 40-8-18 of the General Laws in Chapter 40-8 entitled "Medical
Assistance" is hereby amended to read as follows:
     40-8-18. Local education agencies as EPSDT providers.
     (a) It is the intent of this section to provide reimbursement for early and periodic screening,
diagnosis, and treatment (EPSDT) services through local education agencies for children who are
eligible for medical assistance. A local education agency’s participation as an EPSDT provider is
voluntary. Further, it is the intent that collaboration among the department of human services
(DHS), the department of elementary and secondary education, and local education agencies
(LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT
services.
     (b) The services available to eligible children under Title XIX of the Social Security Act,
42 U.S.C. § 1396 et seq., for early and periodic screening, diagnosis, and treatment (EPSDT) may
be provided by local education agencies.
     (c)(1) Voluntary participation as an EPSDT provider shall require the local education
agency to provide the state match to obtain federal financial participation for EPSDT services and
associated administrative costs by certifying to the department of human services that sufficient
qualifying local funds (local certified match) have been expended for the services and
administrative costs; provided, however, that a local education agency shall not be required to
provide the local certified match for those EPSDT services for which the department of human
services, or another state agency, agrees to provide the state match to obtain federal financial
participation for EPSDT services.
     (2) The local certified match shall be established in the local education agency pursuant to
federal Title XIX provisions. Failure of the local education agency to provide the local match shall
result in the penalties described in subsection (f).
     (3) The department of human services shall pay the local education agency from the federal
matching funds for EPSDT services pursuant to fee schedules established by rules and regulations
of the department of human services, and for associated administrative costs pursuant to
administrative cost reimbursement methodologies to be approved by the federal government, upon
certification of the local match by the local education agency in accordance with federal Title XIX
provisions. Payments made to the local education agency pursuant to this section shall be used
solely for educational purposes and shall not be made available to local communities for purposes
other than education. The local fiscal effort to support education referred to in subsection (d) shall
not be reduced in response to the availability of these federal financial participation funds to the
local education agency. These federal financial participation funds must supplement, not supplant,
local maintained fiscal effort to support education.
     (4) For the purposes of this subsection, the term “local education agency” shall include any
city, town, state, or regional school district or the school for the deaf or the William M. Davies, Jr.
career and technical high school, the Metropolitan Career and Technical Center, any public charter
school established pursuant to chapter 77 of title 16, any educational collaborative established
pursuant to chapter 3.1 of title 16, or the department of children, youth and families (DCYF).
     (d)(1) Each community shall maintain local fiscal effort for education. For the purpose of
this subsection, to “maintain local fiscal effort” means each community shall contribute local funds
to its school committee in an amount not less than its local contribution for schools in the previous
fiscal year.
     (2) Further, state support for education shall not be reduced from the prior fiscal year in
response to local community participation in the EPSDT program.
     (e) The department of human services and the department of elementary and secondary
education shall effect the interagency transfers necessary to comply with the provisions of this
section. The department of elementary and secondary education and the department of human
services are authorized to promulgate any and all regulations necessary to implement this section.
All local school agencies becoming EPSDT providers shall be required to comply with all
provisions of Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., relative to
responsibilities of a Medicaid provider.
     (f) Failure of the local education agency to establish a local certified match under this law
sufficient to support its claims for reimbursement of EPSDT services and associated administrative
costs will result in the withholding of state funds due that community in accordance with § 16-7-
31 in an amount equal to the federal financial participation funds denied by the federal government
as a result thereof. The withheld funds will be transferred to the department of human services.
     (g) The department of human services, with the aid of the department of education, shall
determine which healthcare-related services are eligible for federal Medicaid reimbursement for
health-related services provided by local education agencies to children eligible for early periodic
screening, diagnosis, and treatment. The department of human services, with the assistance of the
department of administration, shall also develop the following resources in furtherance of the goal
of recouping the maximum amount of administrative costs associated with the services:
     (1) A time-study training manual that outlines how to complete a time study by school
personnel to enhance recovery of administrative costs; and
     (2) A claiming manual that outlines the financial information and claim submission
requirements that are needed to complete the claim.
     (h) Services provided by school social workers and certified school psychologists who are
certified by the department of elementary and secondary education shall be included as health-care
related services eligible for federal Medicaid reimbursement pursuant to this section. These school
social workers and certified school psychologists shall be eligible to participate in time studies as
local education agency employees and contractors.
     (i) The general assembly encourages the executive office of health and human services and
the department of elementary and secondary education to collaborate and pursue pathways to
expand opportunities for local education agencies to bill and obtain federal Medicaid
reimbursement for eligible services delivered in schools.
     SECTION 2. This act shall take effect upon passage.
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