| 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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