Chapter 260 |
2023 -- S 0869 SUBSTITUTE A 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: Senators Cano, Gu, and DiMario |
Date Introduced: March 30, 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. |
======== |
LC000744/SUB A |
======== |