Introduced By: Representatives George, Sherlock, Jacquard, Benoit and Fleury
Date Introduced : February 2, 1999
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 education (DOE) and local education agencies (LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT services through special education programs provided, however, that the EPSDT services are limited to those currently provided by LEAs.
(b) The services available to eligible children under Title XIX of the Social Security Act for early and periodic screening, diagnosis and treatment (EPSDT) may be provided by local education agencies through their special education programs provided, however, that the EPSDT services are limited to those currently provided by LEAs. The local education agency may become an EPSDT provider upon authorization by both the local governing authority and the local school committee. State operated districts may become an EPSDT provider upon authorization of the state governing authority.
(c) (1) Voluntary participation as an EPSDT provider shall require the local community to designate state education aid funds as the state match to obtain federal financial participation for EPSDT services or to certify local funds as the local match to obtain federal financial participation for EPSDT services. The state match shall be deposited in a restricted receipt account within the department of elementary and secondary education separate from all other accounts within the department of elementary and secondary education. The account shall be known as the local education agency EPSDT account. The state match will be drawn from state education funds available under chapter 7 of title 16. Funds from the restricted receipt account shall be transferred to the department of human services upon their request.
(2) The local certified match shall be established in the local governing authority pursuant to federal Title XIX provisions. Failure of the local community to provide the local match shall result in the penalties described in subsection (f).
(3) In the case of the state match, the department of human services shall pay the local community from the restricted receipt account and the federal matching funds for EPSDT services pursuant to fee schedules established by rules and regulations of the department of human services. In the case of the local match, the department of human services shall pay the local community from the federal matching funds for EPSDT services upon certification of the local match in accordance with federal Title XIX provisions.
(4) For the purposes of this subsection, the term community 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 or the department for children, youth, and families (DCYF).
(d) (1) [Version enacted by P.L. 1992, ch. 289, section 1.] Each community which chooses to participate as an EPSDT provider shall maintain local fiscal effort for education. For the purpose of this subsection, to "maintain local fiscal effort" means that the annual minimum appropriation for approved school expenditures must be an amount which, when divided by the state's share of the basic program, is no less than the ratio of local to state funds as appropriated in the prior fiscal year.
(2) Further, state support for education should not be reduced from the prior fiscal year in response to local community participation in the EPSDT program.
(d) (1) [Version enacted by P.L. 1992, ch. 399, section 1.] Each community which chooses to participate as an EPSDT provider shall maintain local fiscal effort for education. For the purposes of this subsection, maintenance of local fiscal effort shall mean that the annual minimum appropriation for approved school expenditures must be an amount which, when divided by the state's share of the basic program, is no less than the ratio of local to state funds as appropriated in the prior fiscal year.
(2) Further, state support for education should 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 commissioner of education, 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. Any local school agency becoming an EPSDT provider shall be required to comply with all provisions of Title XIX, 42 U.S.C. section 1396 et seq., of the Social Security Act relative to responsibilities of a medicaid provider.
(f) Failure of the community to establish a local certified match under this law will result in the withholding of state funds due that community in accordance with section 16-7-31. The withheld funds will be transferred to the department of human services through the restricted receipt account in accordance with the procedure outlined in subsection (c).
(g) A review committee shall be established July 1, 1994 to examine the effectiveness of the legislation. The committee shall consist of the director of the department of human services or his or her designee, the commissioner of elementary and secondary education or his or her designees, the director of the department of children, youth and families or his or her designee and representatives from both the local communities and the legislature.
{ADD (h) The department of human services with the aid of the department of education shall conduct a study to determine which health care 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 shall also develop the following resources in furtherance of the goal of recouping the maximum amount of costs associated with such services; ADD}
{ADD (A) A time study training manual which outlines how to complete a time study by school personnel to enhance recovery of administrative costs; ADD}
{ADD (B) A claiming manual which outlines the financial information and claim submission requirements that are needed to complete the claim. ADD}
SECTION 2. This act shall take effect upon passage.
