2017 -- H 5077

========

LC000173

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2017

____________

A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

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

     Date Introduced: January 11, 2017

     Referred To: House Finance

     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

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 such services and

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

provide 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 of the general laws, any

educational collaborative established pursuant to chapter 3.1 of title 16 of the general laws, 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, 42 U.S.C. § 1396 et seq., of the Social Security Act relative to

LC000173 - Page 2 of 4

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 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 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 such services:

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

personnel to enhance recovery of administrative costs; and

     (2) A claiming manual, which 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.

     SECTION 2. This act shall take effect upon passage.

========

LC000173

========

LC000173 - Page 3 of 4

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

***

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

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

reimbursement.

     This act would take effect upon passage.

========

LC000173

========

LC000173 - Page 4 of 4