2023 -- H 5010 AS AMENDED

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LC000041

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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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

     Date Introduced: January 06, 2023

     Referred To: House Education

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 40-8-18 of the General Laws in Chapter 40-8 entitled "Medical

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Assistance" is hereby amended to read as follows:

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     40-8-18. Local education agencies as EPSDT providers.

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     (a) It is the intent of this section to provide reimbursement for early and periodic screening,

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diagnosis and treatment (EPSDT) services through local education agencies for children who are

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eligible for medical assistance. A local education agency’s participation as an EPSDT provider is

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voluntary. Further, it is the intent that collaboration among the department of human services

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(DHS), the department of elementary and secondary education, and local education agencies

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(LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT

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services.

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     (b) The services available to eligible children under Title XIX of the Social Security Act,

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42 U.S.C. § 1396 et seq., for early and periodic screening, diagnosis, and treatment (EPSDT) may

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be provided by local education agencies.

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     (c)(1) Voluntary participation as an EPSDT provider shall require the local education

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agency to provide the state match to obtain federal financial participation for EPSDT services and

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associated administrative costs by certifying to the department of human services that sufficient

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qualifying local funds (local certified match) have been expended for the services and

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

 

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provide local certified match for those EPSDT services for which the department of human

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services, or another state agency, agrees to provide the state match to obtain federal financial

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participation for EPSDT services.

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     (2) The local certified match shall be established in the local education agency pursuant to

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federal Title XIX provisions. Failure of the local education agency to provide the local match shall

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result in the penalties described in subsection (f).

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     (3) The department of human services shall pay the local education agency from the federal

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matching funds for EPSDT services pursuant to fee schedules established by rules and regulations

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of the department of human services, and for associated administrative costs pursuant to

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administrative cost reimbursement methodologies to be approved by the federal government, upon

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certification of the local match by the local education agency in accordance with federal Title XIX

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provisions. Payments made to the local education agency pursuant to this section shall be used

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solely for educational purposes and shall not be made available to local communities for purposes

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other than education. The local fiscal effort to support education referred to in subsection (d) shall

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not be reduced in response to the availability of these federal financial participation funds to the

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local education agency. These federal financial participation funds must supplement, not supplant,

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local maintained fiscal effort to support education.

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     (4) For the purposes of this subsection, the term “local education agency” shall include any

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city, town, state, or regional school district or the school for the deaf or the William M. Davies, Jr.

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career and technical high school, the Metropolitan Career and Technical Center, any public charter

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school established pursuant to chapter 77 of title 16, any educational collaborative established

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pursuant to chapter 3.1 of title 16, or the department of children, youth and families (DCYF).

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     (d)(1) Each community shall maintain local fiscal effort for education. For the purpose of

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this subsection, to “maintain local fiscal effort” means each community shall contribute local funds

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to its school committee in an amount not less than its local contribution for schools in the previous

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fiscal year.

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     (2) Further, state support for education shall not be reduced from the prior fiscal year in

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response to local community participation in the EPSDT program.

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     (e) The department of human services and the department of elementary and secondary

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education shall effect the interagency transfers necessary to comply with the provisions of this

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section. The department of elementary and secondary education and the department of human

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services are authorized to promulgate any and all regulations necessary to implement this section.

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All local school agencies becoming EPSDT providers shall be required to comply with all

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provisions of Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., relative to

 

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responsibilities of a Medicaid provider.

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     (f) Failure of the local education agency to establish a local certified match under this law

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sufficient to support its claims for reimbursement of EPSDT services and associated administrative

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costs will result in the withholding of state funds due that community in accordance with § 16-7-

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31 in an amount equal to the federal financial participation funds denied by the federal government

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as a result thereof. The withheld funds will be transferred to the department of human services.

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     (g) The department of human services, with the aid of the department of education, shall

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determine which healthcare-related services are eligible for federal Medicaid reimbursement for

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health-related services provided by local education agencies to children eligible for early periodic

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screening, diagnosis and treatment. The department of human services, with the assistance of the

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department of administration, shall also develop the following resources in furtherance of the goal

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of recouping the maximum amount of administrative costs associated with the services:

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

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personnel to enhance recovery of administrative costs; and

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     (2) A claiming manual that outlines the financial information and claim submission

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requirements that are needed to complete the claim.

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     (h) Services provided by school social workers and certified school psychologists who are

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certified by the department of elementary and secondary education shall be included as health care

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related services eligible for federal Medicaid reimbursement pursuant to this section. These school

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social workers and certified school psychologists shall be eligible to participate in time studies as

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local education agency employees and contractors.

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     (i) The general assembly encourages the executive office of health and human services and

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the department of elementary and secondary education to collaborate and pursue pathways to

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expand opportunities for local education agencies to bill and obtain federal Medicaid

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reimbursement for eligible services delivered in schools.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE -- THE PROMOTING

ACCESS TO INCREASED MENTAL HEALTH SERVICES FOR ALL STUDENTS ACT

***

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

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

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reimbursement.

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     This act would take effect upon passage.

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