By Bill Scott
KSBA Executive Director
Since 1995, KSBA has assisted Kentucky’s school districts in receiving federal reimbursement for the cost of health services to economically disadvantaged students with disabilities.
What started out as a pilot program for five school districts back in 1995 is now a significant source of district revenue for the 145 participating districts. Subscribers recouped $6.2 million in the most recent school year — and that is not counting the windfall described in the next paragraph.
One of the major reasons for the dramatic growth both in districts and dollars is the relentless advocacy of the service on behalf of school districts. With the support of the Kentucky Department of Education and Cabinet for Human Services, KSBA Medicaid Manager Stephanie Aldridge has worked to expand the scope of district expenses that are eligible for reimbursement. The end result has been a steady increase in revenue for districts.
Cost Settlement Process
The latest of these efforts is the federal Center for Medicaid Services’ recent approval of a cost settlement process for the 2009, 2010 and 2011 school years. Since the reimbursement rates for services provided to Medicaid-eligible students during these years were more than 10 years old, we realized that Kentucky’s districts were not recouping their fair share of the actual cost of these services.
In collaboration with our partners at the Kentucky departments of Education and Medicaid, we convinced the federal Medicaid agency to allow districts to receive the difference between their earlier reimbursements and the actual cost of the service. As a result of this decision, Kentucky’s districts received a windfall of $3.2 million in bonus checks for 2008-09 and an additional $4.6 million for the 2009-10 school year. Both of these payments were received in FY 12. The final 2010-11 cost settlement payment will be issued during the current fiscal year.
Continuous Improvement Yields More Revenue to Members
The cost settlement process is just the latest effort to increase billable services under this program. In 2003, after a year of discussions between KSBA and the Cabinet for Health and Family Services, special transportation services were added to this list.
As a result, on the days that a Medicaid-eligible special ed student receives a related health service, the school district can bill Medicaid for the cost of transporting that student to and from school. At the current rate of $1.50 per mile per child, it’s not surprising that on average, districts taking advantage of this option have doubled the total amount of their annual reimbursement.
KSBA also has led the way in helping districts recoup the cost of assistive technology and equipment for special needs children, such as iPads with speech and hearing applications. KSBA provides districts with contact information for companies willing to sell this equipment at a reduced cost.
This allows districts to receive Medicaid reimbursement for 72 percent to 100 percent of an item’s cost, as long as the equipment is included in the student’s individual education plan (IEP) and purchased with general fund dollars.
In the fall of 2009 KSBA introduced a Web-based application to our Medicaid subscribers called ezEDMed, now used by 60 districts. This customized software allows therapists to electronically document and bill their services in a safe and secure setting that is backed up twice a day and stored in two locations. In addition to its efficiency and confidentiality, districts that submit claims through ezEDMed are receiving their reimbursements within seven days.
Our spirit of partnership with the school districts we serve and our understanding of their financial burden explain why KSBA is constantly improving this service. Aldridge herself, however, goes further with that philosophy.
“As the guardian of a special-needs child for 10 years, I know all too well how important it is to advocate for disadvantaged and disabled children,” she says. “Also as an educator, I know how important it is to understand the special education complexities and how to turn the tremendous amounts of state/federal required documentation into an efficient and user-friendly process.”