[MM Curator Summary]: A CO school will re-sign up to get Medicaid funding for healthcare services after a 10 year break and starting a new plan on how to manage the funding stream.
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After a hiatus of more than a decade, Poudre School District is rejoining Colorado’s Medicaid reimbursement program for school districts. Through the program, PSD will receive partial reimbursements from the state for the cost of providing Medicaid-eligible health services to some students.
Reimbursements to PSD will be based on the cost of delivering services given by eligible service providers — including nurses, social workers, health aides, occupational therapists and more — but it is not limited to services provided to students who are enrolled in Medicaid individually. Rather, the program partially reimburses health services provided to general education students who qualify through certain health or behavioral plans.
The program will serve as “a sustainable source of funding that supports the enhancement and expansion of mental and physical health services in schools,” according to a presentation recently given to the Board of Education.
The money the district receives in reimbursements must be spent on health services for all PSD students, not just those who receive the reimbursement-eligible services. This shift is something PSD spokesperson Madeline Noblett said was one of the main reasons the district wanted to join the program again now.
“We’re really looking at this as an opportunity as a district to be able to grow revenue to support all of our students,” she said, adding that the “mental, social, emotional (and) academic needs of kids have increased.”
“Our needs have continued to increase every year, and our staff are doing incredible work, but they are stretched thin, and they’re supporting so many kids … So we’re constantly just looking to see what the resources available to us are that we may not already be tapping into.”
Though PSD’s new Medicaid Coordinator Corey Henry said they haven’t yet determined what this money will be spent on, it can be used for things such as hiring additional nurses or mental health staff, getting more equipment or engaging with outreach workers to connect families to their needs. A requirement of the program is that the district form a team to assess its needs and how best to spend the money.
Currently, PSD has just 14 nurses for its 53 schools, according to Kim Granger, health services coordinator.
“It just feels like the right thing to do to not leave money on the table when we’re (already) providing the services,” Granger said. “It was kind of a no-brainer in my mind.”
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PSD was most recently a participant in the Medicaid program in 2009. In the 2016-17 school year, former Superintendent Sandra Smyser considered rejoining the program but ultimately put it on hold.
Noblett said that back in 2009, the district left the program because leaders felt it wasn’t “as expansive as possible for the ultimate amount of money that we were generating as a district.”
However, the program has since started using a cost reconciliation method to calculate reimbursements and, in 2020, it expanded to include reimbursement for Medicaid-eligible health services to more students. Prior to that change, the program allowed reimbursement based on care given to students with individualized education plans or individualized family service plans, but it now includes students with 504 plans, behavior intervention plans and other health care plans, Noblett said.
These changes streamlined the program and allowed districts to claim more costs for the health services they provide to students, according to district officials.
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When will the program be in place?
PSD expects the program will be fully in place by Oct. 1 this year, but it won’t see regular revenue to cover the initial investment costs for about three years. The only initial investment required by PSD was the cost to fund Henry’s position and an administrative assistant to help get the program running.
Though district officials cannot predict the exact amount of money it will bring in annually until closer to that three-year mark, neighboring districts and those of similar size have received anywhere from $1.2 million to $2.5 million.
Over the summer, Henry and her implementation team will work to create training schedules for staff, have orientation for administrative teams and begin program training in August and September.
Henry and Granger expect that the biggest change for current PSD providers will be the kind of documentation required to access the reimbursement money, though it’s too early to know what the day-to-day lift will look like.
“There will be some (service providers) with larger caseloads that will probably have more time to spend on their documentation, and some of that won’t take as much time as they think,” Granger said. “I think there’s a ton of fear out there that it’s going to take a huge amount of time, (but) the program is different than what they knew before.”
In the meantime, the biggest lift for Henry and her team will be supporting the staff throughout training and ensuring they understand their roles in the program moving forward.
“We’re really hoping to make this as successful as possible, build a program where staff feels supported through training, have clarity around what their work looks like as service providers and really, again, generate money that PSD has not been accessing so that we can help our students,” Noblett said.
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Molly Bohannon covers education for the Coloradoan. Follow her on Twitter @molboha or contact her at firstname.lastname@example.org. Support her work and that of other Coloradoan journalists by purchasing a digital subscription today.
Clipped from: https://www.coloradoan.com/story/news/2022/04/26/psd-rejoining-colorados-medicaid-reimbursement-program/7374814001/