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OUR PROJECT

Medicaid in Schools 

Increasing access to reimbursement for covered social work services provided in public schools.

 

Issue

In Minnesota, schools are required to seek reimbursement for health related services that are provided as part of an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP). Unfortunately, our schools are not maximizing this reimbursement due to administrative barriers supported by the Minnesota Department of Human Services (DHS). This has cost Minnesota schools around 10 million dollars annually in sustainable federal funding. In addition, services provided by school social workers, while eligible for reimbursement, are not included in state statute for reimbursement and face similarly challenging administrative barriers. 

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Overview 

Education and health are intimately linked. Schools play an ever increasing role in supporting student’s health and improving equity in health and education outcomes. This project aims to support improved methods for leveraging innovative and simplified ways to access reimbursement for Medicaid covered services that are provided by schools.

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Nearly 80 percent of children who receive behavioral services access them at school. 

Top Barriers

  • Stigma around school social workers despite many having the same qualifications as other licensed social workers

  • DHS and NAMI aligned on requiring diagnosis and approvals under CTSS (Children’s Therapeutic Services & Supports)

  • Current language only includes students with IEPs, while school nurses hope to expand reimbursable services to students with 504, IHPs, and BIPs

  • Minnesota requires parents sign a second consent for schools to begin seeking reimbursement; a duplicative consent parents sign when signing up for Medical Assistance. Schools provide Procedural Safeguards to ensure that parents/guardians are informed and then are required to wait a year to bill if the parent does not sign and return the second consent placing undue restrictions and administrative burdens on schools. 

  • Billing criteria is intended for community-based settings and does not align with school operations 

Opportunities for Engagement

01

Legislative Policy

Support efforts to pass legislation changing the statute to include services provided by social workers.

03

Tools for Service Providers

Create guidance for school districts to align on billing procedure and develop mock claims of common situations with clear billing guidance.

02

Administrative Policy

Address administrative burdens with CTSS, DHS, MDH, MDE to identify ways to support billing procedures.

04

Family Advocacy

Share language and success stories with parent-focused groups to debunk common myths and help families understand the benefit of applying Medicaid to school services.

PROJECT FOCUS

Thanks to years of work already in motion, and the advantageous position of the MN State Legislative session for issues related to education and health, our project team determined we could be most effective by supporting bills that would change the statute to include services provided by social workers.

 

THE BILLS

HF 1175: Authors Youakim, Frederick, Pryor, Kiel, Hemmingsen-Jaeger, Clardy, Pursell

SF 1028: Authors Frentz, Wiklund, Abeler, Hoffman, Mitchell
 

PROJECT TIMELINE

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