South Sound school districts that participated in a state study last fall designed to streamline how they are reimbursed for certain services fear it could end up costing them time, money – or both.
But officials at the state Health Care Authority (HCA), which is directing the changes, say they’ve heard the school districts’ concerns and are trying to address them.
The services involve federal Medicaid dollars, which provide medical care to the needy – including students.
The program, overseen by HCA, allows school districts reimbursement for time their employees spend making referrals, steering eligible kids and families toward community medical services, and helping them fill out forms to qualify for Medicaid assistance.
One example: A school principal might talk to a student about how the student can get substance abuse counseling.
About 130 of the state’s 295 school districts choose to participate in the program. The reimbursement system generates an estimated $10 million to $12 million a year, split between participating districts, according to HCA officials.
The idea behind the program is that all parties benefit because students do better in class when they’re healthy, and educators have the greatest access to kids in need.
“If anyone can make sure that students are accessing health care, it’s schools,” says Val Jones, director of Alternative Education in the Franklin Pierce School District. She’s the Parkland-based district’s point person on Medicaid reimbursement, and she’s part of a statewide group of school and HCA officials working on the time-accounting system.
Jones and others have raised concerns over changes HCA has suggested that would alter how school personnel keep tabs on their Medicaid time.
Preston Cody, assistant director for health care services at HCA, said his agency’s intent is not to cut school revenues or create burdens for school employees.
Alan Himsl, supervisor for Medicaid outreach at HCA, said the current paper-based system is old and cumbersome. The agency wants an electronic system to replace it.
What form that system will take is what the school districts and HCA are debating.
“We wanted to move to a less administratively burdensome process,” Himsl said.
An initial HCA proposal involved school personnel replying to computer-generated emails asking what they were doing at random moments in time, and whether their activities were reimbursable Medicaid tasks.
Four school districts – Franklin Pierce, Fife, Olympia and South Bend – volunteered to pilot the system last fall.
What they found shocked them. According to a letter superintendents in those four districts sent March 21 to state Superintendent of Public Instruction Randy Dorn, the change would have cost the districts significant dollars compared with what they currently receive.
Districts currently use a paper-based system that requires them to document their Medicaid activities only 15 days out of the school year. And they can count the activity no matter when it occurs in a school day.
Tying the time accounting to random moments missed a lot of the moments, the districts say.
In Franklin Pierce, officials estimated they could have lost nearly $1.5 million over the school year, had the pilot system been implemented.
In the Olympia School District, the projected losses were smaller – nearly $130,000. In Fife, the projected loss was more than $600,000, and in South Bend, more than $80,000. But superintendents in all four pilot districts were concerned enough to send the letter to Dorn, citing potential budget impacts.
Schools have great flexibility in how they spend their Medicaid money. In Franklin Pierce, for example, it helps fund 29 percent of the cost of eight elementary school counselors.
Himsl said the pilot project did provide good information – enough to prompt HCA to move away from the random moment idea, although Cody said it’s still officially included among three possible options.
Jones remains skeptical and worries about potential losses to programs in the Franklin Pierce district.
“Why can’t we consider other ways to meet whatever their agency needs are, without hurting kids?” she asks.
An outside consultant, JTEC Educational Consultants of Wenatchee, estimated that new proposals could increase how much time school personnel spend on the Medicaid reports and how many school employees would have to participate to make the results statistically significant. Cody said fears that some small school districts would have to require all employees to participate are “off base.”
He said HCA hopes to work with school districts this spring and summer to iron out a workable system in time for the start of the 2013-14 school year.
Debbie Cafazzo: 253-597-8635