Does Medicaid Money Belong In Public Schools? [VIDEO]
Does Medicaid Money Belong In Public Schools? [VIDEO]
May 4, 2017
Quite honestly, education is at a crossroads in this country. As government and parents ask the average teacher to do more with less, and teachers unions negotiate and demand more from government, parents, and the teachers they supposedly represent, the children are left truly in the middle of it all. States and school districts are fighting to get more money from any source that they can, and that includes Medicaid. But should it?
How does Medicaid money even get into public schools? Mostly through special education, as reported by the New York Times.
School districts rely on Medicaid, the federal health care program for the poor, to provide costly services to millions of students with disabilities across the country. For nearly 30 years, Medicaid has helped school systems cover costs for special education services and equipment, from physical therapists to feeding tubes. The money is also used to provide preventive care, such as vision and hearing screenings, for other Medicaid-eligible children.
As a special ed parent, I can testify to how this works. At every IEP (individual education plan) meeting for my children, I am handed a Medicaid eligibility form to sign. This allows my school district to seek Medicaid funding on behalf of my child’s education. The more students a school district has, the more money they qualify for. However, the Medicaid money could be curtailed with the passage of the Repeal and Replace bill.
The new law would cut Medicaid by $880 billion, or 25 percent, over 10 years and impose a “per-capita cap” on funding for certain groups of people, such as children and the elderly — a dramatic change that would convert Medicaid from an entitlement designed to cover any costs incurred to a more limited program.
AASA, an advocacy association for school superintendents, estimates that school districts receive about $4 billion in Medicaid reimbursements annually. In a January survey of nearly 1,000 district officials in 42 states, nearly 70 percent of districts reported that they used the money to pay the salaries of health care professionals who serve special education students.
Now, the point of this column is not to argue the need. I have hashed extensively over special education previously, and yes, funding is necessary for these most vulnerable students, as is required by federal law. The question is, should that funding be coming out of Medicaid?
There is an industry built around helping school districts get their slice of the federal pie.
But what this has really done is create multiple layers of bureaucracy for parents seeking care – and if you have a special needs child on health insurance that is not Medicaid based, then this is coming for you, if it hasn’t already. The Medicaid money that exists to pay certain professionals in the school system, and provide services for special education students, now allows insurance companies to use your child’s education record as part of their medical record. Insurance companies are now requesting children’s IEPs in order to assess the services that they receive in the school setting – and then THEY determine if any additional care outside of school is necessary during a pre-authorization process.
When this first happened to us, almost two years ago, I put in several calls to state insurance commissioners offices to make sure that this was even LEGAL. Surprise! It is. Not all insurance plans are doing this as of yet (when I called my state’s insurance commissioner’s office, I got a slack-jawed silence from the customer service representative, who had never heard of this before), but as insurance companies look for ways to reduce spending and still meet the requirements for coverage under Obamacare and this upcoming Republican bill, this will most likely be standard within the next few years.
For me, this meant arguing with my insurance company that yes, my son needed additional speech therapy outside of the one hour a week that the school district provided for in his IEP – and then providing the IEP itself to the insurance company (I won’t recount the number of times they tried to obtain it from someone other than me – it got to the point where I reported them on the federal level for HIPAA violations), getting documentations from my son’s SLP (speech language pathologist) to PROVE that she was not simply doing the same thing that the school SLP was doing (excuse me, as his parent, don’t I get to decide if he needs more of the same work to IMPROVE his speech?), and then authorizing a handful of speech therapy appointments at a time, which requires his SLP to come back every 8-10 weeks and confirm for the insurance company that yes, his autism still affects his speech, so can we get some more appointments approved, please?
I also need to point out that THIS IS A COVERED BENEFIT ON OUR INSURANCE PLAN. This is what we had to go through to simply use a benefit that WE ALREADY PAID FOR within the plan. Welcome to the insurance bureaucracy!
And yes, the school district was properly horrified when I told them what was happening. That does not stop them from handing me a Medicaid eligibility form to sign. After all, that piggy bank of Medicaid money is there – why shouldn’t they get a piece of it?
The problem is that Medicaid is not a piggy bank. It was meant to be a safety net, but it has become a hammock for far too many services. Does special education require separate funding? Yes, but HOW that should be done needs to be properly addressed. Simply designating Medicaid dollars for special education has allowed competing forces to create chaos for those who need those services the most. Ideally, Medicaid dollars should not be in schools. But putting the genie back in that bottle is going to be near to impossible, and I don’t have good answers that won’t make people angry about something being reduced or cut, or responsibility being shifted. (Have I mentioned that disabilities are just expensive, period?)
There is never going to be unanimous agreement on how much money schools need to properly educate children. (If you ask teachers union leaders, their answer is always “more than we have now” – but they never can tell you how much is enough.) But maybe if insurance companies can no longer hide behind the excuse of school services, it would become easier for those of us with special needs children to get our kids’ benefits provided and paid up without ridiculously asinine hoops to jump through.
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