| 18 | 18 | | Date Introduced: March 30, 2023 |
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| 19 | 19 | | Referred To: Senate Health & Human Services |
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| 20 | 20 | | |
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| 21 | 21 | | |
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| 22 | 22 | | It is enacted by the General Assembly as follows: |
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| 23 | 23 | | SECTION 1. Section 40-8-18 of the General Laws in Chapter 40-8 entitled "Medical 1 |
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| 24 | 24 | | Assistance" is hereby amended to read as follows: 2 |
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| 25 | 25 | | 40-8-18. Local education agencies as EPSDT providers. 3 |
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| 26 | 26 | | (a) It is the intent of this section to provide reimbursement for early and periodic screening, 4 |
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| 27 | 27 | | diagnosis and treatment (EPSDT) services through local education agencies for children who are 5 |
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| 28 | 28 | | eligible for medical assistance. A local education agency’s participation as an EPSDT provider is 6 |
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| 29 | 29 | | voluntary. Further, it is the intent that collaboration among the department of human services 7 |
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| 30 | 30 | | (DHS), the department of elementary and secondary education, and local education agencies 8 |
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| 31 | 31 | | (LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT 9 |
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| 32 | 32 | | services. 10 |
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| 33 | 33 | | (b) The services available to eligible children under Title XIX of the Social Security Act, 11 |
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| 34 | 34 | | 42 U.S.C. § 1396 et seq., for early and periodic screening, diagnosis, and treatment (EPSDT) may 12 |
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| 35 | 35 | | be provided by local education agencies. 13 |
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| 36 | 36 | | (c)(1) Voluntary participation as an EPSDT provider shall require the local education 14 |
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| 37 | 37 | | agency to provide the state match to obtain federal financial participation for EPSDT services and 15 |
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| 38 | 38 | | associated administrative costs by certifying to the department of human services that sufficient 16 |
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| 39 | 39 | | qualifying local funds (local certified match) have been expended for the services and 17 |
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| 40 | 40 | | administrative costs; provided, however, that a local education agency shall not be required to 18 |
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| 41 | 41 | | |
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| 42 | 42 | | |
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| 44 | 44 | | provide local certified match for those EPSDT services for which the department of human 1 |
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| 45 | 45 | | services, or another state agency, agrees to provide the state match to obtain federal financial 2 |
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| 46 | 46 | | participation for EPSDT services. 3 |
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| 47 | 47 | | (2) The local certified match shall be established in the local education agency pursuant to 4 |
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| 48 | 48 | | federal Title XIX provisions. Failure of the local education agency to provide the local match shall 5 |
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| 49 | 49 | | result in the penalties described in subsection (f). 6 |
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| 50 | 50 | | (3) The department of human services shall pay the local education agency from the federal 7 |
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| 51 | 51 | | matching funds for EPSDT services pursuant to fee schedules established by rules and regulations 8 |
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| 52 | 52 | | of the department of human services, and for associated administrative costs pursuant to 9 |
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| 53 | 53 | | administrative cost reimbursement methodologies to be approved by the federal government, upon 10 |
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| 54 | 54 | | certification of the local match by the local education agency in accordance with federal Title XIX 11 |
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| 55 | 55 | | provisions. Payments made to the local education agency pursuant to this section shall be used 12 |
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| 56 | 56 | | solely for educational purposes and shall not be made available to local communities for purposes 13 |
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| 57 | 57 | | other than education. The local fiscal effort to support education referred to in subsection (d) shall 14 |
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| 58 | 58 | | not be reduced in response to the availability of these federal financial participation funds to the 15 |
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| 59 | 59 | | local education agency. These federal financial participation funds must supplement, not supplant, 16 |
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| 60 | 60 | | local maintained fiscal effort to support education. 17 |
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| 61 | 61 | | (4) For the purposes of this subsection, the term “local education agency” shall include any 18 |
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| 62 | 62 | | city, town, state, or regional school district or the school for the deaf or the William M. Davies, Jr. 19 |
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| 63 | 63 | | career and technical high school, the Metropolitan Career and Technical Center, any public charter 20 |
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| 64 | 64 | | school established pursuant to chapter 77 of title 16, any educational collaborative established 21 |
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| 65 | 65 | | pursuant to chapter 3.1 of title 16, or the department of children, youth and families (DCYF). 22 |
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| 66 | 66 | | (d)(1) Each community shall maintain local fiscal effort for education. For the purpose of 23 |
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| 67 | 67 | | this subsection, to “maintain local fiscal effort” means each community shall contribute local funds 24 |
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| 68 | 68 | | to its school committee in an amount not less than its local contribution for schools in the previous 25 |
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| 69 | 69 | | fiscal year. 26 |
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| 70 | 70 | | (2) Further, state support for education shall not be reduced from the prior fiscal year in 27 |
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| 71 | 71 | | response to local community participation in the EPSDT program. 28 |
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| 72 | 72 | | (e) The department of human services and the department of elementary and secondary 29 |
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| 73 | 73 | | education shall effect the interagency transfers necessary to comply with the provisions of this 30 |
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| 74 | 74 | | section. The department of elementary and secondary education and the department of human 31 |
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| 75 | 75 | | services are authorized to promulgate any and all regulations necessary to implement this section. 32 |
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| 76 | 76 | | All local school agencies becoming EPSDT providers shall be required to comply with all 33 |
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| 77 | 77 | | provisions of Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., relative to 34 |
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| 78 | 78 | | |
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| 79 | 79 | | |
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| 81 | 81 | | responsibilities of a Medicaid provider. 1 |
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| 82 | 82 | | (f) Failure of the local education agency to establish a local certified match under this law 2 |
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| 83 | 83 | | sufficient to support its claims for reimbursement of EPSDT services and associated administrative 3 |
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| 84 | 84 | | costs will result in the withholding of state funds due that community in accordance with § 16-7-4 |
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| 85 | 85 | | 31 in an amount equal to the federal financial participation funds denied by the federal government 5 |
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| 86 | 86 | | as a result thereof. The withheld funds will be transferred to the department of human services. 6 |
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| 87 | 87 | | (g) The department of human services, with the aid of the department of education, shall 7 |
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| 88 | 88 | | determine which healthcare-related services are eligible for federal Medicaid reimbursement for 8 |
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| 89 | 89 | | health-related services provided by local education agencies to children eligible for early periodic 9 |
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| 90 | 90 | | screening, diagnosis and treatment. The department of human services, with the assistance of the 10 |
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| 91 | 91 | | department of administration, shall also develop the following resources in furtherance of the goal 11 |
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| 92 | 92 | | of recouping the maximum amount of administrative costs associated with the services: 12 |
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| 93 | 93 | | (1) A time-study training manual that outlines how to complete a time study by school 13 |
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| 94 | 94 | | personnel to enhance recovery of administrative costs; and 14 |
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| 95 | 95 | | (2) A claiming manual that outlines the financial information and claim submission 15 |
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| 96 | 96 | | requirements that are needed to complete the claim. 16 |
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| 97 | 97 | | (h) Services provided by school social workers and certified school psychologists who are 17 |
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| 98 | 98 | | certified by the department of elementary and secondary education shall be included as health care 18 |
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| 99 | 99 | | related services eligible for federal Medicaid reimbursement pursuant to this section. These school 19 |
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| 100 | 100 | | social workers and certified school psychologists shall be eligible to participate in time studies as 20 |
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| 101 | 101 | | local education agency employees and contractors. 21 |
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