2023 -- S 0869 SUBSTITUTE A
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LC000744/SUB A
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S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
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A N A C T
RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE -- THE PROMOTING
ACCESS TO INCREASED MENTAL HEALTH SERVIC ES FOR ALL STUDENTS ACT
Introduced By: Senators Cano, Gu, and DiMario
Date Introduced: March 30, 2023
Referred To: Senate Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Section 40-8-18 of the General Laws in Chapter 40-8 entitled "Medical 1
Assistance" is hereby amended to read as follows: 2
40-8-18. Local education agencies as EPSDT providers. 3
(a) It is the intent of this section to provide reimbursement for early and periodic screening, 4
diagnosis and treatment (EPSDT) services through local education agencies for children who are 5
eligible for medical assistance. A local education agency’s participation as an EPSDT provider is 6
voluntary. Further, it is the intent that collaboration among the department of human services 7
(DHS), the department of elementary and secondary education, and local education agencies 8
(LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT 9
services. 10
(b) The services available to eligible children under Title XIX of the Social Security Act, 11
42 U.S.C. § 1396 et seq., for early and periodic screening, diagnosis, and treatment (EPSDT) may 12
be provided by local education agencies. 13
(c)(1) Voluntary participation as an EPSDT provider shall require the local education 14
agency to provide the state match to obtain federal financial participation for EPSDT services and 15
associated administrative costs by certifying to the department of human services that sufficient 16
qualifying local funds (local certified match) have been expended for the services and 17
administrative costs; provided, however, that a local education agency shall not be required to 18
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provide local certified match for those EPSDT services for which the department of human 1
services, or another state agency, agrees to provide the state match to obtain federal financial 2
participation for EPSDT services. 3
(2) The local certified match shall be established in the local education agency pursuant to 4
federal Title XIX provisions. Failure of the local education agency to provide the local match shall 5
result in the penalties described in subsection (f). 6
(3) The department of human services shall pay the local education agency from the federal 7
matching funds for EPSDT services pursuant to fee schedules established by rules and regulations 8
of the department of human services, and for associated administrative costs pursuant to 9
administrative cost reimbursement methodologies to be approved by the federal government, upon 10
certification of the local match by the local education agency in accordance with federal Title XIX 11
provisions. Payments made to the local education agency pursuant to this section shall be used 12
solely for educational purposes and shall not be made available to local communities for purposes 13
other than education. The local fiscal effort to support education referred to in subsection (d) shall 14
not be reduced in response to the availability of these federal financial participation funds to the 15
local education agency. These federal financial participation funds must supplement, not supplant, 16
local maintained fiscal effort to support education. 17
(4) For the purposes of this subsection, the term “local education agency” shall include any 18
city, town, state, or regional school district or the school for the deaf or the William M. Davies, Jr. 19
career and technical high school, the Metropolitan Career and Technical Center, any public charter 20
school established pursuant to chapter 77 of title 16, any educational collaborative established 21
pursuant to chapter 3.1 of title 16, or the department of children, youth and families (DCYF). 22
(d)(1) Each community shall maintain local fiscal effort for education. For the purpose of 23
this subsection, to “maintain local fiscal effort” means each community shall contribute local funds 24
to its school committee in an amount not less than its local contribution for schools in the previous 25
fiscal year. 26
(2) Further, state support for education shall not be reduced from the prior fiscal year in 27
response to local community participation in the EPSDT program. 28
(e) The department of human services and the department of elementary and secondary 29
education shall effect the interagency transfers necessary to comply with the provisions of this 30
section. The department of elementary and secondary education and the department of human 31
services are authorized to promulgate any and all regulations necessary to implement this section. 32
All local school agencies becoming EPSDT providers shall be required to comply with all 33
provisions of Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., relative to 34
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responsibilities of a Medicaid provider. 1
(f) Failure of the local education agency to establish a local certified match under this law 2
sufficient to support its claims for reimbursement of EPSDT services and associated administrative 3
costs will result in the withholding of state funds due that community in accordance with § 16-7-4
31 in an amount equal to the federal financial participation funds denied by the federal government 5
as a result thereof. The withheld funds will be transferred to the department of human services. 6
(g) The department of human services, with the aid of the department of education, shall 7
determine which healthcare-related services are eligible for federal Medicaid reimbursement for 8
health-related services provided by local education agencies to children eligible for early periodic 9
screening, diagnosis and treatment. The department of human services, with the assistance of the 10
department of administration, shall also develop the following resources in furtherance of the goal 11
of recouping the maximum amount of administrative costs associated with the services: 12
(1) A time-study training manual that outlines how to complete a time study by school 13
personnel to enhance recovery of administrative costs; and 14
(2) A claiming manual that outlines the financial information and claim submission 15
requirements that are needed to complete the claim. 16
(h) Services provided by school social workers and certified school psychologists who are 17
certified by the department of elementary and secondary education shall be included as health care 18
related services eligible for federal Medicaid reimbursement pursuant to this section. These school 19
social workers and certified school psychologists shall be eligible to participate in time studies as 20
local education agency employees and contractors. 21
(i) The general assembly encourages the executive office of health and human services and 22
the department of elementary and secondary education to collaborate and pursue pathways to 23
expand opportunities for local education agencies to bill and obtain federal Medicaid 24
reimbursement for eligible services delivered in schools. 25
SECTION 2. This act shall take effect upon passage. 26
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HUMAN SE RVICES -- MEDICAL ASSISTANCE -- THE PROMOTING
ACCESS TO INCREASED MENTAL HEALTH SERVIC ES FOR ALL STUDENTS ACT
***
This act would require that services provided by school social workers and certified school 1
psychologists be included as health care related services eligible for federal Medicaid 2
reimbursement. 3
This act would take effect upon passage. 4
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