§ 40-8-18 - Local education agencies as EPSDT providers.
SECTION 40-8-18
§ 40-8-18 Local education agencies asEPSDT providers. – (a) It is the intent of this section to provide reimbursement for early andperiodic screening, diagnosis and treatment (EPSDT) services through localeducation agencies for children who are eligible for medical assistance. Alocal education agency's participation as an EPSDT provider is voluntary.Further, it is the intent that collaboration among the department of humanservices (DHS), the department of elementary and secondary education and localeducation agencies (LEAs) will result in state and local funds being used tomaximize federal funding for such EPSDT services.
(b) The services available to eligible children under TitleXIX of the Social Security Act for early and periodic screening, diagnosis andtreatment (EPSDT) may be provided by local education agencies.
(c) Voluntary participation as an EPSDT provider shallrequire the local education agency to provide the state match to obtain federalfinancial participation for EPSDT services and associated administrative costsby certifying to the department of human services that sufficient qualifyinglocal funds (local certified match) have been expended for such services andadministrative costs; provided, however, that a local education agency shallnot be required to provide local certified match for those EPSDT services forwhich the department of human services, or another state agency, agrees toprovide the state match to obtain federal financial participation for EPSDTservices.
(2) The local certified match shall be established in thelocal education agency pursuant to federal Title XIX provisions. Failure of thelocal education agency to provide the local match shall result in the penaltiesdescribed in subsection (f).
(3) The department of human services shall pay the localeducation agency from the federal matching funds for EPSDT services pursuant tofee schedules established by rules and regulations of the department of humanservices, and for associated administrative costs pursuant to administrativecost reimbursement methodologies to be approved by the federal government, uponcertification of the local match by the local education agency in accordancewith federal Title XIX provisions. Payments made to the local education agencypursuant to this section shall be used solely for educational purposes andshall not be made available to local communities for purposes other thaneducation. The local fiscal effort to support education referred to insubsection (d) shall not be reduced in response to the availability of thesefederal financial participation funds to the local education agency. Thesefederal financial participation funds must supplement, not supplant, localmaintained fiscal effort to support education.
(4) For the purposes of this subsection, the term "localeducation agency" shall include any city, town, state or regional schooldistrict or the school for the deaf or the William M. Davies, Jr. career andtechnical high school, the Metropolitan Career and Technical Center, any publiccharter school established pursuant to chapter 77 of title 16 of the generallaws, any educational collaborative established pursuant to chapter 3.1 oftitle 16 of the general laws, or the department of children, youth, andfamilies (DCYF).
(d) Each community shall maintain local fiscal effort foreducation. For the purpose of this subsection, to "maintain local fiscaleffort" means each community shall contribute local funds to its schoolcommittee in an amount not less than its local contribution for schools in theprevious fiscal year.
(2) Further, state support for education shall not be reducedfrom the prior fiscal year in response to local community participation in theEPSDT program.
(e) The department of human services and the department ofelementary and secondary education shall effect the interagency transfersnecessary to comply with the provisions of this section. The department ofelementary and secondary education and the department of human services areauthorized to promulgate any and all regulations necessary to implement thissection. All local school agencies becoming EPSDT providers shall be requiredto comply with all provisions of Title XIX, 42 U.S.C. § 1396 et seq., ofthe Social Security Act relative to responsibilities of a Medicaid provider.
(f) Failure of the local education agency to establish alocal certified match under this law sufficient to support its claims forreimbursement of EPSDT services and associated administrative costs will resultin the withholding of state funds due that community in accordance with §16-7-31 in an amount equal to the federal financial participation funds deniedby the federal government as a result thereof. The withheld funds will betransferred to the department of human services.
(g) The department of human services, with the aid of thedepartment of education, shall determine which health care related services areeligible for federal Medicaid reimbursement for health related servicesprovided by local education agencies to children eligible for early periodicscreening diagnosis and treatment. The department of human services, with theassistance of the department of administration, shall also develop thefollowing resources in furtherance of the goal of recouping the maximum amountof administrative costs associated with such services:
(1) A time study training manual which outlines how tocomplete a time study by school personnel to enhance recovery of administrativecosts; and
(2) A claiming manual, which outlines the financialinformation and claim submission requirements that are needed to complete theclaim.