August 26. 2018 8:18PM

More help on the way for schools, needy kids

By SHAWNE K. WICKHAM
New Hampshire Union Leader


The state has approved an expansion of the Medicaid to Schools program, which will cover half the cost of services for students with medical and behavioral health needs.

And that could be a “game changer” for school districts that struggle to pay for such services, school administrators say.

In the past, the Medicaid to Schools program only applied to children with disabilities who have Individualized Education Plans in their school districts. Last year, 11,218 children were served by the program, according to DHHS.

A new state law that passed last year expanded the program to include all children with medical needs, including behavioral health issues, who are eligible for Medicaid. That means federal dollars will be available to match what school districts spend on such services as mental health counseling; speech, occupational and physical therapy; and rehabilitative services.

But there was a delay in adopting new rules for the program, so the extra funding wasn’t available for the past school year.

Now the Department of Health and Human Services (DHHS) has established temporary rules for the expanded program.

And that will be “a tremendous help,” according to Carl Ladd, executive director of the New Hampshire School Administrators Association.

“I think it’s going to be huge for school districts, from the smallest to the largest,” Ladd said. “Because all it takes is one student with heavy medical issues to really drain the resources of a district.

“So I think that this can really be a game changer in providing real-time services for the kids who are most in need.”

In New Hampshire, Medicaid to Schools (MTS) is a voluntary program that allows school districts to bill Medicaid, with parental consent, for certain services. In 2017, 63% of New Hampshire school districts participated in MTS and were reimbursed for more than $28 million in Medicaid funds, according to DHHS.

In July, the federal Centers for Medicare and Medicaid Services approved DHHS’s request to expand the services included in the State Medicaid Plan. That allowed DHHS to move forward with rule-making to expand the services that can be reimbursed through MTS, including children’s behavioral health services and the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, according to DHHS.

“Schools play an important role in shaping children’s futures by not only ensuring their educational needs are met, but also ensuring children’s physical and behavioral health needs are met,” DHHS Commissioner Jeffrey Meyers said in a statement.

“Changes to the Medicaid to Schools program support schools’ role by expanding the number of schoolchildren served and the services available,” Meyers said. “We thank the Joint Legislative Committee on Administrative Rules for approving these rules for the benefit of New Hampshire students.”

There are approximately 87,000 low-income children statewide who are currently enrolled in Medicaid, a federal/state-funded health care program that serves needy individuals and families.

Ladd said he expects the number of New Hampshire students who qualify for the MTS program will “jump dramatically” this school year. And the federal match means that school districts, especially those in small, rural districts, will be better able to afford the services their students need, he said.

The expanded program also will cover the cost of transportation, Ladd said, “which in rural districts is a huge issue.”

Becky Whitley, policy coordinator with the New Hampshire Children’s Behavioral Health Collaborative, welcomed DHHS’ efforts to make the matching funds available for the new school year.

“At a time when our state is grappling with mental health and substance use crises, the release of temporary rules will allow school districts to provide necessary supports and services to children without further delay,” Whitley said. “The expanded program will allow school districts to better support children and their families by enabling the districts to be reimbursed for providing medically necessary services to all Medicaid-eligible students.

“Students with behavioral health needs will be better supported, as substance use disorder and mental health services are included in the expansion,” she said.

Whitley said her group looks forward to working with DHHS as the agency moves into the formal rulemaking process next month.

That process will include a public comment period to provide an opportunity for the public and stakeholders to offer input and inform the rule-making process, according to DHHS.

Ladd said school administrators have been eagerly awaiting this change ever since the law passed last year. “They’ve been expecting this, so this is great news to start the school year,” he said.



Beyond the Stigma, a series exploring solutions to the state’s addiction and mental health challenges, is sponsored by the New Hampshire Solutions Journalism Lab at the Nackey S. Loeb School of Communications and funded by the New Hampshire Charitable Foundation, Dartmouth-Hitchcock Medical Center, NAMI New Hampshire, and private individuals. Contact reporter Shawne K. Wickham at swickham@unionleader.com.