Saturday, March 19, 2011

“School based” Medicaid services….WTF?

Have you seen this recent news report?

Commissioner Mayhew and her new staff have recently learned that the U.S. Department of Health and Human Services Office of Inspector General will be coming to Maine to audit Medicaid payments for school-based services for years 2006 to 2008.

The total federal dollars that could be in question over the audit period total $138.9 million.

Let’s extrapolate those figures. We’ll assume the following: Medicaid dollars are matched 2 for 1 by the feds; and the way the dates are stated in this report, it sounds like two school years are involved: 06/07, and 07/08.

If $138.9 in federal money is involved, the total Medicaid spending amount, with state dollars, is $208.35 million. Maine school enrollment during this period was about 185,000, so on a prorated basis, the dollars spent on Medicaid 'school based services' is $1126 per student over the 2 year period, or $563 per student per school year.

During this period, Brunswick School System enrollment averaged  roughly 3,000 students.

This would work out to our School System spending $1,689,000 per school year in Medicaid dollars for 'school based care.' Or more than $40,000 per school week.

Does anyone else find these numbers astonishing?

We’re not talking about what the audit might find; we refer only to the magnitude of dollars attributed to this program.

Do any of us really comprehend what is going on around here?  Do these dollars show up transparently in any public documents?

It’s well established that we’re using the schools as government funded meal programs these days; now it appears they are health care clinics as well.

Should we expect to start housing kids in the public schools before long?

Here’s a novel idea: how about if we start focusing on educating in the fundamentals as the primary mission of government schools?  You know, ‘the three Rs,’ as they use to be called.

We suppose that is unenlightened, and ‘so yesterday,’ but we have fond recollections of our own learning years.

And we’re staunch believers that the basics acquired during that time have served us well.

At this point in our lives, we are puzzled as to why these realities have been lost in the muck and mire of modern progressive education theory.

Maybe the look of the new school on McKeen provides some insight into the answers.

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  1. The fact that you managed "just fine" in school without medically-necessary services isn't much of a reason to deny them to children who can't. PL94-142 passed into law during the mid-1970's, so the concept of enabling students to attend school despite whatever disabilities they might have is hardly "modern".

    I encourage you to read about special education and Section 504 requirements at any of the many excellent special education blogs and websites around the net. In addition, you can check the Maine Department of Education's website to learn about Medicaid-specific topics being addressed in schools.

  2. It appears you're saying that special education services fall under the Medicaid heading.

    And is this regardless of the family situation and resources? Does the government pay for all "medically-necessary services" for children?

    Your use of the word "deny" would seem to infer that.

    Since you are well-informed on this subject, how about detailing where the Medicaid dollars show up in our budget.