1. Medicaid Funding for School-Based Services Office of Special Education September 2015

2. Sec. 4. (a) A public agency may use Medicaid or other public benefits or insurance programs in which a student participates to provide or pay for services required under this article, as permitted under the public benefits or insurance program. 511 IAC 7-33-4 (b) A public agency must provide written notice to the parent: (1) before accessing the student's or the parent's public benefits or public insurance for the first time; (2) prior to obtaining the one-time written parental consent as described in subsection (d); and (3) annually thereafter. [As used here, public agency means “school district/charter school]

4. (h) Proceeds from public benefits or insurance or private insurance shall not be considered program income for purposes of 34 CFR 80.25 with respect to the administration of federal grants and cooperative agreements. (i) If a public agency spends reimbursements from federal funds, such as Medicaid, for services under this article, those funds shall not be considered state or local funds for purposes of maintenance of effort provisions. 511 IAC 7-33-4 Use of public and private insurance

5. Examples of Covered IEP-Required Related Services Indiana Medicaid covers the following IEP services: Audiology Occupational Therapy Physical Therapy Speech-Language Therapy Mental Health (Psych) Care Nursing Care Provided by a Licensed, Registered Nurse Plus: Medically necessary specialized transportation on a day when the student receives another IEP-required service at school.

6. Two Different Types of School-Based Medicaid Claiming 1) MAC (M EDICAID A DMINISTRATIVE C LAIMING ) : pays a portion of schools’ costs for performing A DMINISTRATIVE A CTIVITIES to help students/ families address unmet health needs 2) IEP Direct Services Claiming: pays Medicaid rates for providing covered H EALTH -R ELATED S ERVICES in the IEP of a Medicaid-eligible Special Education student In Indiana, school-based Medicaid claiming is strictly on a voluntary basis. Districts may participate in one, both or neither type(s).

7. Two Different Medicaid Reimbursement Methodologies 1) MAC ( MEDICAID ADMINISTRATIVE CLAIMING ) : reimburses based on collective results of quarterly statewide random moment time studies documenting activities of all participating districts 2) IEP Direct Services Claiming : reimburses at Medicaid’s rate for each covered “related” service provided per a Medicaid- eligible Special Education student’s IEP

8. Examples of IndianaMAC-Reimbursable Administrative Activities Providing information to students and families about Hoosier Healthwise, Medicaid, CHIP and available health care benefits Scheduling, coordinating or referring a student to medical, dental, vision or mental health diagnostic and treatment services Gathering information that may be required for service referrals Developing plans and strategies to improve and eliminate gaps in health service delivery for school-age children Meeting with parents or professionals about a child with unmet health care needs Coordinating or attending meetings or trainings related to Medicaid and medical services Arranging transportation or translation services required for a student/family to access needed health care services

9. School-Friendly Materials, Accessible to All

10. Even for those that don’t bill Medicaid

11. School-Friendly Materials, Accessible to All

12. Forms & Systems Help Manage Medicaid Claiming Processes & Details

13. Which Indiana Districts Participate in Medicaid Claiming? http://www.doe.in.gov/sites/default/files/specialed/school -corp-medicaid-report-sfy15-ytd-12-31-14-final.pdf

14. Which Indiana Districts Participate in IndianaMAC? http://www.doe.in.gov/sit es/default/files/specialed/ school-corp-medicaid- report-sfy15-ytd-12-31- 14-final.pdf

15. Even for those that don’t bill Medicaid Where Else Can Indiana Schools Find More Information? www.medicaidforeducation.org

16. Thank you ! Questions? Contact: Tracy Brunner, School-based Medicaid Specialist Office of Special Education Indiana Department of Education tbrunner@doe.in.gov 317.257.0910