Baltimore Co. schools cash in on law for $1 million U.S. repays funds spent on disabled kids

July 27, 1993|By Mary Maushard | Mary Maushard,Staff Writer

Baltimore County schools made $1 million last year by cashing in on a little-used federal law that allows school districts to be reimbursed for money they spend on services for children with disabilities.

The county school department expects to make another $1.5 million this year and become a model for other school districts that want to take advantage of the law.

In fiscal 1993, which ended June 30, the schools were repaid $1 million in federal funds for services, such as medical care and speech therapy, that they provided for disabled children who are eligible for Medicaid.

Judi Wallace, manager of the school system's Office of Third Party Billing, said that amount will increase this year as more services become eligible for reimbursement.

With the $2.5 million collected over two years, the school system plans to hire 10 social workers, four speech therapists and 10 teaching aides for its new inclusion programs, which are moving disabled students from special education centers to neighborhood schools.

It also plans to open two school clinics and buy supplies for nurses, psychologists and physical, speech and occupational therapists. The funds also are to pay for the third-party billing office, which oversees the program.

"The money is to be used to expand services to children, all children," and not to support existing programs, Ms. Wallace said. "This is an untapped resource."

The program, a joint venture of the school system and the Baltimore County Health Department, works like many health insurance plans.

Under the Medicare Catastrophic Coverage Act of 1988, the federal government reimburses half the cost of many services that the school system provides for children with disabilities. These services must be prescribed in the Individual Education Plan that schools must write for each child in special education.

Among the reimbursable services are nursing care, speech and physical therapy, psychiatric counseling and social work.

The student also must be eligible for Medicaid, and the government must be billed after services have been provided.

Medicaid eligibility is largely determined by a family's income, though there are exceptions, Ms. Wallace said.

For instance, anyone 18 or older who still is receiving services is eligible because they no longer have to count their parents' incomes.

The county has more than 1,760 Medicaid-eligible special education students and filed nearly 25,000 claims in the program's first year.

The program costs families nothing and does not reduce other payments they are receiving.

The 400 school system employees who provide the services keep track of them and send a monthly report to the billing office.

To make the program attractive to the nurses and therapists who already have plenty of paperwork, Ms. Wallace said, the billing nTC office promised to return part of the recovered funds to the participating departments. An advisory council worked for six months on a plan for spending the money.

Speech therapy, for example, which accounts for 60 percent of the billings, is to receive $180,000 this fiscal year. That will pay the salaries of four new therapists and buy additional supplies, Ms. Wallace said.

There will also be $90,00 for two new physical and occupational therapists, as well as money for two additional pupil personnel workers and eight resource teachers. In all, the Medicaid funds will pay for about 40 additional positions.

Ms. Wallace said she expects the schools to collect about 50 percent more this fiscal year because additional services, such as consultations about placements, are eligible for reimbursement. After this year, Ms. Wallace said, the annual payments will remain steady.

The new positions are dependent on the continuation of federal funding and won't be moved into the school system's operating budget. Some of the new programs, such as the in-school clinics, may become self-supporting because their services will be eligible for Medicaid reimbursement, Ms. Wallace explained.

If that happens, the schools system can start more clinics, which are open to all eligible students, not just those with disabilities.

The Baltimore and Baltimore County school systems "are the only two that have made a significant amount of money in the state," Ms. Wallace said.

"Our county model is being looked at by Cecil, Prince George's and Anne Arundel counties."

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