Sununu announces temporary, permanent fixes for Medicaid To Schools Program

New Hampshire Union Leader

Dec. 4--CONCORD -- Gov. Chris Sununu on Wednesday signed an executive order that will speed up the licensing of officials who process Medicaid funds for schools, averting the potential loss of millions in grants to local districts because of stringent federal regulations.

Sununu said the initiative brings the state's Medicaid to Schools program into compliance with federal guidance while maximizing how much schools can be reimbursed for health care services.

"The goal is to ensure individuals who are in schools and have the proper credentials are able to provide the services," Sununu at a news conference.

The Medicaid to Schools program, which has been in place for almost two decades, makes some services in the classroom eligible for 50% reimbursement from the federal government.

Controversy ensued after the Legislature greatly expanded the number of students who could be eligible for these services. Previously, only students with needs documented by an individualized education plan qualified -- mainly students with special needs.

In 2017, Sununu signed a state law that allowed any student who comes from a family receiving Medicaid health insurance to be eligible.

Medicaid insurance is offered to low-income families, the disabled and families with senior citizen members.

Last spring, federal officials alerted Department of Health and Human Services there were flaws in how the state had expanded the program.

The federal Centers for Medicare and Medicaid Services advised that schools had to be treated like any other health care setting, so that all the professionals providing these services in the schools had to be licensed health care providers.

Officials with local school districts had been getting Medicaid reimbursement for services done by school employees who weren't licensed.

Two months ago, Sununu confirmed the Department of Health and Human Services was issuing emergency rules so as to prevent school districts from losing federal money in the future.

Sununu's executive order instructs the 15 relevant licensing boards to expedite applications from school specialists seeking to be licensed.

"The boards have overwhelmingly expressed support for making these changes," said Lindsey Courtney, division director of the state Office of Professional Licensure and Certification.

State Sens. Jay Kahn, D-Keene, and James Gray, R-Rochester, have agreed to cosponsor legislation for the 2020 session that will streamline the licensing process.

State Medicaid Director Henry Lipman said the state also will seek an amendment to its Medicaid plan from the Trump administration that will make eligible for reimbursement to schools the administrative cost of filing for Medicaid claims, along with services of personal care attendants and rehabilitative specialists.

Sununu said he has been in contact with federal Medicare and Medicaid Services officials and not received any "negative feedback" to these plans.

"We want to do everything we can do to make Medicaid in Schools program one of the strongest in the country," said Lisa English, director of intergovernmental affairs for the Department of Health and Human Services.

Lipman said that some of what school districts used to receive in Medicaid reimbursement will not qualify in the future.

"A lot of it is recoverable, but some of it will not be," Lipman said.

Sununu praised school district administrators for maintaining services to children despite the prospect of getting less financial help from Washington in the future.

"I haven't heard of anyone directly shutting services off; it's more of how we are going to be billing directly for these services," Sununu said.

Senate Majority Leader Dan Feltes, D-Concord and a 2020 candidate for governor, said Sununu's response made the problem worse.

"Governor Sununu should stop playing politics with the Medicaid to Schools program. The governor's executive order is nothing more than a political stunt. It barely puts a band-aid on the self-inflicted damage caused by the Sununu administration and does nothing to address the root cause of the problem--the governor's ill-advised, fiscally irresponsible rulemaking that is costing New Hampshire students, schools, and property taxpayers millions of dollars," Feltes said in a statement.

Gray said Feltes is turning the school districts' financial dilemma into a political issue.

"This effort is about kids and not politics. It would appear that Senator Feltes would have the entire Medicaid to Schools program in jeopardy by having the state take no action to comply with federal regulations," Gray said, adding that lawmakers from both parties have been involved in talks to respond to this issue.

"Absent at all of those meetings has been Sen. Feltes, who is now attempting to insert himself into the effort with false statements and toxic partisanship," Gray said. "This is a complex issue and I would be happy to sit down with Sen. Feltes anytime to explain it to him."

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