HOUSE DOCKET, NO. 3107        FILED ON: 1/20/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1194

The Commonwealth of Massachusetts

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PRESENTED BY:

Denise C. Garlick

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying resolve:

Resolve relative to the reimbursement of school-based care.

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PETITION OF:

HOUSE DOCKET, NO. 3107        FILED ON: 1/20/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1194

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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Resolve relative to the reimbursement of school-based care.

Resolved, (a) For the purposes of this resolve, the following terms shall have the following meanings:

“Administrative activities,” those activities as defined in the local education authority’s provider contract with MassHealth, and shall include Medicaid outreach services, facilitation or assistance in the MassHealth application process, assistance in coordination and delivery of MassHealth covered services, individual care planning, monitoring, coordination and referrals of MassHealth covered services, and assistance in obtaining MassHealth-covered transportation or translation services that are related to MassHealth covered services.

“Local education authority,” any city, town, charter school, public health commission, or school district.

“School-based services,” any medically necessary MassHealth covered services, as delineated in the Medicaid State Plan, which are provided to a member by a school-based Medicaid provider.

“Individualized education program,” a written statement, developed and approved in accordance with federal special education law in a form established by the Department of Elementary and Secondary Education of the Commonwealth that identifies a student's special education needs and describes the services a local education authority shall provide to meet those needs.

“School-age child,” any person of ages three through twenty-two who has not attained a high school diploma or its equivalent.

(b) Notwithstanding any general or special law to the contrary, the executive office of health and human services shall establish a MassHealth reimbursement of school-based care task force to study and make recommendations with respect to direct MassHealth reimbursement to local education authorities for school-based services, administrative activities, and any other medical benefits provided by such local education authority to any school-age child who is an eligible beneficiary of MassHealth in accordance with chapter 118E of the General Laws, Title XIX, and Title XXI, as appropriate.

(c) The task force shall consist of: the secretary of the executive office of health and human services, or a designee, who shall serve as co-chair; the secretary of the executive office of education, or a designee, who shall serve as co-chair; a representative from the division of local services; 1 representative from each of the following organizations that represent direct care providers within the educational setting: Massachusetts School Nurse Organization, Massachusetts Association of Occupational Therapists, American Physical Therapy Association of Massachusetts, Massachusetts Speech-Language Hearing Association, Massachusetts School Counselors Association, Massachusetts Mental Health Consortium, and the Massachusetts School Psychologists Association; 1 representative from the Massachusetts Association of School Superintendents; 1 representative from the Massachusetts Association of School Committees; and 1 representative from the Massachusetts Municipal Association.

The task force shall also consist of 2 members of the senate to be appointed by the president of the senate and 1 member of the senate to be appointed by the minority leader of the senate, 2 members of the house of representatives to be appointed by the speaker of the house and 1 member of the house of representatives to be appointed by the minority leader of the house of representatives

(d) The task force shall: (1) determine the number of local education authorities enrolled with the division of medical assistance as MassHealth; (2) analyze the extent to which said local education authorities utilize MassHealth reimbursement of school-based services, administrative activities and any other medical benefits provided by such local education authority to any school-age child who is an eligible beneficiary of MassHealth; (3) investigate any impediments to seeking MassHealth reimbursement for said services, including but not limited to student eligibility; and (4) analyze common state and federal reimbursements and other sources of revenue for educational or other school-based services, and the extent to which said reimbursements and sources of revenue are allocated directly to the municipality versus the local education authority.

(e) All appointments to the task force shall be made not later than 30 days after the effective date of this resolve.

(f) The task force shall submit its findings, recommendations, and any determinations regarding necessary legislation and regulations to the clerks of the senate and the house of representatives, the joint committee on education, the joint committee on health care financing, and the senate and house committees on ways and means not later than January 1, 2024. The secretary of health and human services shall make the report publicly available on the website of the executive office of health and human services.