Friday, April 9, 2010

Are Hawaii schools giving up millions in federal reimbursement dollars?

Hawaii's Department of Education may be forgoing millions of federal dollars while it brings infamy down upon the state for cutting a full day from our school week.  The point of the Friday Furloughs (as they're called) was to save the state about $117 million, part of the total $227 million in budget cuts Hawaii Governor Lingle mandated.

Going through DOE's expenditures for FY2010 (which is not over yet), I was able to identify at least $113 million in expense that could be reimbursed by Medicaid.  Medicaid pays seventy-five cents of every dollar spent by schools on health services.  The state should have been able to collect about $85 million from Medicaid, but a DHS budget document shows DOE is only getting about $1.3 million in Medicaid reimbursements.

The expenses I identified as reimbursable through Medicaid include:

Autism services                                              $41 million
Speech pathologists                                       $18 million
Occupational therapists                                  $ 4 million
Physical therapists                                          $ 4 million

Contracted special ed services                       $ 3 million
School health aides                                         $ 6 million
School based mental health services             $  2 million
School based behavioral health services       $35 million

DOE can also receive 75% reimbursement from Medicaid for administrative time spent managing the above services.  What proportion this might represent of the $170 million spent on special education salaries I do not know.

Less than a month before she resigned, Hawaii Superintendant of Schools Patricia Hamamoto reported to the legislature that the state's endeavors to collect from Medicaid were going well.  An outside contractor had been hired in 2006, and DOE was so happy with them the contract was continued until June 2010.  Total collected to date appears from the report to be just over a million dollars, with another seven million projected by 2013. 

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.