M
illions of dollars in Medicaid reimbursement money for transporting special needs students is going unclaimed by school districts annually because of a convoluted application process
involving meticulous and exhaustive record keeping, a general unawareness that the money is available, and a dearth of qualified personnel to administer the program at the district level. These are reasons given by industry experts and
vendors, even though the federal assistance program to offset costs associated with providing the support needed for students with disabilities to gain equal access to education has been in place since 1988. Also, vendors say technology has been developed over the past decade that they claim simplifies the application process and makes it more efficient and less prone to errors asso- ciated with keeping a paper trail on student and staff participation. Confusion, however, can still reign. Medicaid rules can change frequently, and different states have different requirements for submitting the necessary data. Arizona, for example, allows for electronic filing of student forms, while California and many other states require paper. This can lead to mistakes or all-out abuses. But filing for reimbursement continues to be a worth-
while endeavor for districts that have a stomach for the arduous application process. While Medicaid spending on school-based health accounts for only about 1 per- cent of the of the entire federal budget of approximately $400 billion, the fiscal year 2019 appropriations to Indi- viduals with Disabilities Education Act (IDEA) programs was $13.5 billion.
What the Experts Say Linda Bluth, special needs transportation consultant to the National Association for Pupil Transportation (NAPT), concurred that the use of Medicaid funds to ease the expense for transportation and the cost obligations for other services incurred by states and local school
districts related to educating Medicaid eligible children has its challenges. “This federal and state entitlement program for el-
igible low-income children, to assist with financing school health services delivered to special education students enrolled in Medicaid, is more often than not overly cumbersome because Medicaid financial assis- tance requirements are complex and involve multiple state agencies,” Bluth explained. “Unequivocally, fund- ing available under Medicaid for the related service of transportation is extremely complex because children receiving transportation are required to be accurately documented by personnel working outside of the school building setting. This can be done both manually and by utilizing a third-party billing option. Both systems require extensive training and diligence daily.” Bluth added that it is essential for districts to develop a viable mechanism to access this funding source to supplement costly transportation for eligible children with disabilities. School district consultant Alexandra Robinson, like
Bluth a past president of NAPT, has her own theory. “Yes, I think there is a lot of money being left on the table, but I don’t think it is because it is a convoluted application process,” Robinson offered. “School districts receive Medicaid funding for a lot of things, and trans- portation is just one [of them]. The only places where the reporting is complicated are in those areas where there’s a large scale of transported passengers and/or poor stu- dent tracking.” She noted that district reporting requires accurate
documentation and a system o track that documen- tation. “For those school districts that already have a good
documentation process, the Medicaid documentation is just another dashboard to be kept,” Robinson added. “Many people probably shy away from the process for fear they will do it incorrectly or due to lack of staffing. It can be complicated if they don’t have a process in place.”
50% 44%
42 School Transportation News • MARCH 2022
of school districts/companies say their state allows for Medicaid reimbursement. do not know if their state allows for it. (Out of 161 responses.)
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