As the Special Education Director of Fluvanna County Public Schools, in Palmyra, Virginia I oppose the proposed changes by the Department of Medical Assistance Services (DMAS) to the Virginia school-based Medicaid reimbursement program.  

Our nursing supervisor has expressed strong concerns about the proposed changes and is telling me that with the increased workload already, these changes can’t be done without additional staff.  These changes would create a significant amount of additional work and cost for the nursing staff in our school division.  The priority or our nursing staff will always be services to students.  The paperwork they already do is extensive, this will make it even more so, yet it doesn’t increase services to students.  There are concerns with obtaining the required physician’s signature for each Plan of Care and concerns that this will likely result in a decrease in reimbursement for these services. Our nursing supervisor is telling me that the increased paperwork load for nursing services could mean that the nurses won’t do this and therefore will force our school division to hire more staff or to discontinue billing for these services. 

A decrease in Medicaid reimbursement dollars and an additional cost to our and I am sure other school divisions participating in the Medicaid reimbursement program is of great concern.  As the number of students with disabilities continues to increase, so do the complexities of students’ needs.  Consequently, federal, state, and local education funding fails to keep pace with the cost of providing special education, causing school divisions to rely more and more on Medicaid reimbursement to off-set the increasing costs of specialized instruction and related services.