The proposed changes in the DMAS LEA provider manual have been discussed with our Special Education department and Nurse Coordinator.  We are opposed to these changes, as we believe that they will seriously affect our division’s ability to bill for nursing services, personal care services, and transportation services.  The proposed changes will increase the amount of paperwork that is required of our nursing staff.  Billable hours will be lost due to the lag time that will occur waiting for doctors to provide multiple signatures.  Doctors may have to increase staff in their offices to assist with the extra paperwork.  Doctors may even charge a fee for processing which the family would have to pay.  There are students who see multiple doctors or doctors from other states.  Nursing staff will have to track paperwork from several offices, which will result in longer lag times and unbillable hours.  Multiple Plans of Care (POC) would have to be written, sent, tracked, and processed. If there were even the smallest error in the paperwork, the process would start all over.  In addition, if there is a change in the POC (which there could be several times throughout the year), this process would have to start again.  This extra paperwork for nurses takes away from their main and most important duty – collaborating with families, creating health care plans, and addressing the health needs of all of our students.

If this process were cumbersome for the nursing staff, it would be the same for our personnel in the Special Education and Transportation departments.  A school division would have to hire additional staff just to track this process.  As a small, rural school division, that is not an option for us.  If the proposed changes were approved, it may mean that schools would not be able to participate in Medicaid billing and reimbursement.  These funds help offset the lack of other funding from federal, state, and local entities.  Moreover, that would take away needed services from our students. 

We strongly encourage you to reconsider the proposed changes.  The process is cumbersome as it stands.  These changes would make that even worse.