Creating an infrastructure that creates capacity for billing SBS beyond the Individualized Education Program (IEP) - The Oklahoma Health Care Authority (OHCA), along with the Oklahoma State Department of Education (OSDE), proposes to use this funding opportunity to expand Medicaid School-Based Services (SBS). Through this grant, the state plans to increase access to health care services in ways that can narrow disparities in rates of care, promote quality education and achievement, and build a reliable system of support for students in Oklahoma. The state faces several barriers that have prevented the provision of services in schools to Medicaid-eligible students, including a general lack of education about Medicaid, insufficient understanding of Medicaid billing processes, and a deficiency in access to quality health care. This proposal aims to create an infrastructure that creates capacity for billing SBS beyond the Individualized Education Program (IEP) and expands access to services across the state. OHCA and OSDE will use trainings, support manuals, an interactive toolkit and increased technical support to accomplish this goal. The state will explore and identify technology that will meet the needs of the planned expanded in-school clinical services and billing capabilities of schools. The project will be supported through temporarily increased staffing not to exceed funding beyond the limits of the grant, identified technology solutions, peer mentorships at school districts, public/private partnerships, and a competitive grant to incentivize districts to begin expanding school-based services. It will also assist districts in connecting to mobile units, pop-up clinics and telehealth services. Education and training will encompass: how to bill Medicaid, training teachers to identify students that may benefit from available services and how to refer for those services, continuing education for administrators and teachers for ongoing improvement of the in-school clinical services program, assistance negotiating partnerships with private health care vendors, and connecting schools with opportunities for an integrated clinical environment. Measurable outcomes will include the creation of training and education materials, the hosting of trainings and engagement meetings around the state (in-persona and virtual), quarterly webinars and monthly newsletters, public/private partnerships established, and new services provided. The state will also be able to gauge efficacy through the number of schools billing Medicaid services beyond the IEP, the number of students receiving services, and the quantity of services being billed to Medicaid. The State of Oklahoma is requesting $2,500,000.00 to be used for temporarily increased staffing, expenses for regional trainings, office supplies, mentor stipends, a competitive grant opportunity, potential technology solutions, and an external evaluator to analyze efficacy. Finally, expenses will cover a statewide School-Based Medicaid billing conference to empower districts to effectively navigate the complexities of Medicaid reimbursement. Expenditure of grant funds will be approved by OSDE and OHCA.
