Statewide Implementation of Oregon School Based Health Services including training, technical assistance, and billing guidance to increase enrollment, claiming, reimbursement, and access for students. - The Oregon Health Authority (OHA) is pursuing a state grant for the implementation of Medicaid and CHIP School-Based Services (SBS) statewide through local education agencies (LEAs). Oregon’s state leadership and agencies are committed to addressing health inequities through increased access to health care for children and adolescents in school settings. OHA and the Oregon Department of Education (ODE) work closely together on Oregon’s School-Based Health Services (SBHS) program to ensure that LEAs are equipped to successfully implement Medicaid billing while adhering to all education and Medicaid requirements. OHA and ODE have identified several issues related to Oregon’s current SBHS program, including, but not limited to, low district participation in billing and reimbursement, inconsistent data collection and maintenance within education entities, and administrative and structural barriers to participation, such as understanding Medicaid compliance information and LEA staff capacity to coordinate program participation. This implementation grant would help OHA address these foundational and fundamental issues in school Medicaid billing. Oregon’s implementation grant would focus on infrastructure development to support these goals: ● Increased number of LEAs enrolled and actively participating in SBHS, from 59 to 80 ● Increased claiming by 25% for covered services provided to students with an IEP/IFSP and to general education students ● Increased federal reimbursement for participating LEAs ● Increased access to health care services for Medicaid- and CHIP-enrolled students For the three-year grant period, OHA plans to use grant funds to: ● Hire one Limited Duration Grant Coordinator who will coordinate grant activities, including expanding state capacity to provide technical assistance and address infrastructure needs; finalizing needs assessments that identify areas for program improvement and infrastructure barriers; increasing engagement of LEAs and stakeholders; and evaluating the effectiveness of grant activities by reviewing data and stakeholder input to monitor and assess service utilization in school settings. ● Contract with WestEd, which will assist with the needs assessment and initial planning period and develop and implement a training and technical assistance plan that provides support to LEAs in addressing the barriers, challenges, and infrastructure needs to successfully participate and comply with the SBHS program. ● Partner with Multnomah Education Service District (MESD) to expand access to billing infrastructure for a pilot group of LEAs, by supporting the contracting costs for MESD’s third-party billing system. The total project budget to implement these activities and address OHA’s overall project goals is $2,500,000.
