As New Hampshire schools grapple with $29 million in lost funding after a federal clamp-down over school medical billing, lawmakers and the governor are looking for a legal fix.
A bill from Sen. Jay Kahn, a Keene Democrat, would overhaul the licensing system for school health professionals, seeking to smooth over a sticking point in ongoing tensions between Washington and state governments.
The bill would allow school nurses, school psychologists, school social workers and school psychotherapists – all of whom are currently certified by the Department of Education – to fast-track their certifications by other medical boards in order to continue receiving Medicaid funds.
The legislation, crafted with input from the Department of Health and Human Services, the Office of Professional Licensure and Certification and the Department of Education, comes after rapidly unfolding directives in Concord and Washington have left many school districts frustrated.
For years, New Hampshire schools have received large reimbursements from the federal Medicaid program for services they provide to low-income students – like speech pathology and mental health counseling.
But in July, guidance from the Trump administration’s Health and Human Services department upended that arrangement. Federal officials advised that schools must use medically certified professionals in order to continue receiving Medicaid funds, among other requirements.
School professionals certified through the Department of Education alone were not eligible, the guidelines implied.
The new advice sent ripples through state government, prompting New Hampshire’s Department of Health and Human Services to adopt an emergency rule in late August that effectively cut off schools from the Medicaid funding if they didn’t quickly come into compliance.
State officials have argued that without taking that action, Washington’s Centers for Medicare and Medicaid Services would begin cracking down on the state and the entire reimbursement program could be at risk.
Still, the effects were immediate. In a matter of weeks, some districts began writing off the money from their budgets ahead of the start of the school year. In Concord School District’s case, the adjustment meant the loss of $1 million; others have taken similar hits.
Now, lawmakers and the governor are looking to speed up the process for districts to come into compliance.
The new bill requires a number of state licensing boards to accept school health professionals and license them under new designations – provided they meet the current Department of Education standards.
School psychologists, for instance, would be required to be licensed by the Board of Psychologists if they’d either already been certified by the Department of Education or had equivalent qualifications and experience.
Those licensed by the new boards under the new designations would not have new powers – a school psychologist newly licensed by the Board of Psychologists could still not practice outside of a school setting without an additional license, for example.
But lawmakers said they hoped this would bring existing professionals up to par with the new federal guidance – without the need for additional training.
In a statement, Kahn said he was “proud to lead the legislative effort to ensure New Hampshire students continue to receive the medical services they need and that their schools can be appropriately reimbursed for providing those services.”
Rep. Dave Luneau, a Hopkinton Democrat, had a sobering takeaway.
“This year the legislature provided historic investments in education funding including a return to 100% stabilization aid, but without a legislative fix to the Medicaid to Schools program, school districts will see part of that state investment vanish to cover the costs of these vital student services,” Luneau said.