Medical Assistance
The School-Based Access program is a system that can be used by school districts, intermediate units, state-owned schools, or approved private schools (APS) to obtain funding for health-related services for special education students. These agencies can obtain funding for health-related services which are currently being provided to children.
Public Law 94-142 (PL 94-142), the Education for all Handicapped Children Act, was signed into law in 1975. One of the mandates established by this act is that local school districts are responsible for providing health-related services. The act states that Individualized Education Programs (IEPs) shall be provided for each child with special needs. When this law was enacted, the federal government committed to funding 40 percent of the national per pupil expenses for these services. However, the Rand Corporation published a report in 1981 that revealed the federal government's contribution for these programs was less than seven percent of the national average. As a result of this report, it became clear that responsibility for financing health-related services required by this act had to be established because the federal government was not paying its intended share.
Consequently, Congress made a public statement that, "It was not Congress' intent in passing PL 94-142 that financial responsibility previously assumed by Health, Welfare, and other human service agencies be transferred to state and local education agencies." (General Accounting Office, Financing Health and Educational Services for Handicapped Children, HRD-86-62 BR, July 1986)
In 1988, Congress clarified this issue by passing the Medicare Catastrophic Coverage Act (PL 100-360). This law stated that federal Medicaid funds must be available to reimburse for the cost of health related services found in a child's IEP, Individualized Service Plan, or Individualized Family Service Plan (IFSP). Therefore, state education agencies are eligible for federal reimbursement for the health-related services they are providing to children who are eligible for Medicaid.
PDE has responded to this legislation and the increasing need for special education services by developing the School Based Access program. The School Based Access program is a method of gaining medical assistance (MA) reimbursements for the cost of the related services currently being provided to MA eligible students. Examples of services which are billable are speech therapy, occupational therapy, physical therapy, psychological services, etc. Local Education Entities must enroll as medical assistance providers to be eligible. They submit invoices to MA for the services they are providing to the eligible students. The funds received from MA are maintained in an account managed by PDE and must be used to enhance or expand special education programs. All requests for the funds must be approved by the Bureau of Special Education.