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Medicaid Cuts Could Impact Students

Valley News Staff Writer
Published: 5/26/2017 11:50:24 PM
Modified: 5/30/2017 5:00:02 PM

West Lebanon — School officials and lawmakers on both sides of the Connecticut River are tracking proposed cuts to Medicaid funding in the Trump Administration’s budget.

U.S. Sen. Maggie Hassan, D-N.H, in a phone call with reporters on Thursday, said President Donald Trump’s proposed budget threatens at least $8.7 million of the $29 million in Medicaid funds now used annually to help New Hampshire students with disabilities attend and participate in school. The cuts are estimated to be phased in over 10 years.

“Countless children who experience disabilities in New Hampshire are able to go to school and participate in their communities because of the Medicaid program,” she said, noting that her son Ben, who was born with cerebral palsy and is now 29, and the Hassan family have benefited from services such as those supported by Medicaid funds.

Vermont receives a similar amount for its schools through Medicaid, about $27 million annually, according to Vermont Secretary of Education Rebecca Holcombe, of Norwich. Holcombe, however, declined to offer an assessment of the impact of the anticipated cuts.

She is tracking the federal budget’s progress through Congress, she said in an email on Friday.

“Obviously, some of the proposals, if they came to be, would end or curtail critical support for some of our most vulnerable children, and by extension, their families,” she said. “The impact would be most acute in our highest poverty communities. We will track the federal budget, offer comment and work with our congressional delegation as it develops. We are a long way from the finish line.”

In his May 23 budget message to Congress, Trump wrote that “our moral commitment to replacing our current economic stagnation with faster economic growth rests on ... eight pillars of reform,” including health care. In that area, he said “Medicaid, which inadequately serves enrollees and taxpayers, must be reformed to allow states to manage their own programs, with continued financial support from the federal government.”

One of the communities that would be hit hard if the Trump budget was enacted is SAU 23, in North Haverhill. The supervisory unit, which includes the Upper Valley communities of Haverhill and Piermont, receives approximately $420,000 in Medicaid funding annually, said Nancy Schloss, the SAU’s special education director. Because Medicaid reimbursements are based on students’ needs, the actual amount a school district receives fluctuates each year, Schloss said.

If the Medicaid cuts are approved, SAU 23 could stand to lose more than $100,000 in funding that helps to reimburse schools for costs associated with occupational and physical therapy; speech services, instructional assistants, transportation, equipment and counseling, according to an estimate provided by Hassan’s office.

“I don’t know how to really address it,” Schloss said. “(We) still have to provide the services for these kids. (It’s) just going to come out of some other funding source. It is concerning to us.”

Medicaid covers up to 50 percent of the cost of such services, which are deemed necessary in order for students to access their education, Schloss said. In most instances, Medicaid only covers up to 50 percent of the allowed rate for such services, which is usually less than the actual cost to the schools, Schloss said.

“The kids get these services only if they need these services to access their education,” Schloss said. “I’m pretty conservative. I try to be careful to provide these only if the kids need them.”

The cuts could also cost the school district in Claremont $178,000, Lebanon about $64,000, and Mascoma Valley Regional about $29,000, according to the estimates.

Though the cuts to Medicaid for schools would reduce the money available to help schools support students with disabilities, the cuts would not mean fewer students have disabilities, nor would it mean that schools are no longer required to make accommodations for students with special needs, Hassan said.

“Even if the Medicaid to schools money goes away, the requirement that schools provide the services doesn’t,” she said. “The legal requirement would still be there, but there would be much less federal help to do it.”

In order to cover these costs, school districts would have to dip into other sources of revenue, she said.

About half of the Medicaid funds directed to Vermont schools — or about $13 million in 2016 — goes toward prevention and intervention grants, Holcombe said.

In 2016, for example, the Hartford School District spent $174,000 in Medicaid funds for therapeutic services, according to a spreadsheet provided by Holcombe.

“Here in Hartford, the Medicaid Reinvestment funds cover the costs for clinicians in our local mental health agency to be in each of our schools full time,” Hartford Superintendent Tom DeBalsi wrote in an email. “These services are essential and provide counseling to a lot of students who have needs and can’t access private therapy.”

DeBalsi said he is “absolutely” tracking developments in the federal budget process, particularly those that pertain to Medicaid in schools.

“A reduction in Medicaid reimbursements to our school district would have devastating effects,” he said.

Other Upper Valley schools in Vermont also rely on Medicaid funds to support student services, including paraeducators, mental health services, occupational therapy, a social worker, preschool, guidance, a librarian, early education literacy support; planning room, health, nursing, guidance and remedial services; farm-to-school programs, fresh fruits and vegetables; environmental learning, a middle school tutor, a summer learning program, an English Language Learner teacher and a school nurse, according to the spreadsheet from Holcombe.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.


Proposed changes in Medicaid funding in President Donald Trump's budget could cut about $8.7 million over 10 years from programs that help students with disabilities attend and participate in school in New Hampshire, although advocates warn that moving to block-grant or per capita funding for Medicaid could mean the impact is more immediate. An earlier version of this story did not include a time frame for the impact of the cuts.

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