Mark Ylen/Democrat-Herald Susan Goodman, Child and Family Services coordinator for the Albany FACT program, documents billable services for Albany’s last Medicaid reimbursement survey. The federal program is scheduled to end in June.

Mid-valley schools may lose visits from dental vans, time with drug and alcohol counselors and other social services if plans to eliminate a federal Medicaid reimbursement program go through.

The federal Centers for Medicare and Medicaid Services has decided to stop reimbursing schools for Medicaid-related health care services they provide. A moratorium on the elimination expires June 30.

Reimbursement rules have become stricter in recent years, reducing the amount of available funds.

Last year, the institution proposed cutting out schools in part because of improper billing by districts in New York, Michigan and Texas.

If the reimbursement program is eliminated, in Albany that could mean loss of Families And Communities Together, known as FACT.

Created some 15 years ago, FACT links students in the Albany school district with social services. Among many other activities, FACT helps families fill out paperwork for the Oregon Health Plan, connects homeless families with social services, and organizes food, gift and clothing drives.

CMS payments are behind schedule by about a year, so Albany will continue to receive checks for some time even if the reimbursement program ends this June. After that, however, no one has a plan for FACT’s fate.

The organization is looking for grants or other federal funding for which it might qualify, said Ryan Mattingly, Albany’s director of special programs.

FACT helps families solve problems standing in the way of children coming to school, Mattingly said. “If nobody’s there to kick it to, the problem’s not solved, the kid doesn’t come to school.”

Lebanon uses its reimbursement funds for kindergarten health screenings, head lice kits and immunization vouchers for families without insurance. It pays for a half-time position.

In Sweet Home, reimbursement helps pay for Joan Pappin, the district’s Department of Human Services coordinator.

In turn, Pappin, among other things, coordinates nursing services for teen parents, organizes the “Get in Gear” bike mentoring program and sets up twice-yearly dental screenings through the Northwest Medical Team’s dental van. Every month, she spends 12 hours checking 1,200 elementary-age heads for lice.

“I don’t know who will do those. That’s a big job, coordinating stuff, getting people places, making sure there’s a place to go,” Pappin said. “There’s just so many things I end up doing because nobody else has the time.”

Upon learning of the CMS decision this fall, Sweet Home began easing away from Medicaid funds by ending visits from a drug and alcohol counselor three days a week. “That was a big loss,” Pappin said.

Lawmakers could step in to extend the moratorium or reverse the CMS decision, said Vicki Harlos, who coordinates support programs for the Linn-Benton-Lincoln Education Service District. Efforts are under way elsewhere in the nation.

The ESD is stressing to legislators that schools are the ideal setting to do outreach and coordinate health services, Harlos said, because teachers and staff know family needs.

“We really are a critical partner in helping to administer Medicaid effectively and efficiently,” she said.

Medicaid claims

The federal Centers for Medicare and Medicaid Services program reimburses schools for time spent performing Medicaid-related services, such as connecting families with state-sponsored health care.

CMS surveys participating school districts nationwide three times a year, at random, to determine which services qualify for reimbursement. Respondents had to receive special training before each survey.

Until about four years ago, schools in the Linn-Benton-Lincoln Education Service District pooled their reimbursements to ensure a predictable return. This especially helped the smaller districts, which often didn’t have the time or personnel to administer training and surveys, said Vicki Harlos of the ESD. The split led to smaller reimbursements for those districts.

Reimbursements also have dropped in the past few years because of new restrictions on billable services.

Mid-valley Medicaid claims vary considerably from year to year. Here’s a sampling from fall 2006:

Central Linn: $9,858

Albany: $207,255

Harrisburg: $8,467

Lebanon: $25,601

Sweet Home: $41,798

Corvallis: $67,291

Philomath: $37,006

Lincoln County: $142,786

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