Joint Subcommittee Studying Early Intervention Services for Infants and Toddlers with Disabilities
November 24, 1997, Richmond
The joint subcommittee convened its annual meeting to receive an update on the implementation of Part H services for infants and toddlers with disabilities. Among the topics addressed at the meeting were the report of the Department of Mental Health, Mental Retardation and Substance Abuse Services (DMHMRSAS) and the Department of Medical Assistance Services (DMAS) concerning maximizing federal funding for Part H services, the adequacy of Part H providers in contracts entered into between DMAS and managed care organizations (MCOs), and the use of private insurance to cover Part H services.
At the request of the General Assembly, DMHMRSAS and DMAS prepared a joint report on maximizing federal Medicaid funds for early intervention services. The report states that many funding sources are available and utilized for infants and toddlers with disabilities, thus complicating the task of identifying the total sum of public dollars spent on any one child. The report highlights the need for a centralized data system across all participating state agencies that can be used to identify which funding sources are being used to cover Part H services.
Meanwhile, DMHMRSAS and DMAS are working collaboratively to collect, analyze and report data on infants and toddlers with disabilities who were Medicaid recipients and who were enrolled in Part H for fiscal year 1996-97. In addition, the report recommends the development of a work group to examine strategies for enhancing and integrating existing approaches for Medicaid coverage for Part H services.
The subcommittee made the following recommendations:
Federal Part H regulations require that states facilitate the coordination of payment for early intervention services from federal, state, local and private resources (including public and private insurance coverage). Proposed federal regulations for the re-authorization of the Individuals with Disabilities Education Act (IDEA), issued on October 22, 1997, specify that families cannot be required to use their private health insurance to pay for Part H services if any financial cost would be incurred.
These regulations define financial cost as out-of-pocket expenses such as co-pays and deductibles, a decrease in lifetime cap or other benefits, an increase in premiums, and/or discontinuation of the policy. States could require families to use their private health insurance coverage to pay for Part H early intervention services if no financial cost would be incurred. The majority of insurance policies, however, would include a financial cost to a family. The proposed federal regulations do state that Part H funds may be used to pay the costs of co-pays and deductibles in situations where families refuse to use their insurance due to incurred financial costs. Therefore, the joint subcommittee recommended the following:
The Honorable Mary T. Christian, Chair
Legislative Services contact: Amy Marschean