In Idaho, changes to Medicaid could impact students with disabilities

From The Times-News in Idaho:

Facing a shrinking Medicaid budget, the Idaho Department of Health and Welfare has developed a plan to change the way people spend those few remaining dollars. But it may do so by imposing on already-limited Idaho school funds.

On Sept. 1, Health and Welfare released a final version of a proposal to change the way Idaho classifies two childhood disability programs. The Developmental Therapy and Intensive Behavioral Intervention programs help Medicaid-qualified children who have developmental problems and learning disabilities. Medicaid reimburses public schools for the extra care these children need, and have allowed many such children to join their peers in classrooms.

The proposed rule would change the two programs into “waivered services,” which the federal government would not fund in a school setting under Medicaid, IDHW spokesman Tom Shanahan said. Shanahan said the rule change is “cost neutral,” allowing children a wider range of options, including respite care, parental education and community-service options, for the same cost. But the only way that can happen is to get less of any one program.

“People can still get DT or IBI; it just has to happen after school,” Shanahan said.

That’s not acceptable for Wendy Kohntopp of Filer. Kohntopp’s son Tanner, 12, has Down syndrome but is well-adjusted, a fact Kohntopp credits to the DT and IBI help her son has received since preschool.

Kohntopp learned about the rule change one week before its public comment period closed Wednesday. She gathered 21 written letters and more than 100 e-mails from physicians, parents and educators opposing the changes, which she personally delivered to the IDHW in Boise Wednesday.

“These services work,” Kohntopp said. “IDHW is going to pass the buck to public education, which means (the programs will) either get watered down or disappear altogether.”

But they can’t disappear altogether, said Filer Special Education Director Pamela Houston-Powell. Under the federal Individuals with Disabilities Education Act, schools are required to educate students with disabilities in the “least restrictive environment.”

For most disabled students, that means they must have the opportunity to be educated with their non-disabled peers. That requires specialists to be in the classroom, which schools won’t be able to afford on their own. That will put additional burdens on regular teachers.

“If we lose that funding, it affects our whole system that we’ve worked to get up and running since 2006,” Houston-Powell said. “What IDHW wants to replace the current program with doesn’t help us in the schools.”

Shanahan said IDHW has worked on the proposed rule for two years and participants included the Developmental Disabilities Council, the Idaho Department of Developmental Disability Agencies and the Idaho State Department of Education. He said they announced the final draft on Sept. 1.

Houston-Powell said the first she and other special-education directors heard of the proposal was on Sept. 14 at their regional meeting. If IDHW doesn’t alter its proposal and it is approved by the state Legislature, schools won’t be affected until 2012 but there’s no plan to replace the programs.

In the meantime, the rule change may result in lawsuits from angry parents, said Brian Peck, director of the South Central branch of the National Association of Social Workers.

“We’re being irresponsible changing the rule before we know what will happen in schools,” Peck said. “The IDHW is losing sight that these are children we’re talking about.”