1/18/2013. Topics for Discussion. Learning Objectives. The Affordable Care Act (ACA) and School Psychology. Minnesota School Psychologists Association

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1 The Affordable Care Act (ACA) and School Psychology Minnesota School Psychologists Association Minneapolis, MN January 18, 2013 Topics for Discussion 1. Key Components of ACA Impacting Schools 2. Implications for School Psychology 3. Current Federal Efforts 4. Proposed State Advocacy Steps 5. Resources 2 Learning Objectives 1. Participants will understand the implications of ACA for school psychology 2. Participants will understand the importance of recognizing school psychologists as eligible providers of Medicaid services in schools 3. Participants will understand the unique credentialing requirements of their state 3 1

2 KEY COMPONENTS OF ACA IMPACTING SCHOOLS What are we talking about? Health Care in America Are you familiar with the June 2012 Supreme Court decision about the individual mandate? Federal Legislation Patient Protection and Affordable Care Act Nick Named: Affordable Care Act (ACA) AKA: Obamacare Includes Medicaid, Medicare, and Universal Health Care.Are we all on the same page? 5 Key Components of ACA Renews the Children s Health Insurance Program Expands Medicaid Program Requires behavioral health services to be provided in state health exchanges Authorizes new funding for School Based Health Clinics 2

3 References to School Psychology in ACA Section 5002 Definitions: (22) MENTAL HEALTH SERVICE PROFESSIONAL- The term `mental health service professional' means an individual with a graduate or postgraduate degree from an accredited institution of higher education in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance abuse disorder prevention and treatment, marriage and family counseling, school counseling, or professional counseling. References to School Psychology in ACA Section 5203, Subpart 3, Sec. 775 (B) CHILD AND ADOLESCENT MENTAL AND BEHAVIORAL HEALTH For purposes of contracts with respect to child and adolescent mental and behavioral health care, the term `qualified health professional' means a health care professional who-- `(i) has received specialized training or clinical experience in child and adolescent mental health in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance abuse disorder prevention and treatment, marriage and family therapy, school counseling, or professional counseling; `(ii) has a license or certification in a State to practice allopathic medicine, osteopathic medicine, psychology, school psychology, psychiatric nursing, social work, school social work, marriage and family therapy, school counseling, or professional counseling; or ` (iii) is a mental health service professional who completed (but not before the end of the calendar year in which this section is enacted) specialized training or clinical experience in child and adolescent mental health described in clause (i). Key Message Maintaining our ability to provide services to children and youth in schools is critical States and NASP must work together to advocate for school psychologists to be recognized as approved providers of services 9 3

4 IMPLICATIONS FOR SCHOOL PSYCHOLOGY Implications for School Psychology Certified and licensed School Psychologists are specifically identified as members of the Health Care Workforce in ACA, but are not recognized as qualified health providers in some state Medicaid Policy Priority for authorized grants within ACA is given to communities with large populations of Medicaid eligible children and families If states limit reimbursements to licensed only professionals, schools may choose to hire less qualified licensed professionals to deliver school based services to Medicaid eligible students Key Messages Talking Points Recognizing certified/licensed school psychologists as qualified eligible providers of Medicaid services is good for children and youth Utilizing qualified school mental health providers currently employed by schools increases the accessibility and costeffectiveness of services 4

5 Key Messages Talking Points School Psychologists are uniquely qualified to provide behavioral and mental health services in schools and are in place now The credentialing requirements for school psychologists are rigorous and comparable to other eligible providers o In many cases, the minimum requirements to obtained entry level certification meets or exceeds those of community based professionals CURRENT FEDERAL ADVOCACY EFFORTS Current Federal Advocacy Efforts Encourage the Center for Medicare and Medicaid Services (CMS) to update technical assistance manuals to reflect language in ACA Communication with federal agency leaders to ensure that the specific references to school psychologists are maintained in Federal Regulations Collaborative advocacy efforts with allied professional organizations to ensure that school psychologists are considered qualified providers of Medicaid services 5

6 School Psychologists as Qualified Providers See the State Table: Eligible Providers of Services to Medicaid Key Message: The training of SP is comparable and exceeds, in many states, the qualifications required of other providers of Medicaid service. 16 What if the last key message isn t true for your state? Key message: The credentialing requirements for school psychologists are rigorous and comparable to other eligible providers Does your state s credentialing requirements mirror the NASP standards? Example: New York What needs to be done to update your state s credentialing requirements in order to remedy this problem? 17 States where School Psychologists are considered qualified eligible providers: WESTERN REGION SP ARE Eligible Alaska California Idaho Montana New Mexico Utah Washington SP ARE NOT Eligible Arizona Colorado Nevada Oregon Hawaii Does Not Participate Wyoming 6

7 Actions for States Where School Psychologists ARE considered providers: Continue advocacy related to the Practice Model Continue advocacy related to the recognition of NCSP Consider if you are vulnerable to changes in the qualified provider status Educate local and state policy makers about the definitions of Mental Health Service Professional and Qualified Health Professional within the statute of ACA. Monitor your state s implementation of ACA and expansion of Medicaid Ensure that school psychologists remain as qualified providers Actions for States Where School Psychologists ARE NOT considered providers: Educate members about ACA/Medicaid expansion Monitor your state s implementation of ACA and Medicaid Expansion Identify and reach out to potential allies Educate local and state policy makers about the definitions of Mental Health Service Professional and Qualified Health Professional within the statute of ACA Advocate for SP credential to be eligible provider in State Medicaid policy Actions for States Where School Psychologists ARE NOT considered providers: Become familiar with state credentialing/licensing requirements for SP Promote the recognition of the NCSP as an eligible provider credential Promote adoption of the national standards as the entry level for profession Promote the use of school psychologist and Nationally Certified School Psychologist in state statute and regulation Explore appropriate licensing for school psychologists (See VA: SP- Limited License) 7

8 State Planning Activity Consider your state s credentialing for SP and the qualifications of eligible providers of Medicaid services. (See prepared file folder.) 1. What are the policy needs for your state? 2. What are the SP professional development needs related to this? oare there state Medicaid policies or procedures that are important for all SP to know? 3. Develop 2-3 key messages for advocating for SP as eligible Medicaid providers. State Sharing Report Out 1. What is the status for your state regarding these issues? 2. What commonalities do you have with other states in your regions? 3. How do your key messages overlap? 4. What ideas do other state associations have that you could use in your state? 23 Next Steps. Take this information back to the appropriate leaders in your state association and develop an action plan If you need assistance in writing an action plan contact GPR or ATS committees You are now the leaders in your state on this topic!! 24 8

9 RESOURCES For more information on the ACA, see Health Care Reform: What School Mental Health Professionals Need to Know retrievable at: hcarereformbrief.pdf NASP Advocacy Roadmap: School-Based Medicaid Reimbursement retrievable at: map.aspx (under revision 10/12) NASP State Credentialing Page list.aspx QUESTIONS/COMMENTS 9

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