[Congressional Record (Bound Edition), Volume 145 (1999), Part 18]
[Extensions of Remarks]
[Page 26713]
[From the U.S. Government Publishing Office, www.gpo.gov]



       TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999

                                 ______
                                 

                               speech of

                            HON. JERRY MORAN

                               of kansas

                    in the house of representatives

                       Tuesday, October 19, 1999

  Mr. MORAN of Kansas. Mr. Speaker, I rise today, unfortunately, to 
oppose this legislation. I wholeheartedly support the original intent 
of this bill, and I am a cosponsor of H.R. 1180. Improving the current 
system to provide real choices for people with disabilities is 
essential. The Work Incentives Improvement Act would address the 
barriers to employment by improving job training and rehabilitation 
services and providing the health insurance which is so critical.
  Unfortunately, the bill we are considering today is not H.R. 1180. 
The bill today includes troubling language from a substitute bill, 
which could cost Kansas and other states' school districts, million of 
dollars. Section 407 of this bill would limit Medicaid funding for 
school districts and their education of disabled children.
  Section 407 precludes or significantly restricts the use of bundled 
rates. The bundling system allows schools to minimize paperwork by 
billing for a package of medical services, rather than for each 
individual service provided to each child. In May of this year, HCFA 
sent a letter to all State Medicaid directors prohibiting bundled rates 
for school based services for special education health costs. At that 
time, there were seven states that had HCFA-approved bundled rate 
systems, including Kansas. Since this announcement, I have heard from 
nearly every school superintendent in my district. They are extremely 
concerned about this rule. The administrative burden this will impose 
on schools will be enormous. The end result of Section 407 of this bill 
will be to legislate this HCFA rule. Without proper committee hearings 
and discussion of this issue, it is upsetting that we are forced to 
vote on it now. If this provision is passed, I believe we could be 
punishing states that are efficient and accountable. We will once again 
be turning our backs on our students.
  When the Individuals with Disabilities Education was first passed, 
Congress promised that the federal government would pay 40% of the 
costs to schools. The federal government has never lived up to this 
promise and currently only pays out about 10% of the costs. Then 
Congress and the Administration told schools that they could seek 
reimbursements by Medicaid for school-based medical services for 
students with disabilities. HCFA told schools that it would even work 
with states to come up with a system of reimbursement that would not be 
so administratively burdensome to schools. So states and schools agree 
and are enthusiastic about getting more federal funds for special 
education costs. Yet, now both HCFA and Congress turn around and change 
their minds.
  In order to bill Medicaid for these services, schools will now have 
to record each service provided. The administrative burden for small 
schools will keep schools from seeking this reimbursement. The time and 
cost will be so high that schools in my district will not be able to 
afford to seek a reimbursement.
  So this provision is putting schools between a rock and a hard place. 
They do not have the resources to seek reimbursements for Medicaid, yet 
then their school budgets will be devastated because they cannot access 
these federal funds. We are bankrupting our small schools and--who pays 
in the end--our students. The budgets of small schools are already 
being drained by costs associated with special education services. 
Funds they should have access to for books, retaining teachers, and 
school modernization.
  This bill will now go to a conference between the House and Senate. I 
hope that conferees will take this time to listen to the concerns of 
school superintendents and state Medicaid directors. We need their 
advice and input as we form this legislation. I ask that we study this 
issue further before we legislate a rule that could hurt our schools.




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