Agency Investigating Centralia School District’s Medicaid Reimbursements

Posted

A state agency is looking into the way the Centralia School District handles a federal program, after a long-time employee challenged the legality of local administrative practices.

School board candidate and recently retired Edison Elementary Principal Neal Kirby has been raising questions about how the district manages the Medicaid Administrative Match program, which reimburses schools for time spent for referring eligible students and families to services. 

Now, the Washington State Health Care Authority is meeting with district officials to examine practices related to the program. 

The monitoring process could take weeks or even months depending on what HCA officials find, according to spokesman Jim Stevenson. Once the agency completes the process, the public will have access to the findings.

 

Kirby called into question the methods some Centralia schools are using to maximize reimbursements. Additionally, he said, the way the district distributes the funding among buildings creates inequities for students.

Districts can distribute reimbursements at their discretion. 

“They all approach it from their own unique perspective,” said Tom Reese, who owns  JT Educational Consultants, a firm that helps the district and 92 others statewide administer the Medicaid program. “There’s really no right or wrong way.”

 

Centralia has chosen to allocate the money first to cover special education, then to pay JTEC. 

The remaining funds go back to the buildings that sought reimbursements. 

JTEC consultant Scott Adolf said he considers the district a best practice environment with a system in place to help ensure the integrity of claims for reimbursement.

The schools use reimbursement money to buy items such as computers, iPads, library books and training for staff.

 

Kirby said inequities in educational services have resulted due to two factors that determine the amount of reimbursement money schools receive. 

Because special education students tend to have more medical needs, buildings with large populations of these children report more time and receive additional funding.

However, Kirby said, the district already provides extra funding for special education classrooms and additional Medicaid match money districtwide.

 

Another problematic factor, Kirby said, is the random selection of teachers to report. 

Each quarter, five days are chosen for a selected group of core staff from each building to report how they spend their time identifying medical issues.

A districtwide random drawing determines additional staff members to report. 

The district receives reimbursement based on the time the staff reports during those days.

By the luck of the draw, Kirby said, some buildings have more teachers reporting, which leads to differences in budgets.

 

In 2011-12, Centralia Middle School received $138 per student from Medicaid match versus the high school, which collected just $19 per student, according to data from the district office, the HCA and the state Office of the Superintendent of Public Instruction.

Washington Elementary received $43 more per-student than Oakview for grades four through six. 

Medicaid funding also varied at the kindergarten through third-grade level, with Fords Prairie Elementary receiving $20 more per student than Edison.

 



Kirby is pushing for equal per-student funding because the extra money in some buildings has paid for upgraded technology and additional for staff training that benefits pupils in those schools. 

Kirby said citizens should have the right to comparable public educational services no matter which school in the district students attend.

 

Districtwide, Centralia received $317,243 in reimbursements in 2011-12, compared to the Chehalis School District’s $50,476, according to the HCA. Centralia has 24 percent more Medicaid eligible students and twice the staff to administer the program than Chehalis.

For the first two quarters of 2012-13, Centralia has received $313,612, according to HCA. The spring quarter is still being calculated.

About 48 percent of Centralia students qualify for Medicaid, according to JTEC. 

 

Kirby remains concerned that the district has built in a reward structure, which encourages staff to report time beyond their routine activities in order to bring in more money to school budgets.

“It’s incentive for buildings to do the reporting,” said Mitch Thompson, the district’s finance director.

Kirby said he believes some buildings are moving medical meetings to the days Medicaid is counted. Additionally, Kirby said, staff are being encouraged to push medical conversations past the 7.5-minute threshold to trigger a reimbursement.

“Moving a meeting, that’s not something we’d ever do,” said Washington Elementary Principal Danielle Vekich, whose building received the second highest Medicaid funding districtwide over the last two years. “It’s really just doing what we do routinely.” 

 

Kirby points to an email Centralia Middle School Principal Greg Domingos sent to staff titled “BIG MONEY! BIG MONEY! BIG MONEY!” as evidence inappropriate recommendations are taking place. 

“I was trying to get teachers’ attention,” said Domingos, whose building has received more than twice the amount of any other school in the district over the last two years.

In the email, Domingos reminds staff that “‘B’ is for bucks” and asks them to “maximize” Medicaid match funds, reviewing referrals that lead to reimbursements.

Kirby said the email confirms that some buildings are looking to maximize reporting rather than documenting allowable routine conversations. 

 

Superintendent Steve Bodnar points to a clean state audit report as evidence the district is administering the Medicaid program correctly.

“These are people who are educational leaders who aren’t exploiting anything,” he said.

Additionally, Bodnar said, Kirby led a low participation at Edison in 2011-12, which accounts for the school bringing in just $10,143, the lowest figure districtwide. In the first two quarters of 2012-13, Edison has increased to $14,939.

 

Though Edison is improving its funding, Kirby said, other schools are being disadvantaged. 

So far for 2012-13, Fords Prairie Elementary is receiving about $15 less per student than Jefferson-Lincoln. Oakview is bringing in $44 fewer for each student than Washington. And the middle school is receiving $112 more per student than the high school.  

“Kids should be going to schools within Centralia with comparable resources at least across the same grade levels,” Kirby said. “Why should any taxpaying parent be sending their kid to a school that has less per-student funding than the school down the road?” 

 

Michael Kelly, a Centralia School Board member running for re-election, said he is very concerned about the alleged misconducts surrounding the Medicaid match program. After reviewing documents from sources outside the administration, Kelly said, he will be calling on fellow board members to investigate the issue.

“I am hopeful the rest of my board will also question if the current district leadership is the right fit for the future,” Kelly wrote in an email to The Chronicle. “If any abuses of our system have occurred, I will make certain those individuals involved at whatever level are held accountable to the public.”