When officials at the San Diego City Schools decided to convert the district’s special-education system to a new computerized tracking database, it marked the beginning of the end to a long-running bureaucratic nightmare for special-education director Carolyn Nunes.
After spending her entire career struggling to keep pace with the unending barrage of paperwork that followed every one of the district’s approximately 17,000 special-needs students through the school system–the second largest in California–Nunes was convinced the district needed a more efficient means of ensuring that eligible students were receiving the care they so desperately needed & and deserved.
“We were looking for something that could capture everything we needed into one system. In addition to tracking student timelines, we wanted a system that had the ability to keep us in compliance and potentially help us increase our revenue recovery through MediCal,” California’s version of Medicaid, Nunes said.
San Diego is one of dozens of school systems nationwide reportedly benefiting from the use of new technology designed to track, monitor, record, and report the delivery of special-education services. Not only do these electronic tools promise to reduce dramatically the amount of paper pushed across administrators’ desks on a daily basis, but some say the technology is helping foot the bill for special-needs children–giving schools a much more efficient means of applying for and collecting millions in state-provided Medicaid reimbursements.
In St. Paul, Minn., special-ed coordinator Janet Lowe estimates the district increased its recovery of Medicaid funds by more than $1 million per year after moving to an automated tracking program furnished by Boston-based Public Consulting Group Inc. (PCG). And in Baltimore, officials reportedly realized a tenfold increase in Medicaid recovery–to $25 million–within three years of upgrading to a software program from Baltimore-based 4GL School Solutions.
Though the St. Paul school district was entitled to reimbursements from the state for a variety of services, Lowe said, the sheer volume of paperwork and the complexity of the reporting requirements often precluded busy administrators from applying for anything more than standard nursing services.
Using the automated filing system, she said, district officials now can apply for state money to fund everything from physical and occupational therapy sessions to speech and audiological services, as well as necessary social work and additional paraprofessional support.
Accountability is another benefit. Instead of digging through rooms full of file cabinets to account for services provided to students, Lowe said, special-education teachers and district and state auditors now can see those services reflected almost instantly by logging onto the system, which even allows service providers to fill out the necessary paperwork from their Palm Pilots almost immediately after meeting with students.
Clark Easter, chairman of 4GL, which also worked on the San Diego project, first envisioned the benefits of an automated special-education system in 1996.
Charged with helping the beleaguered Baltimore City School System meet its timelines for special-education children, Easter began searching for ways to expedite a process that, at the time, was failing to adequately account for 30 percent of the district’s special-needs students. The situation was so bad, in fact, that the district was under a judicial decree to get its house in order, Easter said.
The problem with a paper-based system is that it’s not very efficient, Easter noted. When a special-education service provider–whether a student psychologist or a physical therapist–comes to the school to meet with a child, the provider’s top concern is to provide assistance to the student. And that’s a good thing. But it also means the paperwork is likely to get put off until the service provider returns to his or her office. For most schools, Easter said, that’s where the trouble starts.
Without the proper paperwork in hand, administrators have a difficult time keeping track of which students are receiving adequate care and which are being forced to go without. In the public school system, every special-needs child is required to have an individualized education plan, or IEP, that charts a course for success from kindergarten through high school graduation. Failing to provide services prescribed in an IEP is a violation of federal law and opens the school up to potential lawsuits filed on behalf of frustrated parents.
For schools, finding the money to pay for such services–from psychoanalysis to physical and occupational therapy–isn’t easy. Though special-education students typically account for less than 20 percent of a school system’s total enrollment, Easter said, districts can spend as much as 50 percent of their full education budgets on special-needs programs.
Fortunately, schools can use state Medicaid dollars to pay for these services, assuming that the paperwork is done correctly and handed in on time. But that alone can be an onerous task. To receive payment for special-needs services, administrators first must navigate a complex web of forms and procedures, which makes meeting deadlines for claims virtually impossible in most cases, Easter said. As a result, it isn’t uncommon for school districts to get less than 50 cents on the dollar for treatment rendered, leaving them to pay for the remainder of the services out of pocket.
When Easter arrived in Baltimore City Schools eight years ago, the district reportedly received $2.5 million a year in Medicaid funds from the state. Three years later, after switching to an automated system, officials reportedly reaped more than $25 million in claims reimbursements.
“People were incredulous that there was that much money there,” he said. “What they failed to realize is that Medicaid and special education are two halves of the same coin.”
Today, a number of companies–including 4GL, PCG, and Mobile, Ala.-based Software Technology Inc.–market web-based software solutions designed to simplify the administrative burdens inherent in special-education record-keeping, while optimizing the financial opportunities available to schools.
Back in San Diego, Nunes said that while she couldn’t imagine life without the technology, it’s not a panacea.
“A large, painful challenge for us is teaching people to do things the right way,” she added. “But I’m a visionary. I know that two years down the road, it will be a beautiful thing.”
See these related links:
4GL School Solutions
Public Consulting Group Inc.
Software Technology Inc.