GOP health-care bill could strip public schools of billions for special …

School superintendents across the country are raising alarms about the possibility that Republican health care legislation would curtail billions of dollars in annual funding they count on to help students with disabilities and poor children.

For the past three decades, Medicaid has helped pay for services and equipment that schools provide to special-education students, as well as school-based health screening and treatment for children from low-income families. Now, educators from rural red states to the blue coasts are warning that the GOP push to shrink Medicaid spending will strip schools of what a national superintendents association estimates at up to $4 billion per year.

That money pays for nurses, social workers, physical, occupational and speech therapists and medical equipment like walkers and wheelchairs. It also pays for preventive and comprehensive health services for poor children, including immunizations, screening for hearing and vision problems and management of chronic conditions like asthma and diabetes.

Many school districts, already squeezed by shrinking state education budgets, say that to fill the hole they anticipate would be left by the Republican push to restructure Medicaid, they would either have to cut those services or downsize general education programs that serve all students.

“We’d have to make a local decision about what services we continue to provide and which we don’t,” said Paul Gausman, superintendent of a school district of 15,000 students in Sioux City, Iowa, that receives about $3 million in Medicaid reimbursements each year.

“I haven’t met many people who enjoy writing a check for their taxes, and I understand that,” Gausman said. “But it does not mean taxation is evil, and we’ve got to consider the most vulnerable of our population.”

In the Washington area, Montgomery County schools receive about $5 million a year in Medicaid reimbursements, Fairfax County about $1.5 million and D.C. Public Schools $49 million. Cutting that money “is not the way to set D.C.’s young people up for success,” D.C. Schools Chancellor Antwan Wilson wrote to families Tuesday.

Schools have been able to register as Medicaid providers and seek reimbursement, as doctors and hospitals do, since 1988. Two-thirds of districts that bill Medicaid use the money to pay the salaries of employees who work directly with children, such as school nurses and therapists, according to a January survey by AASA, the superintendents’ association.

But the Republican push to overhaul healthcare would implement a new “per capita cap” system for Medicaid: Instead of matching whatever states spend on Medicaid, the federal government would instead give them a fixed amount for each Medicaid enrollee.

Under the House GOP bill, which passed last month, that change would reduce federal spending about $880 billion over the next decade, according to the nonpartisan Congressional Budget Office. The Senate GOP version would cut about $772 billion over the same time period.

The Senate bill has stalled amid pushback from several key Republicans — including Sen. Susan Collins of Maine, who has raised concerns about the impact of cutting Medicaid on special education — and so details may change as Senate Majority Leader Mitch McConnell (R-Ky.) seeks to negotiate a deal that can pass.

But the underlying philosophy — that controlling federal spending would force the healthcare system to become more efficient in providing services — almost certainly would not.

Katie Niederee, a spokesperson for the Senate Finance committee, said that cuts to Medicaid in the current version of the bill “reflects Republican priorities to bend the cost curve on federal entitlement programs and encourage states that tend to spend beyond their means to actually stay within their budget.”

The Republican plan for Medicaid is likely to hurt schools in several ways, said Sasha Pudelski, who tracks healthcare policy for AASA. Most directly, states may decide to prohibit schools from receiving Medicaid dollars because of what is likely to be stiff competition against doctors and hospitals for limited resources, she said.

Less directly, states struggling to cover healthcare costs now covered by the federal government would have to seek cuts elsewhere in their budgets, including in education, which accounts for a large share of many states’ spending.

“The kids who will be hurt first and foremost are special ed kids and kids in poverty, but then everybody will be hurt, because we’ll have to shift dollars from the general education budget,” she said.

Schools receive less than 1 percent of federal Medicaid spending, according to the National Alliance for Medicaid in Schools. But federal Medicaid reimbursements constitute the third-largest federal funding stream to public schools, behind $15 billion they receive each year for educating poor children and $13 billion they receive to educate students with disabilities under the Individuals with Disabilities in Education Act (IDEA).

The federal government initially promised far more financial support for IDEA, the four-decade-old law that outlines schools’ obligations to educate students with disabilities. Congress pledged to pick up 40 percent of the cost of special-education services under the law, yet has never come close. It now pays only about 15 percent.

Medicaid payments have helped fill that gap. Without those dollars — and facing a recent Supreme Court decision that raised the bar for the services school districts owe students with disabilities — many districts wonder how they will pay for services they now provide.

In the small town of DuQoin, Ill., about 200 of 1,500 students receive special-education services. Medicaid helps pay the salaries of social workers, speech therapists and school nurses, as well as transportation for students with disabilities.

“If we’re not able to access the resources we have now … we’re going to be hurting kids,” said Superintendent Gary Kelly. DuQoin schools stand to lose about $170,000 in Medicaid reimbursements — a small but important fraction of the district’s $15 million annual budget, Kelly said.

Thanks to a political deadlock in the state capital, Illinois is headed into its third year without a budget, and schools across the state — including in DuQoin — are already scrimping, having cut teaching positions and other costs to balance their books. Illinois schools receive $286 million per year in Medicaid reimbursements, more than any other state except New Jersey and Texas, according to 2015 federal data.

In Crawfordsville, Ind., with a district of 2,400 students, Medicaid helps pay for a full-time registered nurse at each school. Those nurses provide primary care for many low-income students who don’t have a doctor of their own, Superintendent Scott Bowling said.

They also provide a first response to growing mental-health needs, and they care for children with complex medical needs, suctioning tracheostomies, tube-feeding children with gastric tubes, administering breathing treatments and emergency medication for seizures.

Bowling said that without the $50,000 in reimbursements, he’d have to lay off at least one nurse, and schools would be left without full-time nurse coverage. That gives him pause when he thinks about the emergencies his nurses have confronted: One saved a little boy from a severe asthma attack, administering an Epi-Pen to open his airways as they waited for medics to arrive. Another said this year she had intervened with two children who were suicidal, urging their parents to seek help immediately.

“Our nurses have literally saved students’ lives over the past few years – lives that we may have lost if we had to call them in from another site,” Bowling said.

GOP health care bill could strip public schools of billions for special education

School superintendents across the country are raising alarms about the possibility that Republican health care legislation would curtail billions of dollars in annual funding they count on to help students with disabilities and poor children.

For the past three decades, Medicaid has helped pay for services and equipment that schools provide to special-education students, as well as school-based health screening and treatment for children from low-income families. Now, educators from rural red states to the blue coasts are warning that the GOP push to shrink Medicaid spending will strip schools of what a national superintendents association estimates at up to $4 billion per year.

That money pays for nurses, social workers, physical, occupational and speech therapists and medical equipment like walkers and wheelchairs. It also pays for preventive and comprehensive health services for poor children, including immunizations, screening for hearing and vision problems and management of chronic conditions like asthma and diabetes.

Many school districts, already squeezed by shrinking state education budgets, say that to fill the hole they anticipate would be left by the Republican push to restructure Medicaid, they would either have to cut those services or downsize general education programs that serve all students.

GOP health-care bill could strip public schools of billions for special education

School superintendents across the country are raising alarms about the possibility that Republican health care legislation would curtail billions of dollars in annual funding they count on to help students with disabilities and poor children.

For the past three decades, Medicaid has helped pay for services and equipment that schools provide to special-education students, as well as school-based health screening and treatment for children from low-income families. Now, educators from rural red states to the blue coasts are warning that the GOP push to shrink Medicaid spending will strip schools of what a national superintendents association estimates at up to $4 billion per year.

That money pays for nurses, social workers, physical, occupational and speech therapists and medical equipment like walkers and wheelchairs. It also pays for preventive and comprehensive health services for poor children, including immunizations, screening for hearing and vision problems and management of chronic conditions like asthma and diabetes.

Many school districts, already squeezed by shrinking state education budgets, say that to fill the hole they anticipate would be left by the Republican push to restructure Medicaid, they would either have to cut those services or downsize general education programs that serve all students.

“We’d have to make a local decision about what services we continue to provide and which we don’t,” said Paul Gausman, superintendent of a school district of 15,000 students in Sioux City, Iowa, that receives about $3 million in Medicaid reimbursements each year.

“I haven’t met many people who enjoy writing a check for their taxes, and I understand that,” Gausman said. “But it does not mean taxation is evil, and we’ve got to consider the most vulnerable of our population.”

Schools have been able to register as Medicaid providers and seek reimbursement, as doctors and hospitals do, since 1988. Two-thirds of districts that bill Medicaid use the money to pay the salaries of employees who work directly with children, such as school nurses and therapists.

But the Republican push to overhaul healthcare would implement a new “per capita cap” system for Medicaid: Instead of matching whatever states spend on Medicaid, the federal government would instead give them a fixed amount for each Medicaid enrollee.

Under the Senate GOP bill, that change would reduce federal spending about $772 billion over the next decade, according to the nonpartisan Congressional Budget Office. The House GOP version, which passed last month, would cut federal spending $880 billion over the same time period.

Republican proponents argue that controlling federal spending would force the healthcare system to become more efficient in providing services. A spokesman for Senate Majority Leader Mitch McConnell (R-Ky.) referred a request for comment to the office of Sen. Orrin Hatch (R-Utah), chairman of the Finance Committee.

Katie Niederee, a spokesperson for the committee, said that the bill “reflects Republican priorities to bend the cost curve on federal entitlement programs and encourage states that tend to spend beyond their means to actually stay within their budget.”

Democrats believe that the nation’s neediest will be denied essential services — including in schools.

“No matter how they try to spin their massive cuts to Medicaid to make the Senate version look less ‘mean,’ it is clear that Trumpcare would mean massive cuts to schools and districts and massive pain for students and families,” said Sen. Patty Murray (Wash.), the top Democrat on the Health, Education, Labor and Pensions Committee.

The Senate bill, known as the Better Care Reconciliation Act, exempts some of the most disabled children from the per-capita caps, but the number of children who would be affected is not known. Education advocates that whatever the exact number, schools will be in the same pinch.

“Health care will be rationed and schools will be forced to compete with other critical health care providers — hospitals, physicians, and clinics — that serve Medicaid-eligible children,” a coalition of more than 60 education, civil rights and child-welfare groups wrote to senators on Tuesday, urging them to reject the GOP legislation because of the impact on schools.

The Republican plan for Medicaid is likely to hurt schools in several ways, said Sasha Pudelski, who tracks healthcare policy for AASA, the superintendents’ association. Most directly, states may decide to prohibit schools from receiving Medicaid dollars because of what is likely to be stiff competition for limited resources, she said.

Less directly, states struggling to cover healthcare costs now covered by the federal government would have to seek cuts elsewhere in their budgets, including in education, which accounts for a large share of many states’ spending.

“The kids who will be hurt first and foremost are special ed kids and kids in poverty, but then everybody will be hurt, because we’ll have to shift dollars from the general education budget,” she said.

Schools receive less than 1 percent of federal Medicaid spending, according to the National Alliance for Medicaid in Schools. But federal Medicaid reimbursements constitute the third-largest federal funding stream to public schools, behind $15 billion they receive each year for educating poor children and $13 billion they receive to educate students with disabilities under the Individuals with Disabilities in Education Act (IDEA).

The federal government initially promised far more financial support for IDEA, the four-decade-old law that outlines schools’ obligations to educate students with disabilities. Congress pledged to pick up 40 percent of the cost of special-education services under the law, yet has never come close. It now pays only about 15 percent.

Medicaid payments have helped fill that gap. Without those dollars — and facing a recent Supreme Court decision that raised the bar for the services school districts owe students with disabilities — many districts wonder how they will pay for services they now provide.

In the small town of DuQoin, Ill., about 200 of 1,500 students receive special-education services. Medicaid helps pay the salaries of social workers, speech therapists and school nurses, as well as transportation for students with disabilities.

“If we’re not able to access the resources we have now … we’re going to be hurting kids,” said Superintendent Gary Kelly. DuQoin schools stand to lose about $170,000 in Medicaid reimbursements — a small but important fraction of the district’s $15 million annual budget, Kelly said.

Thanks to a political deadlock in the state capital, Illinois is headed into its third year without a budget, and schools across the state — including in DuQoin — are already scrimping, having cut teaching positions and other costs to balance their books. Illinois schools receive $286 million per year in Medicaid reimbursements, more than any other state except New Jersey and Texas, according to 2015 federal data.

In Crawfordsville, Ind., with a district of 2,400 students, Medicaid helps pay for a full-time registered nurse at each school. Those nurses provide primary care for many low-income students who don’t have a doctor of their own, Superintendent Scott Bowling said.

They also provide a first response to growing mental-health needs, and they care for children with complex medical needs, suctioning tracheostomies, tube-feeding children with gastric tubes, administering breathing treatments and emergency medication for seizures.

Bowling said that without the $50,000 in reimbursements, he’d have to lay off at least one nurse, and schools would be left without full-time nurse coverage. That gives him pause when he thinks about the emergencies his nurses have confronted: One saved a little boy from a severe asthma attack, administering an Epi-Pen to open his airways as they waited for medics to arrive. Another said this year she had intervened with two children who were suicidal, urging their parents to seek help immediately.

“Our nurses have literally saved students’ lives over the past few years – lives that we may have lost if we had to call them in from another site,” Bowling said.

Boulder Valley school board narrowly approves budget, disagreeing over dyslexia funding

The Boulder Valley school board on Tuesday approved next school year’s $394 million operating budget in a 4-3 vote, adding more services for dyslexic students and school counselors at elementary schools.

The board also voted unanimously to approve salary increases for administrators and professional staff members, but didn’t approve the handbook that includes salary ranges.

Instead, the board directed the interim superintendent to commission a market salary survey and recommend revisions to the handbook, including potential revisions to salary ranges.

The administrative salary increase approved for the next school year was a standard 2.8 percent cost-of-living raise, plus a 2 percent raise for experience.

The highest priority identified by schools was to hire elementary school counselors. Now, the district only has counselors at middle and high schools.

The budget includes $1.3 million to hire 10 elementary counselors, two behavioral health advocates and a half-time coordinator. Each counselor is expected to serve multiple schools.

While board members agreed on adding elementary counselors, they didn’t agree on how much money to spend to support students with dyslexia.

Parents of students with dyslexia have been regulars at school board meetings, lobbying for $1.2 million to cover general education materials, awareness training for all teachers, professional development for interventions and a screening tool.

The budget, however, included $750,000 for targeted interventions for dyslexic students and teacher training, up from the $500,000 originally proposed.

Staff members also didn’t recommend a screening tool designed specifically to identify students with dyslexia. Instead, district officials said, they plan to better use an existing assessment to screen students.

Board member Shelly Benford proposed an amendment to use $450,000 from a $900,000 ending fund balance being held in reserve to increase the amount for dyslexia support to $1.2 million.

“This is a matter of priorities,” she said. “I would really like this board to make this a priority.”

But board member Tina Marquis said she wanted to stick with the staff recommendation, which includes hiring a consultant to work collaboratively with district staff members and parents of dyslexic students to develop a plan.

If the consultant recommends spending more money, then the district could tap into the $900,000 reserve, she said.

“Staff and community haven’t come together,” she said. “We need to go through this with some vision of success that we share. I feel pretty strongly that we have to get somewhere together.”

Benford’s motion failed 4-3.

Benford and the other two board members who voted for her motion, Richard Garcia and Tom Miers, then voted “no” on the original budget.

Next year’s budget is based on enrollment increasing by about 190 students, with state per-pupil funding increasing by $240 a student, to $7,588.

Adding to the revenue side, Boulder Valley voters in November approved an operational tax increase, freeing up money that otherwise would be spent on operational services and bolstering the budget.

On the expenses side, there’s a 2.8 percent cost-of-living increase for employees, plus increases for experience and additional education for teachers.

The district is keeping $2 million in reserve to address class size issues that come up after the school year starts. District staff members also committed to class size caps for core classes for ninth- and 10th-graders.

Then there’s about $2.3 million to open Meadowlark, a new PK-8 in Erie, and $1 million to hire more special education staff members.

Districtwide, there’s $2.8 million for new learning materials for K-5 language arts in the general classroom that include phonological awareness and phonics kits, plus $100,000 for teacher training in English language development.

The board also set aside $100,000 for a national superintendent search to replace Bruce Messinger, who was fired in May over an unspecified personnel issue. Cindy Stevenson, former Jefferson County Public Schools superintendent, is filling in as interim superintendent.

Funding requests from two outside school readiness programs — the Colorado Statewide Parent Coalition’s PASO program and the Community Foundation of Boulder County’s ELPASO program — didn’t make the cut.

In other business, the school board hired Mike Gradoz as the interim human resources assistant superintendent.

Gradoz, senior director of professional learning at The Colorado Education Initiative, previously worked at the Colorado Department of Education and as a human resources director in the St. Vrain Valley School District.

He replaces Shelly Landgraf, who resigned on May 25.

The board also approved re-hiring Sandy Ripplinger, the assistant superintendent of elementary school leadership.

Ripplinger recently retired, but now will continue in her position for the next year under a “110” plan, allowing her to work 110 days without compromising her retirement benefits.

Amy Bounds: 303-473-1341, boundsa@dailycamera.com or twitter.com/boundsa

Three bills with Triad ties clear General Assembly – Winston

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California Department of Education skewers Tehachapi Unified School District’s special education department in review

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Undergraduate education is broken. Solutions start with faculty and rigor.


Georgetown University (AP Photo/Jacquelyn Martin, File)

In two months, another crop of new high school graduates will head off to college. They will all depart the campuses at some point, but too many will leave without a degree.

Fewer than 40 percent of students enrolling for the first time at a four-year college actually graduate in four years. Even allowing an extra two years for financial challenges or new majors, fewer than two-thirds graduate within six years.

As the baby boomer generation leaves the workforce, the United States risks having successive generations less educated than the ones that preceded them for the first time unless we improve undergraduate education. Here are three ideas to get us started: 

Instead of focusing on tenure, focus on full-time faculty. We need to separate the debates about the future of tenure and its guarantee of lifetime employment from the growing use of part-time, adjunct faculty on campuses.

Only about one-third of college professors are tenured or on the pathway to tenure. That’s the statistic often used by faculty members who worry tenure is under threat as higher education leaders look to cut costs.

But focusing just on the tenure status of faculty is a mistake if we’re looking to cut college costs and improve undergraduate education. Not all faculty, whether tenured or not, are created equal in terms of costs. One recent study found that the increases in faculty salaries have been concentrated among large research universities and among a subset of academic departments.

“Within departments the highest-paid faculty teach fewer undergraduates and fewer undergraduate courses than their lower-paid colleagues,” wrote the study’s authors, Paul Courant of the University of Michigan and Sarah Turner of the University of Virginia.

Faculty salaries, they concluded, “are determined principally by research output and associated reputation.”

Indeed, there is a growing separation between faculty who teach and faculty who research at too many colleges, especially large research universities that enroll the largest number of undergraduate students.

Among those professors who mostly teach, too many are part-timers. Of the faculty members who are not on a track to earn tenure, almost half work part-time.

Full-time professors are more effective in the classroom and as mentors to students whether they have tenure or not, Jacques Berlinerblau, a professor at Georgetown University, noted in his new book, “Campus Confidential: How College Works, or Doesn’t, for Professors, Parents, and Students.” Berlinerblau maintains that the more prestigious the school, the less likely its most valued professors will engage with undergraduates.

On campus tours, prospective students and their parents rarely ask about faculty or how much time professors spend on research compared to teaching and advising undergraduates. Berlinerblau suggests families do their research by combing the college’s web pages to look at how many full-time professors your major’s department has and how many courses are taught by full-timers.

“The dreamier the school,” Berlinerblau writes, “the less likely it promotes a culture that emphasizes educating 18- to 24-year-olds. The less likely its distinguished faculty view teaching as the life’s calling that it surely is.”

In a recent column, I suggested that colleges adopt a recommendation from a former university president to put a cap on tenure—perhaps 30 years, followed by yearly contracts. The response from faculty was swift. The American Association of University Professors called it “a truly awful idea.” Others said that the cost of ever more administrators on campuses, not faculty members, is the real reason tuition prices keep rising.

Instead of fighting to get more professors on the tenure track, faculty advocates should focus on getting more full-time professors in classrooms, whether they have tenure or not.

Make the undergraduate degree more rigorous. One byproduct of the increased use of part-time adjuncts in college classrooms is that students have come to regard professors as yet another service provider. Adjuncts, hired by the semester, depend on positive student evaluations at the end of the term to get their contracts renewed. One way to ensure a good evaluation is to be an easy grader.

So the classroom has become one giant game of favor exchanges between students and professors. When they each play their parts, everyone comes out a winner. Students receive better grades and adjuncts keep their job year after year or spend less time dealing with complaints about bad grades.

A seminal study in 2011 that resulted in the book “Academically Adrift” found that one-third of college students made no gains in their writing, complex reasoning, or critical-thinking skills after four years of college. “American higher education is characterized by limited or no learning for a large proportion of students,” wrote authors Richard Arum and Josipa Roksa. For many undergraduates, they wrote, “drifting through college without a clear sense of purpose is readily apparent.”

The main reason for this, the researchers found, was a lack of rigor. Through surveys they learned that students spent about twelve hours a week studying on average, much of that time in groups. Most didn’t take courses that required them to read more than 40 pages a week or write more than 20 pages over an entire semester.

“You can’t assume that in sending off a student to a typical college that they’re going to get a rigorous education,” Arum later told me.

Design new pathways through the undergraduate degree. As the cost of college has spiraled upward, parents and students have focused more than ever on employment preparation and graduating on time. Intellectual discovery and exploration are no longer a priority, unfortunately. It’s too expensive.

To reduce the tension between the vocational training employers demand and the traditional liberal-arts education, the bachelor’s degree should be split into two parts: a one-year program of general education, followed by separate programs of varying lengths, depending on the needs of a given academic field. So after that first year, the credential for a computer-science major might take three years, but history or English majors might take just one, given that everyone is going to need further education throughout their lifetimes anyway.

The requirements for a bachelor’s degree already vary by major. What’s more, students are already patching together their own versions of a bachelor’s degree: one-third transfer to another college at least once before earning a diploma.

Concerns about the state of teaching led the Carnegie Corporation of New York in 2015 to fund the Commission on the Future of Undergraduate Education. The panel has started to issue studies from its work and its final report is expected next year. Its recommendations and the work some colleges are already undertaking to reform undergraduate education can’t come quickly enough.

California Department of Education skewers Tehachapi Unified …

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Can you spell ‘Tchoupitoulas’? Take a New Orleans street names …

Nothing brings out the competitive spirit of New Orleanians like a test of how well they know their city. Dozens of teams gathered for a street name spelling bee at Second Line Brewing Friday (June 23). 

How hard was it? The top possible score was 51. The two winning teams scored 46. 

Now you can try a cut-down version of the quiz, which was originally created by the New Orleans Public Library as part of its summer reading challenge. 

Post your scores in the comments. If you’re sure you know New Orleans but just can’t spell, the library is holding a geography bee Tuesday. 

Evaluation finds Massena Central School special education understaffed, but doing a good job

By ANDY GARDNER

MASSENA — A recent evaluation found that the Massena Central special education program is doing a good job with the students who need it, but it’s understaffed, according to Superintendent Pat Brady.

He said a company called Futures Education discussed their findings with the Board of Education on Thursday.

“They found the district has a good culture around our special education program to support students, the general education teacher and special education teachers are for the most part collaborating well … and do a good job educating parents,” Brady said. “They also concluded in their, and they had examined many school across the state as well as across the country … they determined our program is understaffed at a time when numbers of students identified as needing special education is on the rise.

“They also felt we need to continue to improve upon our response to intervention program … designed to provide support to students in ELA and math beginning in the primary graders. Part of that effort is to lower the number of students being referred to special education … work to build up their skills … they would have what they need already.”

Brady said the board wrote in two additional special education positions in the 2017-18 budget, but they’re having trouble hiring them.

“Most schools in the North Country and throughout much of the state are finding it difficult to hire special education teachers because they are in limited supply. We are in fact looking for two at this point,” Brady said.

He said the board welcomed the Futures Education report.

“When you have a major program like this, it’s important we examine it from time to time and when you bring in an outside perspective of people who have been in the field as special education teachers, directors of special education, superintendents … I think it was a valuable exercise and we will use their recommendations as we set up our goals over the next couple of years,” he said. “Our special education program impacts a fifth of our students, and approximately one fifth of our school budget.”

The report can be read at goo.gl/RF9WV9

A presentation shown at the June 15 board meeting is at goo.gl/RH4DLY.