Wednesday, August 15, 2007

Special Education...or not?

According to an article in today's Indy some parents are questioning the accuracy of the Charles County Public School Systems tests to determine whether a student should be placed in Special Education.

Read more here.


LegalBeaglette said...

What concerns me is that money (Medicaid) – not educational/medical need – may be behind this significant reduction of students identified for special education services. The federal audit of Medicaid payments to school systems is not a new issue, and the Inspector General identified several weaknesses in the school systems’ billing processes that needed to be corrected: specifically, that services were billed to Medicaid “1) when providers were not qualified to render the service; 2) for services that were not approved in the state plan; 3) when the student was absent or the service did not occur with the appropriate participant; 4) for services that were not authorized or were in excess of the quantity authorized; 5) for transportation services when there was no authorized Medicaid service on the same day; and 6) for services that were insufficiently documented.” That was all based upon a review of the fiscal year 2000 data.

As a result of the audits, MSDE has reduced the amount of money it allows schools to bill for specific services, but the school systems have asserted that, even before the reduced rates were implemented, it cost them more to provide the services than what they were reimbursed by Medicaid.

So, because cost drives all issues, I have to wonder whether CCPS has reduced the number of students it identifies as requiring special services because the Medicaid reimbursement has been reduced even further? The audit documents I could find do not identify the school systems in Maryland upon which the auditing was done (I’d be interested if anyone knows where to locate that information).

In the Maryland Independent article referenced here, I find it curious that a child with such handicapping needs as to require out-of-county placement at a school which specializes in dealing with his disabilities was identified as NOT needing those special education services by CCPS. That does not sound like a slight oversight, and I applaud the parents for challenging the school system’s assessment.

I’ve read concerns by parents of special education students that documentation is poor with regard to special education students and the preparation and fulfillment of their IEPs. From the Inspector General’s report, I think it’s fair to say that appropriate documentation for billing with regard to those students is also poor.

This is what “accountability” is all about. To parents, and to the government which funds the services. That is not to say that I believe special education services are fully funded by the federal or state governments, but such funds that are available should not be squandered. It seems as if school systems used Medicaid as a money pot from which to dip freely, without doing the obligatory management of the spending for which they were seeking reimbursement.

Jennifer Abell said...

In regards to the Medicaid issue, this was brought up to me before and requested staff address the questions. Here is a synopsis of the responses I received.
"This is a national issue and debate that has been ongoing between the Federal Government and State Governments since 2004. The Federal Government subsequently reviewed the agreed upon reimbursement rates (set in 1992) and maintained that the rates they had originally agreed to were not equal to the cost of the services. We did not "over bill," but billed according to the agreed upon rates set by the State and the Feds."
"All school systems in Maryland were audited and the results were incorporated into a State audit review, since the issue/debate is between the State and the Federal Government (Department of Health and Human Services). I am not aware of any report that is County specific, but I do have a consolidated report from the Department of Health and Human Services that was issued to the State department of education and Maryland office of health services, department of health and mental hygiene."
"New rates were determined by joint task force including the Federal Government (Centers for Medicare and Medicare Services) DHMH, MSDE. The reimbursement rate was reduced by a range of 46% to 14% by service level down to a flat $45 for each health related service. Our FY2008 budget incorporated a budgeted revenue reduction of $302,000 which was offset by the total operating budget increase of $28.7 million. We were able to accomodate most of the lost revenue with savings from year end. There may be impacts in future years, depending how the future reimbursements get addressed on a federal level."

Anonymous said...


Thank you, Ms. Abell, for alerting me to your blog and the mention on the blog about the MD Indep article about parents questioning CCPS's Special Ed numbers going I am one of those parents mentioned. By the way, a correction is to be published that I hired an educational advocate, not a lawyer, and that I have 2 sons on the autism spectrum - one with Asperger's and one with PDD-NOS, not one child with both diagnoses..I don't know how the reporter got that messed up.

First, I don't question the testing skills of the CCPS experts (psych, speech, etc)(to counter Ms. Charbonnet's response in the article) but I do feel that the test results are definitely interpreted in favor of the school system rather than the child ...and if parents aren't educated enough in how to interpret the results themselves they can be "hoodwinkled" or pressured into accepting what the school says as gospel. I don't, and never have, accept what the school says is gospel. From my early experiences with CCPS Special Ed in 2003, a parent advocate, who volunteered to help me at the time when I was just coming to grips with my oldest son's autism diagnosis, etc, caught them trying to not respond within required IDEA guidelines of when I first requested testing on my older son & when the testing would be completed and after the testing, when I requested to see the test results prior to the IEP meeting, for the Educational testing I was not sent the subtest scores & had to request it(which showed significant scatter which usually indicates "issues" and large standard deviations (which meant something back then)in certain areas.) With the advocates help, I was able to counter the school on these matters but many parents wouldn't have gotten the assistance of an advocate or known enough on their own, and the child's needs would not have gotten the services required. Also in 2003, my son's psychiatrist who recommended that we get him tested by CCPS, and had done so for a number of her patients, received a letter from CCPS telling her that she was referring too many students for testing ...which I felt was way out of bounds for CCPS to tell a psychiatrist when or when not the children she is seeing need to be referred.

Let's face it ...IEP meetings can be very stressful and intimidating for well educated parents let alone those that don't have as much educational background or haven't done a lot of research on Spec Ed law/test results, LDs, etc.

Dr. Lynda Jacobs, the Director of Harbour School in Annapolis where my older son goes ,kindly emailed very knowledgable remarks on the subject (based on her 40 yrs in spec ed) to the reporter but her input wasn't used for the article. Here is what she said ...

"Ms Debbie Mason, the parent of one of the students in my school, has suggested that I write to you concerning the drop in Special Education students in the Charles County Public School Systems.

By way of vetting my comments, here are my background credentials:

I have been a special educator for 45 years
I have both a master and doctorate in Special Education
I have served as Coordinator of the Undergraduate Teacher Education Program in Special Education at the University of Maryland College Park, the Director of Special Education for Anne Arundel County Public Schools and the Assistant State Superintendent for Special Education for the Maryland State Department of Education
I am currently the Executive Director for The Harbour School at Baltimore and The Harbour School at Annapolis, independent non-public schools for children with learning disabilities, language disorders and high functioning autism and Asperger’s Syndrome.

Since 1975 with the passage of the Education for All Handicapped Children Act (EHA) which has been superceded by IDEA (Individuals with Disabilities Education Act) which require that all children with disabilities receive a free and appropriate education at public expense, school districts across the country have generally reported between 10-14% of their student bodies with having some level of disability as defined by the statue, This pattern has been consistent nationwide for over 30 years.

Prior to the federal laws which required the identification of students with disabilities, school districts identified between 5-7% of their students as handicapped (the term used at that time)

In my view the dramatic reduction in the number of students needing special education services reported by Charles County can only be the result of a failure to identify. In the early 70’s when I served as Director of Special Education for Anne Arundel County Public Schools we changed the definition of what a learning disabled child was. Overnight we reduced the number of learning disabled students in the district by 27%. The children nor their needs had not changed, just the definition.

Children with disabilities have very special instructional and CURRICULAR needs if they are to be successful as adults. While it may well be possible to address some of the instructional needs in a general education classroom providing the teacher has been well trained, the curricular needs generally are not met in the general education curriculum.

If an individual were having a heart attack, he or she would probably head for a cardiologist and not a dermatologist. Both are physicians, but most people would feel better cared for in the hands of someone specially trained to handle this particular health issue. So, I believe, it is with education. Individuals with special and particular learning needs should have those needs addressed by a special educator not by a general educator who lacks the specialized training and most often is not interested in gaining the specialized training or they would have done so in the first instance.

Please let me know if I can provide you with any additional information.


Linda J. Jacobs, Ed.D.
Executive Director
The Harbour School

“Providing a very special education since 1982” "

To conclude, with an autism epidemic going on when 1 in 150 chidlren are being diagnosed on the autism spectrum and the majority of school districts across the country are faced with their Spec Ed Dept's being swamped with kids on the autism spectrum, I find it very strange that CCPS 's Special Ed rates are going down at this time. To me, rather than something to brag about as CCPS did in the original article, this should be a big red flag to parents and local government officials that something is amiss with CCPS's Special Ed approach.

Anonymous said...

Deborah - thanks for your comments.
Can you tell me how the Harbour School as been?

LegalBeaglette said...

What is motivating this failure to identify?

Reduced funding for special education services?

Staffing issues? -- Special education positions are difficult to fill, especially with staff knowledgeable/trained in specific needs, like the autism spectrum disorders. NCLB wants students paired with “highly-qualified instructors,” but Mr. Fisher [EACC] has several times addressed the Board of Education asserting that “special education” teachers should NOT be held to the “highly-qualified” standards of the federal law. [I disagree with him strongly on that.]

Are both factors? Are there others? I simply cannot accept Ms. Charbonnet's assertion that the number of children identified for special education services is lower because instruction in CCPS has improved.

Jennifer Abell said...

I agree on both counts. Our Special Education Instructors should be "highly qualified". IN addition it is hard to swallow that CCPS special education numbers are declining when all of the rest of the nation is incresasing. There must be a logical explanantion and I don't believe it is because our instruction is outstanding. I mean we do have some outstanding teachers, but a child with special needs doesn't just stop having special needs because he has an awesome teacher and awesome instruction. Hhhhmmmm....