Double-Dipping: Special Education and Medicaid

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As
I prepare for yet another clash between my values, and those of
the public educational system, I could not miss the irony of tonight’s
newspaper headline, “MEDICAID FORECAST IS GRIM WITHOUT MAJOR CHANGES.”
The article points out that doctors wait years for 14 cents-on-the-dollar
reimbursements for important medical services rendered; that the
Michigan Medicaid caseload has grown by 162,000 people since 1999
with no sign of leveling off; that “there are fewer dollars available
to cover health care for Medicaid patients.” Even Michigan’s Democratic
Governor-elect Jennifer Granholm has stated, “Universally, people
have come to me and said, ‘Medicaid is broken. It needs to be fixed.'”
(The Associated Press, 11-25-2002)

I
could help Ms Granholm understand how widely the floodgates have
been thrown, but I doubt that my voice would be heard. The aspect
of Medicaid with which I deal is this: public schools are encouraged
to believe that special education teachers provide medical services,
and so public schools are filing claims with Medicaid. These pseudo-claims
are actually being paid, and the always-welcome monies are rolling
into the school districts – while cardiac surgeons wait years
to get paid for real medical services to Medicaid patients.

I
presently face an open threat of disciplinary action because I refuse
to believe that I am a medical provider, and I refuse to fill out
claim forms. Furthermore, I openly and strongly state my belief
that such claims are fraudulent and serve to "double-dip"
the taxpayers. However, the educational establishment will not allow
itself to recognize the lack of logic behind this “special education
equals medical services” scam. The "call of the money"
beckons.

I
have been instructed to note and detail every contact I have, with
any general education teacher, who also works with any of the students
on my caseload, who qualify for Medicaid:

LST:
$$ “Hi there, Mr. Science. The time for the Individual Education
Planning Committee (IEPC) meeting for Mary has been changed to
after school. See you then.” $$ (note 1/4 hour of service time
plus 1–1 hour meeting?)

LST:
$$ “Hi, Miss Artclass. How is Freddy paying attention this morning?
Ummm….that’s nice.” $$ (note 1/4 hour service time?)

None
of these encounters, brief or long, are medically related, or serve
medical purposes, yet I am being ordered to bill Medicaid for them.
In fact, I have been ordered to over-bill, just in
case Medicaid decides to under-pay. The exact wording
of the principal’s memo is, “Only one service coordination activity
can be approved per student per day. Document all services rendered
on the MedBill form. Medicaid covers one service per day and five
per twenty days. It is suggested that you write seven or eight in
case a few get rejected.” (October 21, 2002)

I
sat in the principal’s office, trying to be nice, borrowing from
Bartleby, the Scrivener, “I would prefer not to.” (My thanks to
John Taylor Gatto for the suggestion.) I tried explaining that I
could not, with good conscience, file claims that would double-dip
the taxpayer; that the taxpayers were already paying me to check
up on Freddy and Mary, and should not have to pay double for the
same moment-in-time.

When he asked if I was prepared to accept any repercussions for
my refusal to obey, I pointed out that I have, without complaint,
accepted punishment during all the years that I have been refusing
to file these forms. I explained that the special education director
long ago decided that, since I do not file for any $$booty$$, my
students do not deserve any additional, or more current, technology.
I directed his attention to the Apple IIC and the no-name 286 PC
without printer – all the technology provided for my students
to use in my classroom. (Should my students be forced to suffer
and do without, simply because I have principles that others in
the profession lack?)

When
the principal asked what I would do if he absolutely insists that
I file the claims, I explained that I have already had U.S. Representative
Dave Camp’s northern area director visit my classroom to hear my
concerns about "Special Education & Medicaid." I explained
that my next step would be to file a written complaint with the
U.S. House of Representatives and any other agencies I feel appropriate.
In the likely event that I will end up taking such action, I will
also file complaints will the U.S. Attorney General; with Governor
John Engler; with Governor-elect Jennifer Granholm; and with the
Michigan Attorney General.

Just
as a point of interest, I mentioned the confrontation and this principal’s
determination to push me into violating my own conscience, to our
union rep. I was not asking for help, but the MEA rep decided to
meet with my principal without notifying, or including, me. Following
that meeting-minus-me, this fellow-teacher said that the principal
had convinced him that since “all the other special education teachers
are doing it” and since the amount of work necessary to complete
the forms did not appear to be out-of-line, that the union’s position
would be that I should do as I have been told.

Ah,
I would prefer not to….

November
29, 2002

Linda Schrock Taylor [send
her mail
] lives in northern-lower
Michigan, where she is a special education teacher; a free-lance
writer; and the owner of “The Learning Clinic,” where real reading,
and real math, are taught effectively and efficiently.

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