A nationwide survey of financing health-related services for special education students

The Individuals with Disability Education Acr (IDEA) requires state educati onal systems to provide school-based, health related sen ices (RS). This su rvey determined the financing arrangements used by states for health-relate d services for school aged children,with disabilities. A survey was sent to directors of special education, Medicaid, and public health departments in each of the 50 states. Financial patterns for RS were sought at the stare level for children ages 3-21 with disabilities for the 1993-1994 school yea r, the most recent year for which complete financial data rr ere available. Univariate analyses probed the relationship between systems' variables and the extent of Medicaid usage by local education agencies. Respondents repo rted that schools tapped traditional health resources to supplement educati onal dollars in paying for related sen ices in schools, Medicaid was by far the most common source with 29 states reporting established mechanisms for recouping,Medicaid dollars and 10 stares reporting phase-in activities. Se venteen states reported that departments of public health played some role in administration, training, and demonstrations, but only six stales provid ed specific dollars for related sen:ices through the department. Use of pri vate insurance was reported sporadically with only one stale indicating a s pecific state-lei el program. Correlates of increased Medicaid usage were p resence of interagency agreements (IAAs) (OR 11.1, p=0.002), having specifi c personnel for school-based medical assistance (OR 17.7, p=0.001), and uti lizing school nursing services as a Medicaid optional service (OR 4.2, p=0. 048).