NH subcommittee examines special-education 'catastrophic' aid, Medicaid billing and data gaps

A legislative subcommittee on special education convened to hear local special-education directors and service providers on how New Hampshire districts identify and bill for high-cost students and how Medicaid reporting interacts with state catastrophic special-education aid.

The panel heard that districts use different software and practices to capture service-delivery time and costs, that participation in the Medicaid-to-schools program is voluntary and uneven across the state, and that the state’s current aid formula and reporting systems make it hard to predict the fiscal impact of lowering the threshold where state aid begins.

Why it matters: State lawmakers are weighing whether to change the special-education aid formula (commonly discussed as moving the local “first dollar” threshold from 3.5 times the state average student cost to a lower figure such as 2.5). The subcommittee was told many districts must choose, on a per-student basis, whether to pursue Medicaid reimbursement or to rely on the state catastrophic-aid calculation — a choice that can materially change whether a student’s net cost reaches the state threshold that triggers additional state aid.

District directors described three large cost drivers that most commonly push student costs above the state threshold: one-to-one paraeducators (including benefits and employer costs), specialized transportation, and out-of-district/residential placements. Esther Kennedy, director of student services for Guilford, said her district records every staff “touch” with a special-education student so she can decide “what is our better bang for the buck? Do I put them in as Cat A because I can get more money back? Or do we just keep them in Medicaid where I know that I can't double bill into the state system?”

Process and differences across districts

Speakers described different…