I am a school nurse  and I oppose the proposed changes by the Department of Medical Assistance Services to the Virginia school based Medicaid Care reimbursement program. The proposed changes requiring a physician's signature for each plan of care will be difficult and very time consuming to obtain. This requirement creates a burden on the school system as well as the physician's practices. Many physicians' offices now charge a fee for paperwork completion which could result in a cost to our families or a reduction in the amount of monies we are reimbursed. It is not required to have a physician's signature for a nursing care plan in a hospital setting. Requiring a physician's signature for a school nurse's care plan is beyond the normal standard..

The number of students with disabilities has increased significantly over the years as well as the student needs. Federal, state and local funding is not able to keep up with the cost of providing Special Education needs and has resulted in school divisions relying on Medicaid reimbursements. The children that benefit form this program require special equipment,  transportation, and individualized care in order to participate in Public Education. The extra time and resources required by the proposed changes could result in a decrease in school participation in this program. The monies our schools would lose will adversely affect services to our students with special needs.

I urge that the current school-based Medicaid reimbursement program requirements stay the same.