Management . The advantage of this option is that administrative costs wider EPSDT do not require billing as they do under Targeted Case Management and thus the administrative burden to local schools is considerably simplified . The state Medicaid agency also does not have to establish a new targeted case management option, which would require an additional state plan amendment and HCFA approval . At the local level, this option is administratively similar to funding these services entirely from EPSDT . The major difference is that if the, rehabilitation option is used to fiend services, a physician's signature will not - „', '! . . . .1 e under state policy . At the state level, use of rehabilitation services for this population will require a change in the State Medicaid Plan, and will require policy and procedural work. The new school-based rehabilitation benefits are discussed earlier in this report . Overall, this option may represent the best combination of service coverage and administrative and procedural feasibility, both for local schools and for the state Medicaid agency . The rehabilitation services option allows the state agency to specify which specific service activities will be eligible for reimbursement . The administrative burden of service documentation, while a significant addition to current practice, would be manageable . (Although it would require additional administrative costs for such things as billing and processing of bills, these could be paid for at the state and local level with part of the additional revenue generated .) Summary of Options Several viable options are available to fund related services for special education students . As described, each option has particular requirements that will impose new record keeping activities on the school districts . Clearly, however, the schools are currently providing a significant number of services that fall within the scope of the Medicaid program, yet are receiving no federal reimbursement for these services . The table next page summarizes the primary advantages of each of the options and lists implementation issues that need to be considered .
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