Medicaid
Medicaid Reimbursement
Access the Medicaid Forms on the SE Forms page.
Medicaid is a jointly funded Federal-State health insurance program for persons with low income and/or disabilities. School Based Services allows districts to receive reimbursement for services provided to students with special needs under the Individuals with Disabilities Education Act (IDEA).
The program's purpose is to assure that Medicaid eligible children and teenagers, who are special-education certified, receive needed health care. Shiawassee RESD is the Medicaid provider under which all claims are made.
The School Based Services program is divided into two very distinct segments:
- The Fee for Service program receives partial reimbursement for direct medical services provided to special education students through the age of 21.
- The Administrative Outreach program receives partial reimbursement for the administrative costs to identify and help students who are considered "at risk" for various health problems.
Health services in the school systems include not only physical health, but mental and emotional health as well.
Fee for Service Program
This portion of the program obtains reimbursement for districts to provide direct health-related services and for case management services for special-education certified, Medicaid eligible students.
The personnel in the local districts who service these students are as follows:
- Audiologists - licensed
- Certified Occupational Therapy Assistants
- Early Identification/Intervention Personnel
- RNs and LPNs
- Occupational Therapists
- Orientation and Mobility Specialists
- Licensed Physical Therapists
- Physical Therapy Assistants
- Psychiatrists
- Psychologists
- Social Workers
- Special Education Classroom Teachers
- Teacher Consultants
- Speech Pathologists
- Personal Care Paraprofessionals
These dedicated school staff provide a wide range of health services to their students. Special education teachers provide case management services by making sure the student's plan of care is adhered to. The above staff report their services monthly for reimbursement.
Administrative Outreach Program
The Administrative Outreach Program receives partial reimbursement for the administrative costs to identify and help students who are considered "at risk" for various health problems. The goal is to direct these students and their families to the proper resources for help. This program generates revenue by tracking the time spent on Outreach activities by school personnel, and by factoring the district's expense for staff providing these services. School personnel chosen in the random moment sample are expected to complete their time study. Failure to do so affects the administrative portion of the state-wide reimbursement.
The following school personnel participate in the Outreach portion of the School Based Services program:
- Audiologists
- Speech Pathologists
- Social Workers
- Occupational Therapists
- COTA's
- Physical Therapists
- PTA's
- RNs and LPNs
- Psychologists
- Psychiatrists
- Orientation and Mobility Specialists
- Teacher Consultants
- Counselors
- Early Identification/Intervention Personnel
- Hearing Impaired Interpreters
- Special Education Administrators
- Program Specialists
- Personal Care Paraprofessionals
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