School-Based Medicaid Services

Kentucky school districts may participate in two Medicaid School-Based Programs. 1.School-Based Health Services 2.School-Based Administrative Claiming

School-Based Health Services  The School-Based Health Services (SBHS) program authorizes local education agencies in Kentucky, including KSB and KSD to enroll as a Medicaid Health service provider for children who are eligible under the Medicaid program and under the Individuals with Disabilities Education Act(IDEA). The Medicaid SBHS program is designed specifically to allow school districts to act as health care providers and be reimbursed under Medicaid. School districts may be reimbursed approximately 70 percent of the state and local funds they spend on some related services in the individualized education programs (IEP) of children with disabilities who are eligible under both IDEA and Medicaid.

Direct Reimbursement  Sample of approved services for direct reimbursement from Medicaid that Trigg County Public Schools currently provide:  1. Speech/Occupational/Physical Therapy  2. Nursing/Health Aides  3. Purchase of Assistive Technology  4. Special Transportation

KSBA Direct Billing Services  KSBA is a Medicaid billing service provider which provides training/technical assistance for an 8% fee of total district reimbursement.  Trigg County Schools Estimate of Annual Revenue for Direct Service Billing is calculated as follows: Child Count x district free/reduced lunch % = billable students x $ x 70% = 184 x $400 = $73,640

School Based Administrative Claiming  The Medicaid School-based Administrative Claiming (SBAC) program reimburse school districts for the time employees spend in administrative activities that directly support efforts to identify and enroll potentially eligible children and their families into Medicaid. SBAC involves all school district staff who, as part of their routine job duties, help students and their families learn about Medicaid, apply for Medicaid benefits, refer students to community medical and mental health providers or collaborate with other school staff or community agencies to better address the health care needs of students.  Conducted through KDE and is a requirement for the Direct Billing component.