Medicaid School Based Program

The federal Individuals with Disabilities Education Act (IDEA) ensures that all children with disabilities between the ages of 3 and 21 have available to them a free appropriate public education (FAPE) that emphasizes special education and related services designed to meet their unique needs and prepare them for further education. Under Part B of IDEA, school districts must prepare an individualized education plan (IEP) which specifies all special education and related services to be provided to a child with a disability. Medicaid, a joint state-federal program, offers school districts reimbursement for many of the covered medical services included in an IEP/504 and provided to Medicaid eligible children.

In Connecticut, the Medicaid School Based Child Health (SBCH) Program is the mechanism by which a school district may seek federal Medicaid reimbursement for many of the Medicaid covered services that are provided to an eligible student pursuant to the student’s IEP/504. These services include assessment, audiology, clinical diagnostic laboratory, medical, mental health, nursing, occupational therapy, physical therapy, respiratory care, speech/language, and optometric services. Federal reimbursement may also be pursued by the school district for administrative activities which support the provided Medicaid health services. The Connecticut Department of Social Services (DSS) is the state agency responsible for administering the SBCH Program. State legislation requires school districts to enroll in School Based Child Health Medicaid Reimbursement.