School Health and Related services SHARS School Health and Related services

What is SHARS? School Health and Related Services (SHARS) is a Medicaid financing program and is a joint program of the Texas Education Agency and the Texas Health and Human Services Commission (HHSC). SHARS allows local school districts to obtain Medicaid reimbursement for certain health-related services provided to students in special education.  http://www.tea.state.tx.us/SHARS.html CCISD seeks reimbursement by billing for services. This program provided almost 2 million dollars to CCISD every year. Maybe your salary!

What criteria must a child meet in order for the district to bill Medicaid under the SHARS program? The child must: • Be enrolled in a public school’s special education program; • Be 20 years of age or younger; • Have an Admission, Review, & Dismissal (ARD)/Individual Education Plan (IEP) documenting the medical necessity for services • Have a disability or chronic medical condition; • Be Medicaid eligible.

Who Handles shars? Self Contained Classroom Teachers - AA, SD, PPCD, & SLL - Speech Language Pathologists Occupational Therapists Physical Therapists Nurses LSSPs

Psychological Services What do we do with shars? We bill for and receive reimbursement for services such as: Personal Care Physical Therapy Occupational Therapy Speech Therapy Psychological Services Evaluations Transportation All services billed must be specifically documented in the ARD. We bill for students who are Medicaid eligible only.

Random moment time study The monies we receive are from a federally funded grant. To participate in this grant, we must also participate in the Random Moment Time Study (RMTS). RMTS- is a mandatory survey. It is four questions long and asks what you were doing at a specific moment in time. Participants will be picked randomly by an outside company. You will be notified if you must participate in this study.

Can billing for SHARS effect a child’s family? No, the child’s eligibility for Medicaid services outside the school setting is not compromised by receiving SHARS services at school. The services provided at school are so the child may receive a free and appropriate public education. The child may need additional services outside of school due to medical necessity. For example, a school may provide and bill for SHARS speech therapy for a student who also receives Medicaid Children’s Services -Comprehensive Care Program (Medicaid Children’s Services CCP) speech therapy outside the school. http://www.tea.state.tx.us/SHARS.html

Could billing SHARS cause a child to exceed any “cap” or lifetime maximum on their Medicaid benefits? There is no lifetime benefit cap for Medicaid services to children 20 years of age or younger in Texas. SHARS is a program under the EPSDT (Early and Periodic Screening, Diagnosis and Treatment) program. Under EPSDT, there are no set limitations or cap on Medicaid services to clients 20 years of age or younger, so long as the service is medically necessary. The Medicaid services the child receives at school do not affect the type or amount of Medicaid services the child receives outside the school. http://www.tea.state.tx.us/SHARS.html

Common errors that will fail an Audit Failure to deduct services times of other providers from personal care. For example, forgetting to deduct time from personal care when the student is receiving speech therapy Billing individual care when they are actually receiving group personal care Not changing billing status when there are changes within a new ARD / IEP Not identifying the need for services within the ARD/IEP, over billing, or billing for services not documented in the ARD / IEP Not checking attendance and billing when a student is absent Billing for federal monies fraudulently will result in our school district having to pay back these monies and could result in further consequences.

What if I make a Billing mistake? Correct it as soon as possible and complete an Appeal If it is corrected within 120 school days, CCISD is only charged a percentage of remittance If it is after the 120 school day limit, CCISD will have to give back all funds for the entire day Either call eSHARS: 1-800-381-6334 Or contact the CCISD SHARS Clerk: Erin VanCamp X-40747 You want Appeals on an audit, not mistakes.

Training and assistance is available Contact the District SHARS Clerk Erin VanCamp X-40747 evancamp@ccisd.net