Overview

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. The Department hosted a training program on December 12, 2017 for new school districts. The training program covered interim claiming, random moment time study, admin claiming and cost reporting. Download the New District Training PowerPoint.

Updated state legislation allows school districts with a student count less than 1,000 students to submit a cost benefit analysis to the Department in order to determine whether the cost to participate in the SBCH program exceeds the revenue generated for the district. The excel form can be found on the What's Next page of the SBCH website. The exempted districts will be required to complete and submit the cost benefit analysis every three years to remain exempt.

SBCH Program Bulletins

August 18, 2018  Cost Report Update Bulletin

November 29, 2018  Psychological Testing Procedure Code Update

May 23, 2022  SBCH Service Documentation & Retention and MSI Form Part 2