Educator Login
 tease
 email-update

Follow us...  
Twitter Flickr You Tube Logo facebook

School Health and Related Services

 The School Health and Related Services (SHARS) program allows Texas school districts (LEAs) and/or shared service arrangements (SSAs) to request Medicaid reimbursement for certain health-related services. The Admission, Review, and Dismissal (ARD) committee determines SHARS services. Services must be medically necessary and reasonable to ensure that children with disabilities are able to participate in the educational program.

SHARS reimbursement is provided for children who meet all of the following requirements:

  • Are 20 years of age and younger and eligible for Medicaid
  • Meet eligibility requirements for special education described in the Individuals with Disabilities Education Act (IDEA)
  • Have Individualized Education Program (IEPs) that prescribe the needed services

Services covered by SHARS include:

  • Audiology services
  • Counseling
  • Nursing services
  • Occupational therapy
  • Personal care services
  • Physical therapy
  • Physician services
  • Psychological services, including assessments
  • Speech therapy
  • Transportation in a school setting

Qualified personnel who are under contract with or employed by the LEA/SSA must provide SHARS services.

SHARS Frequently Asked Questions

Participation in SHARS  

A district must enroll as an active Medicaid provider for SHARS to become eligible to submit claims and receive reimbursement for SHARS services. The Texas Medicaid fee-for-service provider enrollment form is located on the Texas Medicaid and Healthcare Partnership (TMHP) website. Additional information about becoming a SHARS Medicaid provider is located on the Texas Health and Human Services Commission website.

Federal Reimbursement Opportunity for the 2014-15 School Year

The Texas Medicaid Provider Procedures Manual

Notice and Consent  

LEAs/SSAs are required to provide written notification and obtain a one-time written consent before accessing a child’s or parent’s pubic benefits or insurance.

  1. Written Notification
    • Provided to parents before accessing the benefits or insurance for the first time
    • Provided prior to obtaining the one-time parental consent
    • Provided annually
    • Written in language understandable to the general public and in the native language or other mode of communication used by the parent, unless clearly not feasible to do so
    • Explains all of the protections available to parents as described in 34 CFR §300.154(d)(2)(v)
     
  2. One-Time Written Consent
    • Obtained after providing the written notification described above
    • Obtained before accessing the child’s or the parent’s public benefits or insurance for the first time
    • Specifies the personally identifiable information that may be disclose
    • Specifies the purpose of the disclosure
    • Specifies the agency to which the disclosure may be made
    • Specifies that the parent understands and agrees that the public agency may access the child’s or parent’s public benefits or insurance to pay for services
     

Non-Regulatory Guidance Regarding Parental Consent for the Use of Public Benefits or Insurance

Compliance Review 

TEA and the Health and Human Services Commission (HHSC) cooperate in the oversight of the SHARS program. All SHARS services require documentation to support the medical necessity of the service. TEA in coordination with HHSC will conduct reviews of selected LEA's SHARS documentation.

The purpose of the SHARS review is to:

  • Monitor compliance with documentation guidelines
  • Ensure LEAs/SSAs are adequately documenting health-related services for which Medicaid reimbursement is requested
  • Provide policy clarifications to districts
  • Validate information reported to HHSC by districts
  • Work in cooperation with districts and HHSC to minimize exposure to provider waste, program abuse, and fraud.

SHARS Compliance Review Guide

SHARS Self Monitoring Tool

Federal Health and Human Services; Office of the Inspector General


 

Page last modified on 9/22/2014 11:20:48 AM.