School Health and Related Services

The School Health and Related Services (SHARS) program allows Texas local educational agencies (LEAs) and shared service arrangements (SSAs) to request reimbursement for Medicaid 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;
  • Have a disability or chronic medical condition;
  • Be eligible for Medicaid;
  • Be enrolled in a public school's special education program;
  • 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
 
 

Participation in SHARS  

General Enrollment

 

A district must enroll as an active Medicaid provider for SHARS to become eligible to submit claims and receive reimbursement for SHARS Medicaid services.  Additional information about becoming a SHARS Medicaid provider is located on the Texas Health and Human Services Commission website.

 
 

*NEW*   Texas Medicaid Policy- THIRD PARTY LIABILITY (TLP) for SHARS INTERIM CLAIMS  *NEW*

Enrollment in SHARS is optional for districts and parents.  Participation does not preclude the district's responsibility to provide a free and appropriate public education to all students with disabilities.

Beginning on October 1, 2017, a new policy was instituted.  After Medicaid reimburses districts for SHARS services, the state may seek recovery claims from a student's private insurance.  Districts are expected to share this information with parents and ensure informed consent for SHARS services. Information regarding TPL can be found on the Texas Medicaid Healthcare Partnership (TMHP) website: Third Party Liability for SHARS Interim Claims

Parental Notice and Consent   

LEAs and SSAs are required to provide notification and obtain parental consent before accessing a child’s or parent’s public benefits or insurance.
 

Written Notification 

The LEA or SSA must provide written parental notification prior to requesting consent and accessing benefits for the first time and annually thereafter.  Minimally, it must include: 

1. A statement of the parental consent to access public benefits {34 CFR 300.154(d)(2)(iv)(A)-(B)]:

  •  specify the personally identifiable information that may be disclosed (e.g., records or information about the services),
  •  describe the purpose of the disclosure (e.g., billing for specific IEP services),
  •  identify the agency to which the disclosure may be made (e.g., Medicaid).

2. A statement of the "no cost" provisions: voluntary participation will not decrease lifetime benefit or incur out-of-pocket expense [34 CFR 300.154(d)(2)(I)-(iii)];

3. A statement that the parents have the right to withdraw their consent at any time (34 CFR part 99 and part 300); and

4. A statement that the withdrawal of consent or refusal to provide consent does not relieve the public agency of its responsibility to ensure that all required services are provided at no cost to the parents [34 CFR 300.154(d)(2)(v)].

      The notification must be written in language understandable to the general public and in the native language of the parent or other mode of communication used by the parent, unless it is clearly not feasible to do so [34 CFR 300.503(c)].

         One-Time Written Consent

        A public agency must obtain parental consent before releasing a child's personally identifiable information for billing purposes to a public benefits or insurance program for the first time.  Minimally, it must include:

        1. A statement of the parental consent to access public benefits [34 CFR 300.154(d)(2)(iv)(A)-(B)]:

        • specify the personally identifiable information that may be disclosed (e.g., records or information about the services),
        • describe the purpose of the disclosure (e.g., billing for specific IEP services),
        • identify the agency to which the disclosure may be made (e.g., Medicaid).

          2. A statement indicating 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 specific services identified in the child's IEP.

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

             
             

            Implementation Guidance

            The oversight of SHARS is a cooperative effort between the TEA and the HHSC.  Monitor activities are intended to ensure adherence to Medicaid standards as well as ensure the implementation of quality student services.

            TEA support includes:

            • monitor compliance with documentation guidelines,
            • perform regular desk reviews and field audits;
            • provide policy clarifications to districts,
            • validate data submitted for SHARS billing;
            • work to minimize exposure to provider waste, program abuse, and fraud.

               SHARS Self Monitoring Tool

               School Health and Related Services (SHARS) Frequently Asked Questions (Updated July 2017)

             

            Additional Resources and Training

             HHSC TETN Presentation 4/4/2018

             TEA TETN Presentation 4/4/2018 

             HHSC TETN Presentation 12/12/2017

             TEA TETN Presentation 12/12/2017 

             HHSC Rate Analysis/ Payment Information

             SHARS Update: Bulletin Registration

            Office of Inspector General (US Department of HHS): Centers for Medicare and Medicaid (CMS)