SSES+ Medically Fragile

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SSES+ Medically Fragile Overview:

Students who receive special education services, who are currently enrolled in a Texas public school, and are identified as "medically fragile" now qualify for the new SSES+ grant from TEA. Additional information about the SSES+ Medically Fragile program can be found below in the FAQs.

  • Families of qualifying students will receive online accounts to purchase goods or services that help their student access public school and/or health related services at home or where care is provided.  
  • SSES+ accounts are a $5,000 grant. 
  • There is currently enough funding for all students who are identified as medically fragile. This funding is separate and apart from the current SSES program. 

SSES+ Medically Fragile Resources:

  • One-Pager: What is the difference in the original SSES program and the SSES+ Medically Fragile program?
  • One-Pager: SSES+ Medically Fragile Overview:
  • SSES+ Medically Fragile Program: Customizable letter or email (PDF):
  • One-Pager: SSES+ Medically Fragile Eligibility

SSES+ Medically Fragile FAQs:

All FAQs for the main SSES Program apply to the SSES+ Medically Fragile program as well, below are the specific FAQs for just SSES+ Medically Fragile.

If you have a question not on this list, please contact us at

Click on the topics below to go to that section:

General FAQs

Who qualifies for SSES+ Medically Fragile?

What is available to purchase?

Regular SSES Program FAQs (links to another page)


General FAQs


How much are the SSES+ Medically Fragile accounts?



Eligible families will receive a $5,000 online account.



Why are SSES+ Medically Fragile accounts more than the regular SSES program?

In December of 2021, the Office of the Governor designated $20 million dollars in ESSER III funds to be awarded to provide a direct benefit to students identified as medically fragile.  Due to the unique and highly specialized needs of this population, the SSES+ Medically Fragile program makes more funds available to these families.



What if my student already had or currently has an SSES/ClassWallet account?

SSES + Medically Fragile families that currently have an existing ClassWallet account through the regular SSES program will receive an additional $3,500 funds to bring the total amount up to $5,000. You will be contacted by email about the additional funds being added into your account.



Can my child qualify for both regular SSES and SSES+ Medically Fragile?

The SSES+ Medically Fragile program is considered a special part of the SSES program. Students who qualify for SSES+ Medically Fragile receive all the basic benefits of the SSES program plus the extra benefits described here. Students who meet the Public Education Information Management System (PEIMS) coding definition of Medically Fragile will qualify for the SSES+ Medically Fragile program.



How do I apply for the SSES+ Medically Fragile program?

You will apply in the same way you would apply for the SSES program, visit SSES.TEA.TEXAS.GOV or click on the “apply today” button below. After applying, if approved for an SSES+ Medically Fragile account, you will receive an email from TEA and from ClassWallet with information about how to access your account.

Apply Now
Apply Today!



What if I already applied for the SSES program, will I need to apply again?

If you have already applied, you will not need to apply again, your family will receive your ClassWallet account with information on how to log in and access these SSES+ Medically Fragile funds. Please check your spam/junk mail for an email from with this information.


What is the difference between the SSES+ Medically Fragile program and the SSES program?


Please see this one-page document on SSES+ Medically Fragile vs. SSES.


Who qualifies for SSES+ Medically Fragile?

What is medically fragile?

Texas Public Education Information Management System (PEIMS) code defines Medically Fragile using the criteria listed below. For PEIMS code purposes, all criteria must be true.  

Whether the student receiving special education and related services is ALSO:

  • in the age range of birth to 22 years, AND
  • has a serious, ongoing illness or a chronic condition that has lasted or is anticipated to last at least 12 or more months or has required at least one month of hospitalization, and that requires daily, ongoing medical treatments and monitoring by appropriately trained personnel which may include parents or other family members, AND
  • requires the routine use of medical device or of assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living, AND
  • lives with ongoing threat to his or her continued well-being.



What does TEA use to verify eligibility?

After a family has applied for SSES, TEA uses PEIMS data from state records and the “Medically Fragile Indicator” (criteria listed above) to identify eligible applicants.  Records data must also show the student is currently enrolled in a Texas public school and served through special education.

One-Page Resource: SSES+ Medically Fragile Eligibility



What if my student’s medically fragile status recently changed?

TEA uses student data provided by PEIMS coding to verify medically fragile status, which is updated once per year. At this time, TEA reprocesses all applications and, if the student’s medically fragile status has changed in PEIMS, TEA will notify parents. However, if your student has recently been identified as Medically Fragile in your student’s Individualized Education Program (IEP) and you wish to update your student’s SSES+ eligibility before the yearly update, you will need to complete the SSES Appeals process. Please reach out to to learn more about the appeals process.



What are some examples of conditions that meet the definition of “medically fragile"?

PEIMS also provides a list of some examples of conditions that could be regarded as meeting the definition of “medically fragile.” This is not an exhaustive list.

  • Ventilator dependence,
  • tracheotomy dependence/breathing through tracheostomy tube,
  • nutritional difficulties causing gastrostomy tube dependence,
  • bronchial or tracheal malacia,
  • congestive heart problems,
  • life threatening respiratory infections,
  • apnea monitoring,
  • kidney dialysis,
  • conditions requiring suctioning of lung and throat,
  • or state of health is tenuous to the point of being life threatening.



What are examples of items common in the IEP for Medically Fragile students?

  • A health plan, safety plan, or an action plan for a specific event – e.g., a Seizure Action Plan.
  • Personal nurse, self-care support, or a 1-on-1 aide throughout the day.
  • Specialized classrooms and services or placement in homebound or hospital settings.
  • At least one related service – e.g., Personal care, occupational therapy, or physical therapy.
  • Participates in adaptive physical education.
  • Other Health Impaired (OHI) where a licensed physician has provided input to the
    ARD committee.



Note for ARD Committees:

Keep in mind that per Texas Education Code (TEC), §29.048(a), and 19 TAC §102.1601(j), ARD Committees may not consider the SSES program(s) when developing a student’s IEP or in making decisions related to the special education and related services or provision of FAPE to the student.

  • TEC, §29.048(a). A student’s admission, review, and dismissal committee shall develop a student’s individualized education program under Section 29.005, in compliance with the Individuals with Disabilities Education Act (20 U.S.C. Section 1400 et seq.), without consideration of any supplemental special education services that may be provided under the [SSES Program].
  • 19 TAC § 102.1601(j). Restrictions. A student’s ARD committee may not consider a student’s current or anticipated eligibility for any supplemental special education services or materials that may be provided under this section when developing or revising a student’s individualized education program, when determining a student’s educational setting, or in the provision of a free appropriate public education.

What is available to purchase?


What can we purchase?

Families will be able to purchase educational goods and services from the ClassWallet marketplace. The SSES+ Medically Fragile program has its own purchasing guidelines, separate from the regular SSES program.



Does someone approve the purchases?

All purchase requests will be reviewed before approving – it is helpful if you add additional information in the justification section on the item(s) attempting to be purchased. Families may also use the direct pay feature on ClassWallet to purchase items that might not be available currently in the marketplace.



What if I do not see what I am looking to purchase?

The ClassWallet marketplace has a variety of vendors, but we understand that not everything your student might need will be on the marketplace. You can request a vendor be added or you can use our direct pay feature to request purchase of items you cannot find within the ClassWallet marketplace. If you need help with this, please reach out to our SSES team at or call 1-855-773-3839. Please note the SSES+ Medically Fragile and SSES programs do not reimburse for items purchased, you may only purchase items through the online marketplace.



What if I cannot find a service provider or a particular service in my area?

If you are unable to find a service provider or a particular service in your area, please reach out to our SSES team at or call 1-855-773-3839.  The SSES team will be able to assist you in looking for a service provider that may already be on the ClassWallet platform or assist with getting a service provider in your area added to the marketplace. Please note, not all services may be provided in some areas of Texas, the SSES team is working hard to increase the number of service providers across the state.