Annual Medicaid Notice

 2016-2017 WRITTEN NOTIFICATION REGARDING USE OF PUBLIC BENEFITS OR INSURANCE

Dear Parent or Guardian,

You are receiving this written notification to give you information about your rights and protections under Part B of the Individuals with Disabilities Education Act (IDEA), so that you can make an informed decision about whether you should give your written consent to allow your school district to use your or your child’s public benefits or insurance to pay for special education and related services that your school district is required to provide at no cost to you and your child under IDEA. First we will provide some basic information about IDEA.

Part B of IDEA is the Federal law that provides for assistance to States and school districts in making a free appropriate public education (FAPE), which includes special education and related services, available to children with disabilities in the least restrictive environment.  If your child has been evaluated and found eligible for services under IDEA because he or she has a disability and needs special education and related services, your school district must develop and individualized education program (IEP) for your child.  Your school district must provide the special education and related services included in your child’s IEP at no charge to you or your child.

IDEA funds pay a portion of your child’s special education and related services.  Funds from a public benefits or insurance program (for example, Medicaid funds) also may be used by your school district to help pay for special education and related services, but only if you choose to provide your consent, as explained below.  Also, your school district cannot access your or your child’s public benefits or insurance if it would result in a cost to you, such as a decrease in your benefits or an increase in your premiums.  These “no cost” provisions are explained below as well.

Before your school district can ask you to provide your consent to access your or your child’s public benefits or insurance for the first time, it must provide you with this notification of rights and protections available to you under IDEA.  This notification is intended to help you understand these rights and protections, including the type of consent your school district will ask you to provide. If you choose not to provide your consent, or later decide to withdraw your consent, your school district has a continuing responsibility to ensure that your child is provided all required special education and related services under IDEA at no charge to you or your child.

Notification Requirements- 34 CFR §300.154(d)(2)(v)
You are receiving this notification because IDEA requires that you be informed of your rights and protections when your school district seeks to use your or your child’s public benefits or insurance to pay for special education and related services.  The following sections explain when you must receive this notification and what information must be included in the notification.

When Notification Must Be Provided
You must receive this notification:

  • before your school district seeks to use your or your child’s public benefits or insurance for the first time and before it obtains your consent to use those benefits or insurance for the first time (the consent requirement is described below); and
  • annually thereafter.

Format of Notification
This notification must be:

  • written;
  • in language understandable to the general public; and
  • in your native language or in another mode of communication you use, unless it is clearly not feasible to do so.

Contents of Notification- 34 CFR §300.154(d)(2)(v)(A)-(D)
This notification will explain: 

  • the consent that your school district must obtain from you before it can use your or your child’s public benefits or insurance for the first time;
  • IDEA’s “no cost” provisions that apply to your school district if it seeks to use your or your child’s public benefits or insurance;
  • your right to withdraw your consent to the disclosure of your child’s personally identifiable information to your State’s public benefits or insurance program agency at any time; and
  • your school district’s continuing responsibility to ensure that your child is provided all required special education and related services at no charge to you or your child, even if you withdraw your consent or refuse to provide consent.

Parental Consent- 34 CFR §300.154(d)(2)(iv)(A)-(B)
**If your school district has not accessed your public benefits or insurance in the past to pay for services that it was required to provide your child under IDEA at no charge to you or your child, all of the parental consent requirements described below apply.

Before your school district can use your or your child’s public benefits or insurance for the first time to pay for special education and related services under IDEA, it must obtain your signed and dated written consent.  Generally, your school district will provide you with a consent form for you to sign and date.  Note that your school district is only required to obtain your consent one time.

This consent requirement has two parts.

  1. Consent for Disclosure of your Child’s Personally Identifiable Information to the State agency responsible for administering your State’s Public Benefits or Insurance Program

    Under Federal law—the Family Educational Rights and Privacy Act (FERPA) and the confidentiality of information provisions in IDEA—your school district is required to obtain your written consent before disclosing personally identifiable information (such as your child’s name, address, social security number, student number, IEP, or evaluation results) from your child’s education records to a party other than your school district, with some exceptions.  In this situation, your school district is required to obtain your consent before disclosing personally identifiable information for billing purposes to the agency in your State that administers the public benefits or insurance program.  Your consent must specify the personally identifiable information that your school district may disclose (for example, records or information about the services that may be provided to your child), the purpose of the disclosure (for example, billing for special education and related services), and the agency to which your school district may disclose the information (for example, the Medicaid or other agency in your State that administers the public benefits or insurance program).

  2. Statement to Access Public Benefits or Insurance

Your consent must include a statement specifying that you understand and agree that your school district may use your or your child’s public benefits or insurance to pay for services under 34 CFR part 300, which are special education and related services under IDEA.  The school district typically seeks consent at an IEP team meeting.

Both parts of this consent requirement apply to the school district that is responsible for serving your child under IDEA.  If your child moves to a new school within the same school district, you would not be required to provide a new consent because the same school district is still responsible for serving you child under IDEA.  But if you enroll your child in a new school in a new school district, the new school district that is responsible for serving your child under IDEA must obtain a new consent from you before it can bill your child’s public benefits or insurance program for the first time.  The consent you would provide to your child’s new school district must include both part of the consent as described above.

No Cost Provision- 34 CFR §300.154(d)(2)(i)-(iii)

The IDEA “no cost” protections regarding the use of public benefits or insurance are as follows:

  1. Your school district may not require you to sign up for, or enroll in, a public benefits or insurance program in order for your child to receive FAPE.This means that your school district may not make your enrollment in a public benefits or insurance program a condition of providing your child the services it is required to provide your child under IDEA at no charge to you or your child.
  2. Your school district may not require you to pay an out-of-pocket expense, such as the payment of a deductible or co-pay amount for filing a claim for services that your school district is otherwise required to provide your child without charge.For example, if you child’s IEP includes speech therapy and your insurance requires a $25 co-pay or deductible payment for a session, you could not be charged the $25.Your school district would need to pay the cost of your co-pay or deductible in order to bill your or your child’s public benefits or insurance program for the particular service.
  3. Your school district may not use your or your child’s public benefits or insurance if using those benefits or insurance would:
    1. Decrease your available lifetime coverage or any other insured benefit, such as a decrease in your plan’s allowable number of physical therapy sessions available to your child or a decrease in your plan’s allowable number of sessions for mental health services;
    2. Cause you to pay for services that would otherwise be covered by your public benefits or insurance program because your child also requires those services outside of the time your child is in school;
    3. Increase your premiums or lead to the cancellation of your public benefits or insurance; or
    4. Cause you to risk the loss of your or your child’s eligibility for home and community-based waivers that are based on your total health-related expenditures.

Withdrawal of Consent- 34 CFR §300.154(d)(2)(v)(C)
If you provided your consent for your school district to disclose your child’s personally identifiable information to the State agency that is responsible for administering your public benefits or insurance program [insert the name of the agency], you have the right under 34 CFR part 99 (FERPA regulations) and 34 CFR part 300 (IDEA regulations) to withdraw that consent at any time.

If you do not want your school district to continue to bill your or your child’s public benefits or insurance program for special education and related services under IDEA, you would need to withdraw your consent to your school district’s disclosure of your child’s personally identifiable information to the agency in your State that is responsible for administering that program.  The FERPA and IDEA regulations, however, do not contain procedures for withdrawal of consent to disclosure of your child’s personally identifiable information.  If you wish to withdraw your consent, you should ask your school district what procedures you would need to follow.  For example, your school district may ask you to submit your withdrawal request in writing.

What Your School District Must Do if You Withdraw Your Consent or Refuse to Provide Your Consent- 34 CFR §300.154(d)(2)(v)(D)
Finally, without your consent, your school district cannot bill your or your child’s public benefits or insurance program to pay for special education and related services that it is required to provide your child under IDEA at no charge to you or your child.  If you withdraw your consent or refuse to provide consent under the FERPA and IDEA regulations, your school district may not use your withdrawal of consent or refusal to provide consent to disclose personally identifiable information to a public benefits or insurance program to deny your child the special education and related services he or she is otherwise entitled to receive under IDEA.  Therefore, if you refuse to provide consent or withdraw consent, your school district has a continuing responsibility to ensure that your child is provided all required services necessary to receive an appropriate education at no charge to you or your child.

We hope this information is helpful to you in making an informed decision regarding whether to allow your school district to use your or your child’s public benefits or insurance to pay for special education and related services under IDEA.

Contact information:  For additional information and guidance on the requirements governing the use of public benefits or insurance to pay for special education and related services see: http://www2.ed.gov/policy/speced/reg/idea/part-b/part-b-parental-consent.html.

Sarah Reinhardt
SAU 50 Director of Special Education
48 Post Road, Greenland, NH  03840
603-422-9572 or sreinhard@sau50.org

 

**Complete the section below ONLY if parent/guardian is withdrawing consent to access the child’s Medicaid.**

 WITHDRAWAL OF CONSENT
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Student Name: _____________________________________             Date of Birth_____/______/_____

Medicaid ID Number___________________________________

As the parent/guardian of the above student, I withdraw my consent to allow the school district to access the child’s Medicaid. I understand that this means that the school district will no longer be able to use my child’s Medicaid to help pay for my child’s special education and related services. This withdrawal of consent is effective upon the school district’s receipt of the parent/guardian’s signed Withdrawal of Consent form.

 

______________________________________________                   _____________________________________
Parent/Guardian Signature                                                              Today's Date

 

Original to student’s file-----copy to parent/guardian


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