Special Programs Office

281-229-6020

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Welcome to the SHARS / Medicaid page.

Here you will find information about the School Health and Related Services (SHARS) program that allows Texas school districts to request Medicaid reimbursement for specific health-related services that our staff provides to students who receive special education services.  

Eligibility requirements:

  • 20 years of age and younger;
  • current eligible for Medicaid;
  • enrollment in a public school's special education program;
  • meet requirements for special education described in the Individuals with Disabilities Education Act (IDEA);
  • current Individualized Education Program (IEP) that prescribe the needed services

Eligible Services:

  • Audiology services
  • Counseling
  • Nursing services
  • Occupational therapy
  • Personal care services
  • Physical therapy
  • Physician services
  • Psychological services, including assessments
  • Speech therapy
  • Specialized transportation as defined by the Texas Health and Human Services Commission (THHSC)

Eligible Telehealth Services:

  • Audiology services
  • Counseling
  • Occupational therapy
  • Physical therapy
  • Physician services
  • Speech therapy
Dickinson ISD takes it responsibility for informed consent very seriously.  The information below is taken directly from the TEA website for SHARS guidance and is duplicated here for parents' and staff ease of reference.

Parental Notice and Consent   

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

Written Notification 

LEAs and SSAs 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

LEAs and SAAs  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

     

     

    Texas Medicaid Policy- Third Party Liability (TPL) for SHARS Interim Billing

    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.   Parents/adult students cannot be charged for special education services provided to 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.  The THHSC has decided to begin a lookback period on SHARS TPL claims on October 1, 2020.

    School districts have the responsibility to share the TPL policy with all families participating in the SHARS program:

    • Share the policy with parents/adult students. Ensure that they understand their right to withdraw consent to participate in SHARS.

    • If parents produce a document they believe is an insurance bill:

      • verify whether the document is a bill;  Some documents may include an Explanation of Benefits (EOB) that may or may not indicate that money is owed; and

      • if it is an insurance bill, contact the TMHP Contact Center at 1-800-925-9126.

    Information regarding TPL can be found on the Texas Medicaid Healthcare Partnership (TMHP) website: Third Party Liability for SHARS Interim Claims.

     

    Implementation Guidance

    The oversight of SHARS is a cooperative effort between the TEA and the HHSC.  TEA 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.

    District Self-Monitoring Tool

     

    Our SHARS process:
    Our RMTS process:

    DISD has a contract with Lone Star Educational Billing Services to serve as our 3rd party SHARS Medicaid Billing Service.

     

    Lone Star provides:

    • a SHARS representative for our district
    • Secure Electronic Billing
    • Unlimited Training
    • Audit preparation
    • Assistance with records management

    DISD Staff Secure Log In:

    Click HERE.

     

    Training & Manual

    (only DISD staff can view)

    2020-21 Training 

    MCX Manual 

    What is RMTS?  Random Moment Time Study is a federally accepted statewide random sampling to capture a participant's time performing work activities.

    • Participants are staff members who are randomly selected from the district's participant list in the Fairbanks system.
    • Sampling is done during the first 3 quarters of the year (not done for the 4th quarter of July-Sept.).
    • The RMTS process is provided by the state selected vendor: Fairbanks LLC 

    Participants respond to 3 questions:

    1. WHO was with you?

    2. WHAT were you doing?

    3. WHY were you performing the activity?

     

    An overall training is provided to all staff at the beginning of the year, and as each participant is selected, personalized training is provided by Patricia Perkins (281-229-6086).

     

    2020-21 RMTS Training

    2020-21 RMTS Participant Training

     

     

    The mission of the Dickinson Independent School District is to ensure that all students have safe and successful learning opportunities that help them reach their full potential and add quality throughout their lives. 

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