Accessing Behavioral Health Services in Schools
Did you know that students in Arizona who receive Medicaid benefits can access behavioral health services in the school setting? AHCCCS helps school administrators and leaders connect with behavioral health providers statewide to meet their students' needs.
While schools have historically been approved settings for Medicaid-covered behavioral health services, in 2018 $3 million in state General Fund dollars were appropriated to expand behavioral health services in schools; $1 million of this funding is being used in a partnership with the Arizona Department of Education to provide mental health training to schools and school districts. The remaining dollars are matched with Federal Funds to generate $10 million in Medicaid funding to AHCCCS health plans to bring established behavioral health providers into the school setting, meet Medicaid-eligible students where they are and where they have a health needs, and pay for Medicaid-covered behavioral health services in schools.
The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Managed Care Medicaid Program, developed as a result of Title XIX of the Social Security Act. While AHCCCS also administers other state and federal health care programs, only Title XIX members are eligible for the DSC Program. The Medicaid Administrative Claiming (MAC) program is one of the two federally funded programs endorsed by the Arizona Department of Education (ADE) and AHCCCS. AHCCCS is the agency that develops the policies and administers the Medicaid School Based Claiming Program through PCG and in collaboration with the ADE.
- SB 1523, also known as Jake's Law:
In order to access and utilize the funding that is included through SB 1523, The Children’s Behavioral Health Services Fund, schools must develop policy related to the referral of students for behavioral health services. These policies must be publicly vetted through a public comment period, and posted on schools’ websites. Additionally, any school who wishes to access and utilize the funding provided through SB 1523 must provide students’ families with the opportunity to opt-in or opt-out to participate in the referral process on an annual basis. Finally, it is further required that students who have received a referral for behavioral health services be offered the opportunity to participate in a survey related to the referral process, and experience with the services received.
This template serves as a resource for schools to assist in the development of policy which meets the minimum requirements to access funding through SB1523. Schools do not have to use this template, and may develop their own policy.SB1523 Policy Template:
Example Purpose Statement: In conformance with SB 1523, this policy establishes a process to ensure parents are provided an opportunity to opt-in for their child to receive referrals to a behavioral health provider on an annual basis. Ensures that parents are provided an opportunity to furnish feedback related to the referral process, availability of services and providers, and their experience with receiving behavioral health services as the result of the referral. Outlines the process for identification of participating behavioral health providers, to be posted on schools’ websites for public access. Finally, the Policy will create a process to conduct a survey of parents whose children were referred to and received behavioral health services. For funding requirements, refer to AHCCCS AMPM 320-T2.Example Referral Process:
A School District Governing Boards/Charter School Governing Body must develop a method by which parents/guardians are able to opt-in or out of the behavioral health referral process annually. An example consent document has been included for reference. Schools may personalize and utilize this form, or a form of their own in order to obtain parent/guardian consent prior to making a referral for behavioral health services for a student.
(School District Governing Boards/Charter School Governing Body to include specific opt-in or out process here).
School District Governing Boards/Charter School Governing Body must develop and implement a referral pathway for students who have opted-in, and have been identified as needing behavioral health services. A resource available to schools to develop an effective referral system, based upon multidisciplinary problem-solving teams that match students’ needs with appropriate types or levels of evidence-based of support within a systems that has multiple tiers of support Figure 1.1; SMHRP Toolkit Introduction for detailed description.
Monitoring: (School District Governing Boards/Charter School Governing Body to include specific referral tracking information here)Example Survey Information:
Parents/Guardians of students referred for behavioral health services as a result of a referral will be invited to complete a survey about the referral process and their satisfaction with the services and providers of services received. This survey will be conducted through the behavioral health provider working with the student. The survey will include the following elements at minimum:
Whether the parent opted into the program
Whether the parent was notified before the referral took place
Whether the behavioral health services were appropriate to meet the students needs
Whether the parent is satisfied with the choice of behavioral health service providers
Whether the parent intends to opt into a program again in the following school year
Project AWARE: The Arizona Department of Education (ADE), in collaboration with AHCCCS, works in three school districts to improve access to behavioral health and suicide prevention resources. This includes a variety of evidence-based suicide prevention trainings that meet the Mitch Warnock Act requirement for Arizona school staff, postvention policies, and more. The five-year SAMHSA grant began in 2018. As a result, ADE and AHCCCS partner on multiple projects to improve the social and emotional wellbeing of Arizona’s students.
Arizona Medicaid School-Based Claiming Program: Arizona participates in two Medicaid reimbursement programs for school based services, the Direct Service Claiming (DSC) program and the Medicaid Administrative Claiming (MAC) program. These two school-based programs assist participating school districts, referred to as Local Education Agencies (LEAs), including charter schools and the Arizona School for the Deaf and Blind (ASDB), by reimbursing them for their costs to provide Medicaid covered services to eligible students. The purpose of the DSC Program is to allow LEAs to receive reimbursement for the cost to provide Medicaid covered medical services to Title XIX eligible students. The purpose of the MAC program is to allow LEAs to receive reimbursement for Medicaid administrative outreach activities that are done routinely within the school setting. The Centers for Medicare and Medicaid Services (CMS) is the federal agency that oversees these two school-based programs. In Arizona, these programs are overseen by the Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid agency. AHCCCS contracts with a Third Party Administrator (TPA), PCG, to administer both the DSC and MAC programs.
FAQ for Schools
- How do I get behavioral health services for my student/at my school?
- How are behavioral health services in schools paid for? What if my child doesn’t have Medicaid?
- What is the Mental Health Block Grant and how do I know if my child is covered for services?
- What services are covered?
- Does my student need an individualized education plan to qualify for behavioral health services in schools?
- My child attends school on tribal lands. Can he/she receive these services?
- My child is a foster child. Does he/she qualify for these services?
- My child is adopted and I receive a state subsidy. Does my child qualify for these services?
FAQ for Providers
- Is the funding for this initiative only for Title XIX/XX1 (Title 19/21) members?
- What types of behavioral health services are available?
- Which schools are participating?
- Which health plans are participating?
- How much money was allocated?
- How the funding was appropriated?
- How does this initiative differ from regular Medicaid-funded, school based behavioral health services?
- If it is only for Title XIX/XXI (T19/21) members, are there any funds for children who not eligible for Medicaid?
How do I get behavioral health services for my student/at my school?Each school has unique relationships with behavioral health providers in their area. Some schools allow services to be provided on campus; other schools refer students off campus. Speak with your school nurse or principal on how to connect your student with services.
How are behavioral health services in schools paid for? What if my child doesn’t have Medicaid?Students who are eligible for AHCCCS may receive behavioral health services from providers in the community. These providers may also accept private insurance and/or offer a sliding fee scale.
What is the Mental Health Block Grant and how do I know if my child is covered for services?The Mental Health Block Grant is a federal grant that funds behavioral health services for children and adults. To be covered by this grant, a child must be determined to be Seriously Emotionally Disturbed (SED). These grant dollars pay for services for children who are not otherwise eligible for AHCCCS services.
What services are covered?Complete list of behavioral health services that are covered. (The list does not include physical health services, such as eye exams.)
Does my student need an individualized education plan to qualify for behavioral health services in schools?No.
My child attends school on tribal lands. Can he/she receive these services?Not at this time. AHCCCS is working with Tribal Regional Behavioral Health Authorities to determine whether these services can be offered in the future.
My child is a foster child. Does he/she qualify for these services?Yes. Children in state foster care in Arizona receive health care through the Comprehensive Medical and Dental Program (CMDP) and would qualify for these services until age 21.
My child is adopted and I receive a state subsidy. Does my child qualify for these services?Yes. Children whose guardian receives a state subsidy qualify for these services until age 18.
Is the funding for this initiative only for Title XIX/XX1 (Title 19/21) members?Yes, this Medicaid funding is reserved for AHCCCS members or children enrolled in Kids Care.
What types of behavioral health services are available?
Which schools are participating?This depends on the health plan involved as well as the school district. Parents should contact their behavioral health provider or school administration to see if their children’s school is participating.
Which health plans are participating?All AHCCCS Complete Care and RBHA health plans are participating in this initiative.
How much money was allocated?A total of $10 million dollars was allocated for this initiative; $9 million of which is dedicated to services and $1 million was allocated for schools to provide Mental Health First Aid training.
How the funding was appropriated?The funding comes from an increase in the capitation rate for Medicaid members aged 1-21.
How does this initiative differ from regular Medicaid-funded, school based behavioral health services?This allocation from the capitation increase is specifically targeted to be use in schools. The billing code 03 designates the service as provided in a school setting.
If it is only for Title XIX/XXI (T19/21) members, are there any funds for children who not eligible for Medicaid?Yes, through the Community Mental Health Block Grant (MHBG) and the Substance Abuse Block Grant (SABG) the Regional Behavioral Health Authorities have targeted funds for providing BH services to individuals not eligible for Title XIX/XXI (T19/21) funding.
- Toolkit Resource
- Toolkit Resource
- Toolkit Resource
Billing information for providers: AHCCCS staff is also working to improve partnerships between behavioral health providers and school administrators. A list of service billing codes approved for use in school settings.