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.

  1. Jake’s Law: SB1523

    In 2020, the Arizona legislature passed Senate Bill 1523, establishing the Children's Behavioral Health Services Fund. This $8 million fund is to be administered by AHCCCS and will provide behavioral health services to uninsured/underinsured students who are referred for services by an educational institution and who have written parental consent to obtain the behavioral health services. AHCCCS will distribute the funding to the Regional Behavioral Health Authorities (RBHAs), which will then contract with local behavioral health service provider agencies. These agencies will create agreements with public and charter schools to provide services on and off of school campuses. AHCCCS is currently developing policies and procedures for this behavioral health service delivery, in partnership with stakeholders.

    This bill further requires schools to survey parents whose children have been referred for, and/or received, behavioral health services as the result of a referral from an educational setting. This survey will ask the student’s and family’s satisfaction level with the referral process, the overall provision of services, and the availability and selection of providers. It will also ask whether the recipients would opt-in to receive services again in the future. AHCCCS will compile the survey results in a report to the Governor’s office in December 2022.

  2. Project AWARE: In collaboration with the Arizona Department of Education, AHCCCS is working with three school districts to implement Mental Health First Aid training. This training has been shown to improve behavioral health outcomes and reduce suicides. During the next five years of this grant, approximately 12,000 students and staff at Baboquivari Schools on Tohono O'odham tribal lands, Glendale Unified School District, and Sunnyside Unified School District in Tucson will receive access to mental health training.

  3. ADE Training Partnership: In 2018, Governor Ducey led the Safe Arizona Schools Plan which included funding for investing in mental and behavioral health resources at schools. With $1M in funding, the Arizona Department of Education and AHCCCS signed an agreement to partner efforts in expanding access to behavioral health training in schools statewide. The goal of this partnership is to implement an evidence-based curriculum focused on education school personnel and students on commonly-occurring behavioral health issues to reduce stigma and empower schools to appropriately recognize and intervene.

  4. 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

FAQ for Providers

  • 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?
  • 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.

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.