Idaho - School-based health services: Policy requirement

Area: 
Policy Or Plan Requirements
Policy Type: 
Regulation
Summary: 

State law addresses aspects of traditional school-based health services (noted below), but does not formalize a program to aid in the establishment of clinics or health centers on campus for students. Health services provided for may:• Establish a school health board to govern school district health services• Set qualifications and certification required for physicians and health professionals providing school-based health services• Provide financial support for school-based health services• Address community involvement and/or partnership with school-based health services• Provide details as to the type of services provided

Idaho Administrative Code 16.03.09.853. School-Based Service: Coverage and Limitations

The Department will pay school districts and charter schools for covered rehabilitative and health-related services. Services include medical or remedial services provided by school districts or other cooperative service agencies, as defined in Section 33-317, Idaho Code.

03. Reimbursable Services. School districts and charter schools can bill for the following health-related services provided to eligible students when the services are provided under the recommendation of a physician or other practitioner of the healing arts for the Medicaid services for which the school district or charter school is seeking reimbursement. A school district or charter school may not seek reimbursement for services provided more than thirty (30) days prior to the signed and dated recommendation or referral. The recommendations or referrals are valid up to three hundred sixty-five (365) days.

  • c. Medical Equipment and Supplies. Medical equipment and supplies that are covered by Medicaid must be medically necessary, ordered by a physician, and prior authorized. Authorized items must be for use at the school where the service is provided. Equipment that is too large or unsanitary to transport from home to school and back may be covered, if prior authorized. The equipment and supplies must be for the student's exclusive use and must be transferred with the student if the student changes schools. All equipment purchased by Medicaid belongs to the student. (7-1-16)

  • d. Nursing Services. Skilled nursing services must be provided by a licensed nurse, within the scope of his or her practice. Emergency, first aid, or non-routine medications not identified on the plan as a health-related service are not reimbursed. (7-1-16)


Idaho Administrative Code 16.03.09.855. School-Based Service: Provider Qualifications And Duties

04. Nursing Services. Nursing services must be provided by a registered nurse or licensed professional nurse (RN), or by a licensed practical nurse (LPN) licensed to practice in Idaho. (7-1-13)

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