Frequently Asked Questions

Q. How do children qualify for Medicaid?
1. Low income families: These students tend to cycle on and off the eligibility list due to a parent's current employment status.
2. Foster Care Students: These children are taken care of by the state.
3. Students that could be a financial burden to the parent due to their long-term severe diagnosis.

Q. Why does one sibling from a family qualify for Medicaid but another sibling does not?
A. One sibling may qualify while another does not because the state in which the child lives makes the decision regarding qualifications. Sometimes the parent only applies for one child because only one child has severe health or medical conditions. In all cases, as a billing agent, we are never informed as to the reason(s) why a student does or does not qualify.

Q. Does the SBS program jeopardize a student's regular Medicaid eligibility or benefits?
A. The School Based Services program has no impact on the ability to access other outside therapy services. This program simply allows a school district to bill Medicaid without any cost to the family.

Q. Does the school district need parent permission?
1. Yes, districts need a signed written parent permission.
2. This can be obtained at the IEP meeting or yearly mailing.

Q. What is Attendant Care Services or Personal Care Services?
A. Attendant Care Services include a range of human assistance provided to students with a disability and/or chronic condition. The assistance enables them to accomplish tasks in the educational setting that they would normally do for themselves if they did not have a disability or chronic condition. Assistance may be in the form of hands-on assistance (i.e. actually performing an attendant care task for the student) or cuing the student so that he or she performs the task by himself or herself. Such assistance most often relates to performance of activities of daily living (ADLs) (Wisconsin Only).

Q. Do OT/PT staff need to do an OT/PT Intervention Plan?
A. The Standards of Practice for both AOTA and APTA, specify the expectation that therapists document a treatment (intervention) plan for the therapy being provided. Administrative codes vary from state to state in their language around the requirement of treatment plans, however, it remains a best practice issue, regardless of the state in which you practice.

Often therapists ask, "Doesn't the IEP serve as our treatment plan?" The answer is no. The therapy treatment plan should be a separate document from the IEP. The IEP goals should be educational in nature and focus on what the child is learning. The Intervention Plan identifies the motor and/or sensory components impacting the educational goals established in the IEP and connects the therapy support to the educational program of the student. (Wisconsin Only)