Welcome to the Medicaid School-Based Services (SBS) topic page. We acknowledge that navigating Medicaid SBS can be complicated and confusing. The purpose of this topic page is to provide information, resources, and training to support LEAs implementing and seeking reimbursement for Medicaid SBS.

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Use the online Medicaid SBS Clarification Form to submit questions, concerns, or issues related to implementing and/or seeking reimbursement for Medicaid School-Based Services. Once we receive your online Clarification Form, we will respond to your question, concern, or issue via email, usually within 2 weeks. Then, we post your question, concern, or issue with our response to the Clarifications webpage. If you have an urgent question, concern, or issue, please indicate as such when completing the online Medicaid SBS Clarification Form.

Before submitting a new Clarification form, please:

1. Review the Medicaid School-Based Services Reference Guide, linked at the top of this webpage.
2. Browse the Clarifications webpage to see if your question, concern, or issue has already been addressed in an existing Clarification.
3. Submit only one question, concern, or issue per Medicaid SBS Clarification Form.

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The Clarifications webpage includes the questions, concerns, and issues submitted using the Medicaid SBS Clarification Form, with responses developed collaboratively by DHW and SDE staff.  Questions and their accompanying responses are organized by categories and are searchable. Please browse these clarifications for answers to your questions, concerns, and issues before submitting a new Medicaid SBS Clarification Form. If you notice conflicting responses or need additional information, please let us know by submitting a new Medicaid SBS Clarification Form.

Click this link to access all Clarifications.

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The Department of Health and Welfare (DHW) and the State Department of Education (SDE) collaborate to support the Medicaid Advisory Committee (MAC). The purpose of the MAC is to facilitate collaboration among Local Educational Agencies (LEAs), the SDE, and the DHW related to Medicaid School-Based Services (SBS) and providers. The MAC's role is to serve as a consulting body for matters of Medicaid SBS policy and practice and to recommend changes to Medicaid SBS policy, within the scope of applicable state and federal rules.

The MAC meets on the second Wednesday of September, December, March, and June, 1:00 - 3:00 PM (Mountain) /12:00-2:00 Pacific. MAC meetings are open to the public for in-person attendance at the Idaho State Department of Education, 650 W State Street in Boise and via Zoom (preregistration required). Meeting agendas and approved minutes from the past three years are available in the School-Based Medicaid Resources section of this topic page and are organized by school year. Agendas and approved minutes for this year will be posted as they become available.

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• Gainwell Technologies Forms
• Idaho Medicaid | Gainwell Technologies
• Idaho Medicaid Health PAS OnLine
• Idaho Medicaid Provider Handbook | Agency Professional
• Idaho Parents Unlimited
• Medicaid Basic Plan Rules: IDAPA 16.03.09 (Note: School-Based rules begin with IDAPA 16.03.09.850)
• Medicaid School-Based Service Providers | Idaho Department of Health and Welfare
• Online Medicaid SBS Clarification Form
• Provider Reimbursement Rates | Fee Schedules (Click HCBS and LTSS to locate School-Based Services Fee Schedule)
• Training, Resources, and Forms | Idaho Department of Health and Welfare
• United States Medicaid.gov

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Shannon Dunstan

Early Childhood and School Supports Coordinator
Idaho State Department of Education, Special Education Department
208-332-6908
SBMedicaid@sde.idaho.gov

Almira Mackaben

Medicaid Program Policy Analyst for School-Based Services
Idaho Division of Medicaid
Bureau of Developmental Disability Services
SchoolBasedServices@dhw.idaho.gov

Idaho State Department of Education
650 W. State Street
PO Box 83720
Boise, ID 83720-0027