School Based ACCESS Program (SBAP)
The School Based ACCESS Program (SBAP) is a program that allows school districts and intermediate units to receive reimbursement through Medicaid for medical/mental health-related services that are provided by health care professionals to students with an IEP that are enrolled in the PA Medical Assistance program. The program works in partnership with the Pennsylvania Department of Education (PDE) and the Department of Human Services (DHS) through the state’s contracted agency Public Consulting Group (PCG).
Parents & Educators:
In 1988 Congress passed the Medicare Catastrophic Coverage Act which allows school districts to receive reimbursement for the cost of health-related services found in the child’s IEP, Individualized Education Plan, as long as the child is eligible for Medicaid. The ACCESS program is a specially designed program that was initiated in Pennsylvania during the 1991-1992 school year. Now known as the School Based ACCESS Program it is a venue for school entities to receive additional federal funding through Medicaid, assisting in the support of children who are mentally and physically challenged. Some services included are Speech Therapy, Occupational and Physical Therapy, Hearing, Nursing, and Vision. Through the school district’s claim submission process for listed services, SDP receives Medicaid reimbursement that we are able to use to enhance your child’s educational experience through the use of adaptive equipment, technology, and manipulatives.
In order for the School District of Philadelphia to receive a reimbursement and be able to assist in the purchase of supplementary materials and equipment to support the child’s IEP goals, we must have consent from the parent or guardian.
*NOTE: The claim information forwarded to Medical Assistance is the health-related service provided with the duration of service and provider information; when identified on the IEP or PTE/PTRE and when the data meets the reimbursable criteria.
*(ex. Speech; if Speech is listed on the IEP and your child receives Medical Assistance, the school district may request your permission to obtain reimbursement).
Who can Submit? When do I start?
Qualified Service Providers
Health care providers who meet the State of Pennsylvania’s licensure and certification requirements are eligible to participate in the program. These credentials must remain current and in good standing. Contracted therapists are reviewed to verify that they qualify for the SBAP credentialing. For specific qualifications for your specialty please contact the ACCESS office staff.
Each School via the SEL or LEA designee needs to submit the necessary IEP pages or PTE/PTRE Pages to obtain medical authorization and remain compliant with the SBAP program requirements. They should be scanned and emailed to email@example.com
**Submission must be sent in within 5 days of the student’s valid IEP once all of the program requirements have been met, including valid IEP, or signature of the PTE/PTRE, health service is on the IEP, MA Parent permission is granted with signature on file, medical authorization has been obtained and child is MA eligible. Services may be claimed through the ACCESS Program.
The program has excellent rewards that benefit our students and the health care provider. A portion of the dollars goes back into the schools to support the special education program in providing our students with the resources needed to work toward achieving their IEP goals and objectives. There are two methods for students to benefit from the school’s participation in the billing process. The two processes are the provider incentive program and the proposal writing process.
Health care service providers who are credited for 10 or more eligible claims processed for MA eligible students during the calendar year (1/1-12/31) will receive a $700 allotment to use for ancillary items that assist them in rendering service to our students. Providers who have larger caseloads may qualify for additional incentive dollars for participating in the program.
This method allows schools, teachers, and service providers a way to request supplementary materials that will enhance the learning environment of their students and allow them to work toward achieving their IEP goals.
Proposal Writing is a means of enhancing the educational experience by targeting the specific needs that a special education child has or specific needs that autistic support, life skills, or emotional support classroom may have to assist the students and bring them to a higher level of competency. There is a designated time frame that is open for Proposal submission. A letter is sent out from the ACCESS program to the Principals announcing this process.
Follow the website link to locate the form for Proposal Writing. During the submission process complete the form, print it out, and have it signed by all parties listed on the Proposal Submission Form. Completed forms should be delivered to the ACCESS office at the Education Center, Suite 323, before the designated due date.
There is a link in the proposal section of this website with a list of previously approved vendors frequently used by the school district for purchasing requested proposal items. Examples of requested materials may be manipulatives, adaptive equipment, or supplies that assist with overcoming the difficulty caused by the disability or that will challenge cognitive skills. The School District of Philadelphia implemented a new finance system in Fiscal Year 2021 and only the approved vendors in the ERP system can be used when submitting a proposal. The school team should coordinate with the principal and individual who places orders for the school to determine if the vendor is listed in the ERP system as an approved vendor and obtain their vendor number and information. If the vendor is not listed, they must become an approved vendor in the ERP system or the proposal cannot be considered by the ACCESS committee.
Random Moment Time Study
The Random Moment Time Study is another way the state allows school districts to obtain reimbursement for allowable administrative activities. Services such as related Medicaid outreach, referrals, coordination, and program planning are included. The RMTS is performed quarterly. A random selection of participants will be included each quarter and will receive notification by email that they will be sent a link in about 5 days to answer a few questions. They will have a designated time period to respond. The participants for the study included but are not limited to: Counselors, Hearing Therapists, Physical/Occupational Therapists, Nurses, Psychologists, Speech Therapists, and Vision Itinerants.
The ACCESS program is required to maintain documentation for transportation services provided to Medicaid-eligible students who have an IEP and receive a health-related service.
The documentation is recorded by the bus attendant on a monthly bus ridership attendance log. The logs are printed out by the principal or designee from the new Compass electronic system and given to the bus attendant at the beginning of the month. The bus attendant for public schools will return the signed completed log at the end of the month to Transportation Services, Education Center, Portal C.
If you have any questions regarding the bus logging you should call Melanie Hobbs at 267-784-6147 or call 215-400-5152.
Public Consulting Group
PCG is the Pennsylvania Department of Education’s contracted vendor to execute Medicaid claiming for the School Based Access Program. All claims are submitted to PCG and sent by PCG to the Department of Human Services for reimbursement. The School District of Philadelphia has the claims submitted by our providers extracted from its FED (full electronic documentation) system, EASY TRAC.
Medicaid eligibility of a child may be checked by submitting the name and birth date to the ACCESS office for verification. If you need to certify that a child is Medicaid eligible contact the ACCESS staff.