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District reviews state multi-payer fee schedule that could expand reimbursements for school health services
Summary
Staff explained current Medi‑Cal billing (about $79,000 returned in 2022–23) and described a proposed multi‑payer fee schedule under the Children and Youth Behavioral Health Initiative that could allow reimbursement for services to general‑education and privately insured students when launched (state projection 2026–27).
Staff explained how the district’s existing Medi‑Cal billing for IEP‑related services works and described a state-proposed multi-payer fee schedule that could broaden reimbursements to services provided to general‑education students and those with private insurance.
“Receiving those dollars back that we would otherwise never see” is a benefit, staff said, noting the district received roughly $79,000 in Medi‑Cal reimbursements for 2022–23 for IEP‑eligible services. Under the proposed fee schedule, districts could potentially bill for additional services and insurance types; staff emphasized the model is not yet launched and state projections point to a possible 2026–27 rollout.
Trustees and staff discussed tradeoffs: while the fee schedule could increase revenue, it would require substantial administrative and personnel capacity (more service logs and third‑party billing workflows), parental consent processes and clarity on whether families would face co‑pays or penalties. Staff described next steps: the county office consortium (PCOE) is applying for CYBHI grants, will circulate MOUs for districts to join a consortium, and districts may apply for state cohorts (cohort 4 application window expected in January) to begin onboarding and pilot work.
No decision was made; trustees asked staff to track legal and parental-consent implications and to report back as the consortium and state timeline develop.
