Outside Therapy and Personal Nurses

What's Required

The term "related services" means transportation, and such developmental, corrective, and other supportive services as may be required to assist a child with a disability to benefit from special education. 1401(26) 300.34(a)

What We Do

The district is required to provide all students with a Free Appropriate Public Education (FAPE). For students with disabilities there are often additional materials, services, or resources that must be utilized to ensure FAPE is provided. It is the duty of the ARD/IEP Committee to outline the required services and accommodations that the student needs to be provided with the equal educational opportunities as their non-disabled peers. Depending on the individuals students needs, this may included  a number of related services such a therapy, special transportation, adapted equipment, and nursing care. 

Although students may be receiving therapy and nursing care at home our outside of the school, the school district has a duty to identify if those same services may be necessary at school to ensure FAPE is provided. If the ARD Committee identifies that this need exists, than the district has a responsibility to provide the required serves and equipment. 

Due to this requirement:
  • At no time should outside therapy and/or a home personal nurse/care giver provide services at school during the instructional day. If the ARD Committee determines that such services are necessary the duty will employ/contract for staff to provide the services. Note: Providing therapy during the school day by an outside therapist would change the students instructional day as notated on the SOS and the district would be required to provide compensatory time for lost instructional time.
  • All therapy, adapted equipment, and services must be documented in the ARD. 


SHARS/Medicaid Questions Related to Therapy and Nursing Care

1, If a child receives Medicaid billable services at school under the SHARS program, are they also able to receive the same service through Medicaid outside of the regular school hours?

Yes, the child’s eligibility for Medicaid services outside the school setting is not compromised by receiving SHARS services at school. The services provided at school are so the child may receive a free and appropriate public education. Due to medical necessity, the child may need additional services outside of school. For example, a school may provide and bill for SHARS speech therapy for a student who also receives Medicaid THSteps-CCP speech therapy outside the school.  

2. Could billing SHARS cause a child to exceed any “cap” or lifetime maximum on their Medicaid benefits?

There is no lifetime benefit cap for Medicaid services to children under 21. SHARS is a program under the EPSDT (Early and Periodic Screening, Diagnosis and Treatment) program. Under EPSDT, there are no set limitations on Medicaid services to clients under 21, so long as the service is medically necessary. The Medicaid services the child receives at school do not affect the type or amount of Medicaid services the child received outside of the school.