Current through Register 2024 Notice Reg. No. 12, March 22, 2024
(a) Local Educational Agency (LEA) Services,
as defined in Section
51190.4, are covered to the extent
specified in this section. Frequency limitations are set forth in Section
51535.5.
(b) LEA Services shall include (1) through
(8) below:
(1) LEA health and mental health
evaluation and health and mental health education services, which include any
or all of the following:
(A) Nutritional
assessment and nutrition education, consisting of assessments and non-classroom
nutrition education delivered to the LEA eligible beneficiary based on the
outcome of the nutritional health assessment (diet, feeding, laboratory values,
and growth).
(B) Vision assessment,
consisting of examination of visual acuity at the far point conducted by means
of the Snellen Test.
(C) Hearing
assessment, consisting of testing for auditory impairment using at-risk
criteria and appropriate screening techniques as defined in Title 17,
California Code of Regulations, Sections
2951(c).
(D) Developmental assessment, consisting of
examination of the developmental level by review of developmental achievement
in comparison with expected norms for age and background.
(E) Assessment of psychosocial status,
consisting of appraisal of cognitive, emotional, social, and behavioral
functioning and self-concept through tests, interviews, and behavioral
evaluations.
(F) Health education
and anticipatory guidance appropriate to age and health status, consisting of
non-classroom health education and anticipatory guidance based on age and
developmentally appropriate health education.
(2) LEA physical therapy, which consists of
physical therapy services as set out in Section
51309(b) when
provided by an LEA practitioner to an LEA eligible beneficiary.
(3) LEA occupational therapy, which consists
of physical therapy services as set out in Section
51309(c) when
provided by an LEA practitioner to an LEA eligible beneficiary.
(4) LEA speech pathology and audiology
services, which consist of: speech pathology services as defined in Section
51096, and audiology services as
defined in Section
51098 when provided by an LEA
practitioner to an LEA eligible beneficiary.
(5) LEA psychology and counseling services,
consisting of diagnosis and psychological counseling of LEA eligible
beneficiaries with identified mental health, substance abuse, behavioral
adjustment, or social problems.
(6)
LEA nursing services, consisting of preventive and medically necessary nursing
services rendered at the school site. Services for accompanying the LEA
eligible beneficiary off-campus for delivery of health services are also
reimbursable if specified as medically necessary in the Individualized
Education Plan (IEP), as defined in Education Code, Section
56340 et
seq.; or in the Individualized Family Service Plan (IFSP), as set forth in
Government Code, Section
95020.
(7) LEA school health aide services,
consisting of the direct provision of specialized physical health care services
rendered at the school site. Services for accompanying the LEA eligible
beneficiary off-campus for delivery of health services are also reimbursable if
specified as medically necessary in the child's IEP, as set forth in Education
Code, Section
56340 et
seq.; or in the IFSP, as set forth in Government Code, Section
95020.
(8)
(A) LEA
specialized medical transportation services and the associated
mileage.
(B) For LEA eligible
beneficiaries with an IEP or IFSP, LEA specialized medical transportation
services may include trips to and from the residence, school site or other
sites of service when all of the following conditions are met on the day of
service:
1. The LEA eligible beneficiary
receives a Medicaid covered service other than LEA specialized medical
transportation services at the site being transported to; and
2. Both the Medicaid covered service and LEA
specialized medical transportation services are included in the LEA eligible
beneficiary's IEP or IFSP.
1. New
section filed 12-22-93 as an emergency; operative 12-22-93 (Register 93, No.
52). A Certificate of Compliance must be transmitted to OAL by 4-22-94 or
emergency language will be repealed by operation of law on the following
day.
2. Certificate of Compliance as to 12-22-93 order including
amendment of subsections (b)(7)-(8) and new subsections (b)(8)(A)-(B)2
transmitted to OAL 4-20-94 and filed 6-2-94 (Register 94, No.
22).
3. Amendment of subsections (a), (b)(6)-(7), repealer of
subsection (b)(8), amendment of subsections (b)(8)(A)-(b)(8)(B)2. and amendment
of NOTE filed 12-10-2015; operative 4-1-2016 (Register
2015,
No. 50).
Note: Authority cited: Section
20, Health and Safety Code; and
Sections
10725,
14115.8
and
14124.5,
Welfare and Institutions Code. Reference: Sections
14115.8,
14124.5,
14131,
14132,
14132.06,
14132.15,
14133,
14133.1,
14133.3,
14133.6
and
14133.9,
Welfare and Institutions Code; Section
56340 et seq., Education Code;
Section
95020,
Government Code; and Section
300.34, Title 34 Code of Federal
Regulations.
