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California

California’s Local Educational Agency Billing Option Program and Children and Youth Behavioral Health Initiative reimburse school systems for eligible health services provided to students enrolled in California’s Medi-Cal program. School systems that maximize reimbursement receive significant recurring funding that offsets the growing cost of special education.

Eligible services

Occupational Therapy ServicesSpeech and Language Pathology ServicesPhysical Therapy Services Psychology and Counseling ServicesNursing ServicesRespiratory ServicesSchool Health Aide Services Physician ServicesOrientation, Mobility, and Vision Services Audiology ServicesTargeted Case ManagementMedical TransportationPhysical and Mental Health Evaluation and Education Assessments

California schools are leaving $431 million on the table each year

653Participating LEAs (districts, charters, county offices)
$171Median reimbursement per economically disadvantaged student
975KStudents in LEAs not participating in the school-based Medicaid program
42%Of districts not participating in the school-based Medicaid program

Based on FY24 school-based Medi-Cal cost reporting.

Per capita distribution

There is an enormous gap in per capita reimbursement among California LEAs. We support school systems to move to the right side of this distribution.

Medicaid Reimbursement Per Economically Disadvantaged Student FY24 $431M+ left on the table annually BOTTOM 3 QUARTILES VS. TOP QUARTILE 0 25 50 75 100 125 Number of California LEAs Top quartile 61 Less than $25 89 $25–$49 40 $50–$74 23 $75–$99 27 $100–$124 30 $125–$149 41 $150–$174 38 $175–$199 44 $200–$224 26 $225–$249 30 $250–$274 33 $275–$299 22 $300–$324 33 $325–$349 10 $350–$374 106 Over $375 Bottom 3 Quartiles (Under $325 per economically disadvantaged student) 13 ranges | 504 LEAs Top Quartile ($325+ per economically disadvantaged student) 3 ranges | 149 LEAs

*Distribution reflects FY24 school-based Medi-Cal reimbursement per economically disadvantaged student across California LEAs.

Our California K-12 school-based Medicaid services

Mile 2 Consulting is currently building our initial cohort of local education agencies in California. We will provide implementation and analysis support for the Local Educational Agency Billing Option Program (LEA BOP), the School-Based Medi-Cal Administrative Activities Program (SMAA), and the Children and Youth Behavioral Health Initiative (CYBHI).

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