Orland Unified School District

Eligibility for Services:   This program will not impact students' access to behavioral health services.  Rather, the program is creating a new, sustainable method for providers to be reimbursed.  Services delivered to students covered by Medi-Cal Managed Care Plans and Medi-Cal Fee For Service, most commercial health plans, or disability insurers, with certain exceptions, are eligible to be reimbursed at the CYBHI fee schedule rate.

 

Privacy and Consent:  Our school will ask for your student's health insurance information.  All health information will be securely stored and only shared in alignment with existing federal and state laws.  

 

Billing:  There will be no cost to parents or caregivers for students who receive services eligible for reimbursement under the CYBHI fee schedule program (i.e., no co-pays).  Receiving services at school will not reduce or impact students or their family's ability to obtain care outside of school, and will not impact deductibles or out of pocket minimums. 

As part of Governor Newsom's Master Plan for Kids' Mental Health and the CYBHI, the Department of Health Care Service (DHCS), the Department of Managed Health Care (DMHC), and the Department of Insurance (CDI) are partnering with schools to expand access to school-based and school-linked mental and behavioral health services for students aged 25 years and younger.

 

Through the CYBHI fee schedule, our schools and affiliated providers are eligible for reimbursement of behavioral health services, including screenings, assessments, and ongoing mental health supports given to our students.

 

This reimbursement will come directly from the insurance companies that cover the students at our school, at no cost to the parents or caregivers.  This program will not affect your insurance coverage (i.e., no co-pays, no higher premiums or deductibles).  Receiving services at school will not reduce or impact students or families' ability to obtain care outside of school.

Eligibility for Services
Will the CYBHI fee schedule change the services my student receives?
This program is not intended to significantly change the way your student currently receives behavioral health services - rather, it is a way for our school to be reimbursed for the provision of behavioral health services, thus giving us a sustainable source of funding for these services.  Examples of eligible services include behavioral health screenings, assessments, and ongoing mental health supports.  The CYBHI fee schedule may not apply to students on certain insurance plans (e.g., self insured plans, high-deductible health plans).  Services will be provided to students regardless of if they have insurance that will provide reimbursement through the CYBHI fee schedule. 

 

How does this relate to students receiving special education services?
Services required through an IEP are not reimbursable through the CYBHI fee schedule.  However, this program may provide reimbursement for behavioral or mental health services that students receive outside of their IEP.

 

Privacy and Consent
Why do I need to provide health information?  How will this information be used?
Our school will need to gather students' health insurance information so that it can claim reimbursement for eligible services under the CYBHI fee schedule.   This health information will be used to verify insurance coverage, enabling SLCUSD to submit claims under CYBHI.  All information will be securely stored and only shared in alignment with existing federal and state privacy laws.

 

Can I choose which behavioral health services my student receives? 
Parents and caregivers will continue to have the same process for consenting for services or allowing their student's information to be shared.  Note:  minors aged 12 years or older in California may be able to independently consent for certain services.

 

Billing
Will parents or caregivers have to pay for services provided to their student?  
Our school will need to gather students' health insurance information so that we can receive funding for eligible services under the CYBHI fee schedule.  This health information will be used to verify insurance coverage, enabling OUSD to submit claims under CYBHI. 

 

How does the CYBHI fee schedule affect a family's insurance?
Parents or caregivers do not need to pay for behavioral health services provided to students within the context of the CYBHI fee schedule program.  The program will not seek co-payments for services provided.  The CYBHI fee schedule program is designed to complement existing insurance coverage and participation in the program will not affect a family's insurance (e.g., premiums or deductibles).