SECTION 354.1341. Benefits and Limitations  


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  • (a) Subject to the specifications, conditions, limitations, and requirements established by HHSC, school health and related services (SHARS) are those Medicaid services that are determined to be medically necessary and reasonable to ensure a Medicaid-enrolled student, 20 years of age or younger with a disability, receives the benefits accorded to the student by federal and state legislation guaranteeing a free and appropriate public education.

    (b) SHARS must be prescribed in the student's approved individualized education program (IEP) as required by the Texas Education Code, §29.001(7), and implemented through Commissioner of Education rule at 19 TAC §89.1001 (relating to the Scope and Availability).

    (c) SHARS audiology services must be prescribed in an IEP as described in subsection (b) of this section or in a written Section 504 Plan as required by Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794).

    (d) SHARS must be delivered in the least restrictive environment consistent with the nature of the specific service(s) and the physical and mental condition of the student.

    (e) SHARS include:

    (1) audiology, individual and group delivered by licensed/certified therapist or licensed/certified assistant;

    (2) counseling, individual and group delivered by licensed/certified therapist;

    (3) physician services;

    (4) occupational therapy, individual and group delivered by licensed/certified therapist or licensed/certified assistant;

    (5) physical therapy, individual and group delivered by licensed/certified therapist or licensed/certified assistant;

    (6) psychological services;

    (7) speech therapy, individual and group delivered by licensed/certified therapist or licensed/certified assistant;

    (8) nursing services, including medication administration and nursing services delegated by a registered nurse (RN) (in compliance with RN delegated nursing tasks criteria as determined by the Texas Board of Nursing) to an employee or health aide;

    (9) special transportation services; and

    (10) personal care services.

Source Note: The provisions of this §354.1341 adopted to be effective April 30, 1991, 16 TexReg 2227; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; amended to be effective November 29, 1993, 18 TexReg 8354; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective October 17, 2004, 29 TexReg 9254; amended to be effective October 1, 2011, 36 TexReg 4651; amended to be effective November 27, 2022, 47 TexReg 7657