CHINO VALLEY UNIFIED SCHOOL DISTRICT ANNUAL NOTICE TO PARENTS/GUARDIANS

Notice Regarding the District’s Participation in the LEA Medi-Cal Billing Program

The District, in cooperation with the California Departments of Health Care Services and Education, participates in a program that allows the district to be reimbursed with federal Medicaid dollars for select health services provided to enrolled Medi-Cal students at school. The money received through this program is directly reinvested into expanding and improving health and social services for all students.

In accordance with state and federal rules and guidelines, we are notifying you that some information may be released from your student’s records to our reimbursement recovery vendor, Paradigm Healthcare Services, LLC and to the Department of Health Care Services (DHCS) for claiming purposes only (and your child’s Medi-Cal benefits may be accessed). This information is only released if we have received your consent to do so. Your consent may have been provided to the district when you registered your student for school, as part of your back-to-school paperwork, or during the IEP/IFSP development and review process (if applicable).

All information that is shared is encrypted and transmitted securely to both our vendor and to DHCS. The education records that may be shared as a result of our participation in this program include:

• Student name, date of birth, and health-related evaluation, intervention, and referral information (for services received at school)
• Practitioners’ notes related to these health services and select data from child’s IEP/IFSP (if applicable)

You have the right to withdraw your consent to disclose your student’s information at any time—feel free to visit your school’s front desk to discuss this program. Please note that students will not be denied services they require to attend school, and parents will never be billed by the school district for services provided as a result of your consent, or nonconsent. Further, while Medi-Cal is reimbursing the district for select health services, your child’s Medi-Cal benefits should not be impacted in any way. We participate in this program in an effort to obtain federal funding for the Medi-Cal reimbursable health services already being performed at school, and then use this funding to expand services that are available to all students.

Additional notes:

• Confidentiality & Privacy. The district’s reimbursement recovery vendor is bound by a contract that contains specific provisions to keep student records confidential, ensuring information is not used or disclosed inappropriately; further, our vendor is HIPAA compliant. In addition, the district and DHCS are bound by agreements that include specific provisions about the use of the information shared in this program, and governing security protocols.

Third Party Liability. If your student is enrolled in Medi-Cal and is also covered by a third party insurer, DHCS may attempt to recover third party liability if they pay a school-based claim submitted by us. This occurs due to the assignment of third party liability rights that was provided when your application to Medi-Cal was approved