School Health and Related Services (SHARS) FAQ

Get answers to the most commonly asked SHARS questions, such as who is eligible, what services qualify, and more.

FAQ

Texas school districts can get reimbursed for some of the special education services they provide by participating in the School Health and Related Services (SHARS) program. Federal reimbursement for schools is provided through Medicaid for designated services delivered to special education students.

The SHARS program consists of three components:

Participating in three quarterly Random Moment Time Studies
Filing interim claims and receiving payments throughout the year
Completing an annual cost report

How much revenue are we eligible to receive from SHARS reimbursements?

The amounts individual schools are eligible for varies. The Health and Human Services Commission (HHSC) and the Texas Education Agency (TEA) are part of the process of establishing how much SHARS reimbursement a school can get. HHSC’s Rate Analysis Department (RAD) establishes the SHARS interim rates. They base the rates on the actual costs reported and certified as correct by the district in the cost report. HHSC gets the total salary information from the cost report data for all allowable SHARS direct services and transportation. TEA is responsible for setting the unrestricted indirect cost rate (UIDCR).

If your school is not yet participating in SHARS or if you would just like a third-party analysis of your program, TASB School Medicaid Services can help. We can work with you to analyze your current students and services to identify the range of revenue your school is eligible for.

What documentation is a school required to keep to participate in SHARS?

At a minimum, the following is a suggested checklist of documents related to SHARS direct services that should be collected and maintained for SHARS documentation, this is not an exhaustive list:

ARD/IEP documents (medical necessity; examples of SHARS services)
Attendance records
Assessment/evaluations
Provider qualifications (current licenses and certifications)
Written agreements (contract) for contracted service providers
Required prescriptions or referrals for services
Supervision logs
Session notes or service logs
Transportation documentation (daily trip logs; maintenance logs/records; bus documentation; documentation for cost report)
Claims Submittal and Payment Histories (R&S Reports and General Ledger)
Copies of signed/notarized quarterly Certification of Funds (COF) letters and supporting documentation, including quarterly COF Reports
Non-school SHARS provider affiliation letter and attachments (if applicable)
Cost Report and supporting documentation
Parent notification and consent as required by Section 300.154(d) of the reauthorized IDEA 2004.

Who do I put on my SHARS Participant List (PL)?

The PL should include all providers that deliver direct medical services (SHARS) and Medicaid Administrative Claiming services (MAC only). When creating or updating the PL for SHARS, be sure to only include providers that perform SHARS activities on a regular basis. The list is maintained so a district can participate in the Random Moment Time Study. The study is used to determine the percentage of time a participant spends assisting individuals with direct medical services.

SHARS Direct Medical Categories:

Registered Nurse (RN)
Licensed Vocational Nurse (LVN)
Advanced Practical Nurse (APN)
Delegated Nursing Services
Physicians (MDs and Dos)
Licensed Audiologist
Licensed Assistant in Audiology
Licensed Occupational Therapist (OT)
Certified Occupational Therapy Assistant (COTA)
Licensed Physical Therapist (PT)
Certified Physical Therapy Assistant (LPTA)
Licensed Psychological Associate
Licensed Psychologist
Licensed Specialist in School Psychology (LSSP)
Licensed Psychiatrist
ASHA – Equivalent Speech Language Pathologist (SLP) with Texas license and master’s degree
ASHA SLPs with Texas license
Grandfathered SLP with Texas License and no master’s degree
TEA or SBEC Certified Speech Therapists
Licensed Assistant in SLP
Licensed SLP Intern
Licensed Professional Counselor (LPC)
Licensed Marriage and Family Therapist (LMFT)
Licensed Clinical Social Worker (LCSW)
Personal Care Providers

All-inclusive list of SHARS providers approved by Center for Medicaid & Medicaid Services (CMS)

MAC only categories:

Behavioral counselor
Interpreter/translator/bilingual specialist
Licensed Bachelor of Social Work (LSW)
Licensed Master of Social Work (LMSW)
Physician assistant
Pregnancy, Education and Parenting Program personnel
Psychology intern
Orientation and mobility specialist
Outreach workers
Service coordinators/case managers

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