Medicaid Nursing Services

About

Nurses play an important role in the school. When a new student is enrolled, a nursing packet should be included in the enrollment packet.

 The nurse should discuss with the parents the child’s medical care and prepare consent forms, an emergency care checklist, immunization checklist, and receive medical documents from the previous school. This information is vital in preparing for the health care of the child. 

The Medicaid program, as established by Title XIX of the Social Security Act, provides quality health care to low-income, and disabled individuals by utilizing state and federal funds, to reimburse providers for approved medical services.

  Local Education Agencies (LEA)

The SCPSCD is recognized as an LEA by the South Carolina Department of Education (SCDE) and has contracted with SCDHHS to provide Medicaid-reimbursable school-based services to Medicaid-eligible children with special needs. Individual Charter Schools must sign an annual contract with the South Carolina Public Charter School District each year. 

Individual service providers employed or contracted by an LEA must meet the specified Medicaid provider qualifications.

Medicaid Nursing Policies

Medication Policy

All medication must be delivered to the School Nurse or other designated school employee by the student’s parent, legal guardian, or a previously designated adult. It is against School District Policy for a student to carry ANY medication on their person without physician permission, parent permission, and school district permission to self-administer and self-monitor (SC Law S144). All medication will be maintained in the health room. Medication required for field trips must be given to and administered by an employee designated by the principal. There are separate permission forms for medications on field trips. 

South Carolina Immunization Requirements 

A child will not be allowed to attend any school or child development program without a valid SC Certificate of Immunization or a medical, religious, or special exemption. If your child does not have a valid certificate, take his/her shot records to your physician or the county Health Department. A parent or adult authorized by the parent must accompany a student under 16 who requires shots. The child's immunization record must be submitted to the school prior to starting school. For additional information contact the district office. 

Who can receive Medicaid Nursing Services? 

Nursing services for children under 21 years are those specialized health care services including:

•nursing assessment and nursing diagnosis

•direct care and treatment

•administration of medication and treatment as authorized and prescribed by a physician or dentist and/or other licensed/authorized healthcare provider

•nurse management

•health counseling and emergency care.


Medicaid Nursing Documents

An RN as allowed under state licensure and regulation must perform acts of nursing diagnosis or prescription of therapeutic or corrective measures. The need for services must be appropriately documented in an IEP, IFSP, IHP, or ITP or clinical service notes, when appropriate.

Nursing documents must be completed annually and for new students entering school.


Medicaid Nursing Credentials

A nurse is defined as an individual who is currently licensed as a registered nurse (RN) or a licensed practical nurse (LPN) by the State Board of Nursing for South Carolina. Services performed by health room aides, nurses’ aides, or any other unlicensed medical personnel are not Medicaid reimbursable. 

Nursing Supervision Requirements

•An LPN must be supervised at all times by an RN.

•RN must be physically present or accessible by phone/pager, and must be readily available (i.e., physically accessible to the individual being supervised within a certain response time based upon the medical history and condition of the beneficiary and competency of personnel).

•The RN supervisor will provide the initial assessment of the child’s condition as appropriate and establish a plan of care based on the child’s medical condition in accordance with state licensure and regulation.

•If the LPN receives additional information regarding the child’s health condition after the initial assessment, the LPN will consult with the RN.

•Supervision by the RN of the LPN must be performed at a minimum of every 60 days via direct observation or review of clinical service notes. It is best practice to have written or electronic documentation of the RN’s supervision of the LPN. Nurses billing Medicaid must show proof of supervision.

On October 21, SCDE and DHHS sent an email to update the nursing supervision. Medicaid will not require the RN to co-sign the LPN’s clinical service notes. Click here for a copy of the RN Supervisory log for the LPN. 

Staff Credentials - Checklist 

•Schools are required to check the credentials of all licensed staff through SCLLR to verify their license, which may exclude them from providing services. A copy of the nurse’s license must be submitted to the district office. An updated copy must be kept on file.

•Schools using a software company must notify the district office of any staff changes.

•The copy of the South Carolina nurse license can be found at the South Carolina Labor and Licensing Regulatory Authority at https://llr.sc.gov.

•Medicaid nurses must check the OIG’s office twice a year and keep a copy on file.The link is Search the Exclusions Database | Office of Inspector General (hhs.gov). 


Technical Assistance

Training and support are provided by the district office. Contact the district office point of contact for additional information

Medicaid Contact

Deitrich Drayton

Medicaid and Nursing Administrator

Phone#: 803-212-5482

Email: ddrayton@sccharter.org