Medicaid Expansion for School Health Learning Collaborative Participant Site

MESH Illinois Teams Site

MESH Newsletter Archive

State of Illinois Guidance and Resources

Sample Parental Notice for Consent to Allow the School District to Access Medicaid Benefits

Sample parental consent form developed by the Illinois State Board of Education (ISBE).

Illinois Medicaid School-Based Health Services (SBHS) Program Changes Frequently Asked Questions: School Health and Mental Health Service Providers

FAQs on Illinois School-based Medicaid for school health service providers developed by HFS and ISBE.

Illinois Medicaid School-Based Health Services (SBHS) Program Changes Frequently Asked Questions: Local Education Agency (LEA) Business Officials

FAQs on Illinois School-based Medicaid for school business officials developed by HFS and ISBE.

LEA Handbook on School Medicaid Claiming

Official guidance from HFS (does not yet reflect changes in the State Plan Amendment).

PCG Claiming System

Portal for administrative claiming and cost settlement.

Illinois ABE Portal

Platform to assist Illinois families with applying for Medicaid and other benefits.

National Tools and Resources

Numerous materials that districts can use for Medicaid outreach and enrollment.

Illinois State Plan Amendment Information

How Illinois Can Leverage Medicaid Funds to Expand School Health Services

Building off Schools Are Key to Improving Children’s Health, this brief looks at the state of children’s health and school staffing in Illinois and outlines the steps Illinois must take to amend its Medicaid state plan and increase access to health services.


School Funding and the Illinois Healthy Student State Plan Amendment

In this recorded webinar, learn about a federal policy shift that allows billing for all health services provided to all students enrolled in Illinois Medicaid.


Frequently Asked Questions about the Illinois State Plan Amendment

Answers to common questions about the Illinois State Plan Amendment and the benefits and changes to school Medicaid reimbursement.

School Medicaid Basics

Medicaid 101 for School Superintendents

This brief explores what Medicaid is, what it covers—in and out of school—and how school districts can leverage Medicaid to enhance school health services.

Understanding the Early and Periodic Screening, Diagnostic, and Treatment Benefit

This webinar provides an overview of the Early and Periodic Screening, Diagnostic and Treatment Benefit (EPSDT) requirements.

Introduction to Expanding School Medicaid Programs Webinar

This webinar recording describes the Medicaid program and what it covers, discusses how school districts can leverage Medicaid to enhance school health services, and provides information about the free care policy reversal and how states are leveraging this opportunity to expand their school-based Medicaid programs. Tips are shared on how key stakeholders, including school health providers and school superintendents, can support this work in their states and communities.

Schools Are Key to Improving Children’s Health

This national policy brief addresses the opportunities to expand on health services delivered within a school by school nurses and other district-employed providers.

Office of the Inspector General School-Based Medicaid Reports: A Consolidated Review

This report reviews 33 audits of school-based Medicaid programs conducted by the Office of the Inspector General (OIG) and summarizes key findings. The report highlights what OIG looks for during audits and can be used to help states and school districts prepare for future audits. Sample checklists are included to help guide states toward developing robust internal guidance and policies that meet OIG expectations.

School Medicaid Expansion

A Guide to Expanding Medicaid-Funded School Health Services

This comprehensive, step-by-step guide provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds.

An In-Depth Look at Expanding School-Based Medicaid Programs

This recorded webinar provides an in-depth look at trends in expanding school-based Medicaid programs, including detailed information about how states have successfully structured their programs. Presenters from Colorado and Michigan share how they expanded their programs and highlight key decisions they made along the way.

Understanding Medicaid Reimbursement in the School Setting

Presentation delivered by CMS for the Healthy Students, Promising Futures Learning Collaborative providing an overview of Medicaid reimbursement in the school setting. The presentation addresses issues including the free care policy, certified public expenditures, and telehealth.

Documenting Medical Necessity Through Plans of Care

The policy brief explains the importance of using a plan of care to document medical necessity, which is required for all school health services submitted for Medicaid reimbursement, and offers guidance on implementing plans of care for students without an IEP or 504 plan.

School Medicaid Policy Issues and Opportunities

Opportunities in Medicaid to Improve Access to Behavioral Health Care for Children and Youth

Presentation by Kirsten Beronio, Centers for Medicare and Medicaid Services.

State Medicaid and Education Standards for School Health Personnel

This report reviews reimbursement challenges across the country and demonstrates how alignment between state Medicaid and education standards for school health personnel can reduce barriers to Medicaid reimbursement for school health services.

Medicaid Coverage of Crisis Intervention Services in a School Setting

This brief considers the circumstances under which school districts can bill their state Medicaid program for sudden and acute mental health crises that students may experience.

Third Party Liability and School-Based Medicaid Services

This policy brief includes information on how third party liability (TPL) applies to school-based health services and offers resources for additional reading.

Expansion of School Medicaid Programs: An Opportunity to Ensure Qualified School Health Providers Are Medicaid-Eligible

In order to encourage school districts to maximize resources for school-based healthcare, state Medicaid programs must ensure that school healthcare providers are eligible for Medicaid reimbursement. This policy brief explains how states can resolve identifying school health personnel as Medicaid-qualified providers and shows how six states improved alignment.

School Medicaid Expansion Examples From Other States

Case Studies: How States Are Expanding School Health Services Using Medicaid

These case studies reflect the work states have completed, and the success they have achieved, in leveraging federal Medicaid policy to expand physical, behavioral, and mental health services.

Expanding Michigan’s School-Based Medicaid Program

This Healthy Students Promising Futures Learning Collaborative case study highlights Michigan’s work to leverage the reversal of free care policy to expand the state’s school-based Medicaid program.

State Efforts to Expand School Health Services: Activity Tracker

This regularly updated brief tracks state efforts to expand access to school health services, either through a state plan amendment or through legislative/administrative action, allowing school districts to bill Medicaid for health services delivered to all Medicaid-enrolled children.

Illinois School Medicaid Billing & Reimbursement Process

Background Materials

Reimbursement Process Guidance

For detailed guidance on implementing each step in the reimbursement process, click on the links in the flowchart or the titles below.

Additional Resources

This guidance is intended to assist school districts with improving and expanding Medicaid reimbursement for school health services. It should not be construed as legal advice. The information is accurate to the best of our knowledge as of January 2023, based on a review of publicly available guidance from the Illinois Department of Healthcare and Family Services (HFS) and its partner Public Consulting Group (PCG), and discussions with subject matter experts. School Medicaid requirements are subject to change. Please refer to the most recent guidance from HFS and PCG.

2022 -2023 School Year

2022-2023 Training Calendar 


Evaluation and Wrap-Up: April 25, 2023

Monitoring Your Medicaid Program & Medicaid Unwinding Update: March 14, 2023
Monitor Compliance and Maintain Documentation

Staff Training: February 16, 2023
Conduct Ongoing Training for Providers

Office Hours: February 6, 2023

Random Moment Time Study: January 18, 2023
Respond to RMTS
Monitor Completion of RMTS
Update Provider Information Required by PCG

Documentation: December 13, 2022
• Document Medical Necessity
• Provide and Document Services 
• Submit Service Claims to HFS

Identifying Eligible Providers and Services: November 17, 2022
Identify Eligible Providers and Services Guidance Document

Action Planning: November 2, 2022
Action plan template
Action plan example 

In-person Kickoff Meeting: October 13, 2022
Team building activity 
• Process map 
• Needs assessment template 
• Obtain consent 
• Identify Medicaid-enrolled students 
• Medicaid lookups

Outreach and Enrollment: September 28, 2022
Promoting All Kids Health Insurance: Outreach and Enrollment Tips for Schools

Orientation call: September 8, 2022 
Meeting Packet 

2021-2022 School Year

Year 1

Kickoff Meeting: October 28, 2021
 Meeting packet
District needs assessment guide 

Peer Call: December 15, 2021

Meeting 2: February 15, 2022
Action Plan Template 
Action Plan Example 
• Acronym List 
• Recording

Meeting 3: March 16, 2022
• Recording

Peer Call: April 21, 2022

Meeting 4a: May 11, 2022
• Slides 
• Recording

Meeting 4b: May 24, 2022


Through training, technical assistance, and peer-to-peer learning opportunities, the MESH Learning Collaborative has helped teams from 23 school districts in Illinois increase sustainable revenue from Medicaid reimbursement, expand health services for students, and improve cross-departmental collaboration.

Collectively, the school districts that have participated in MESH impact over 400,000 students.

View List of Participating School District Teams


Please submit this form below any time you add new partners to your team so that we can include them in project communications.





EverThrive Illinois

Illinois Alliance of Administrators of Special Education

Illinois Association of School Business Officials

Illinois Association of School Nurses

Illinois School Counselor Association

Illinois School Psychologists Association

National Association of Social Workers, Illinois Chapter