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(14.21) Can the school district require that I pay for my child’s nursing services or use Medi-Cal in order for him to attend school?

(14.21) Can the school district require that I pay for my child’s nursing services or use Medi-Cal in order for him to attend school?

No. Services that children need to attend school, and benefit from their education, must be at no cost to the parents.  [20 U.S.C. Sec. 1401(29); 34 C.F.R. Sec. 104.33(c)(1).]

The district must look to other non-educational public agencies, like the Medi-Cal program, to pay for services before using its own funds.  However, you must give your consent for the district to access public benefits or insurance including Medi-Cal.  You do not need to give your consent.  Your refusal to give consent does not relieve the district of its responsibility to insure that all required services are provided at no cost.  [34 C.F.R. Secs. 300.154(a)(1) & (d)(2)(iv).]  The district may not require you to pay out-of-pocket expenses, such as deductibles or co-payments (but the district may pay these costs).  In addition, the district cannot require you to sign up for Medi-Cal or to use your child’s Medi-Cal if that use would:

  1. Decrease your available lifetime coverage or any other insured benefit;
  2. Result in the family paying for services that would otherwise be covered by Medi-Cal and that are required for your child outside of the time he is in school;
  3. Increase premiums or lead to discontinuation of benefits; or
  4. Risk loss of his eligibility for “home and community-based waivers” based on “aggregate health-related expenditures.”
    [34 C.F.R. Sec. 300.154(d)(2).]

Even if the district requests your consent to use public benefits, and meets the requirements listed above, you may still refuse to give your consent.