Special Programs Arkansas

Parent Consent to Access Public Insurance

The IEP section titled “Parent Consent to Access Public Insurance” is a legal authorization that parents or guardians must provide before a school can access a student's Medicaid benefits to cover special education services. This consent enables the school to bill Medicaid for the services specified in the student's Individualized Education Program (IEP).

According to the Individuals with Disabilities Education Act (IDEA) and the Family Educational Rights and Privacy Act (FERPA), schools cannot access a student’s Medicaid benefits without explicit written permission from the parent or legal guardian.

Parents have the right to decline or revoke consent at any time. If a parent decides to refuse consent, the school remains obligated to provide all services mandated under the student's IEP or 504 Plan at no cost to the family, as outlined by IDEA. However, declining consent means that the school will need to explore alternative funding sources, such as local or state education funds, which may impact the availability of services.

Will Sign Paper Copy
If you have selected this option, then the document is sent in ‘Printed Format’ for the parent/guardian to sign on the paper copy.
However, if this option is not selected, then the parent or guardian will receive a digital version of the document through email, and they will be expected to sign the document using a digital signature.
Click the link to read more about “How to sign a document through digital signature?

If there are required fields not yet completed, the system will display the following error message:

Section was saved, but is incomplete until all required fields (pink highlighted) are filled.

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A detailed technical reference and explanation of all fields and data notations of this form is provided here.

  1. Once you open the ‘Draft’ version of the Parent Consent to Access Public Insurance of an IEP Document, you will find the following fields already pre-filled.

  2. Pre-filled fields are: Student Name, ID, Date of Birth, Age, Grade, Local Education Agency.

  1. Primary Care Physician’s Name: Type the name of the physician (optional).

  2. Medicaid Number: Type the number (optional).

  3. Select the appropriate name in the Parent/Guardian Signature section. Parent will have to complete the signature either through a Digital Signature or a physical signature, if “Will Sign Paper Copy” has been selected in the IEP Cover Page.

  4. Select the appropriate response for the “Is your child covered by private insurance?”

    1. Choosing Yes for the above response, will also require the user to complete the “Third Party Liability Section”. Please check one of the following:

      • I do NOT give permission to the school district to bill my private insurance for healthcare services delivered in the school.

      • I give permission to the school to bill my private insurance for healthcare services delivered in the school.

    2. Have the parents complete the signature either through a Digital Signature or a physical signature.

The following details about the Private Insurance coverage of the student will be completed on paper or when signing digitally (not within the application).

  1. Insurance Company

  2. Address

  3. Phone

  4. Name of Policy Holder

  5. Policy Holder Date of Birth

  6. Policy Number

  7. Group Number

  1. The user must enter the parent’s response to consent in the Document Delivery section.

  2. Select Save, Done Editing