Opportunity Overview
Ongoing Pennsylvania school-health reimbursement pathway. The Pennsylvania School-Based ACCESS Program (SBAP) allows participating Local Education Agencies (LEAs) to obtain Medicaid reimbursement for qualifying school-based direct health-related services and for Medicaid-allowable administrative activities. This is a recurring financing mechanism, not a one-time competitive grant.
Who Can Participate
Participating Pennsylvania LEAs must be enrolled as Medical Assistance providers; Pennsylvania DHS states that LEAs must revalidate that enrollment every five years. Direct-service reimbursement applies to qualifying health-related services provided to Medical Assistance-eligible students ages 3 through 20 when the services are documented in an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP). Parental consent is required before the LEA may access a student’s Medical Assistance coverage for billing.
Immediate September 2026 Deadlines
- September 11, 2026: October-December 2026 Random Moment Time Study (RMTS) participant list due.
- September 18, 2026: April-June 2026 Medicaid Administrative Claiming (MAC) Certified Public Expenditure (CPE) forms become available.
- September 30, 2026: April-June 2026 MAC CPE forms are due, along with all remaining 2025-26 CPE forms.
The September 4 deadline for changes to annual calendars/work schedules for the October-December quarter has passed.
Reimbursement and Cash-Access Workflow
Pennsylvania DHS separates direct-service claiming, RMTS, Medicaid Administrative Claiming, cost settlement, Medical Assistance eligibility/parental consent, required documentation, and compliance/oversight. Pennsylvania Department of Education guidance further explains that direct-service reimbursement dollars are held in LEA-specific ACCESS accounts. To draw those funds, an LEA submits a PDE-352 request signed by its chief administrative officer to the Bureau of Special Education.
PDE states that approved direct-service reimbursement withdrawals may support the education of special education students and publishes examples of allowable expenditures including certain special-education personnel, nurses for the applicable special-education share of time, computers, treatment-room furniture, assistive technology, technology devices, networking hardware/software, training and other special-education program costs. These examples govern use of reimbursed ACCESS funds; they should not be confused with the separate rules that determine whether a service or cost is Medicaid-claimable in the first place.
Atlas Analysis
Atlas Opportunity Score: 94/100. SBAP is one of Pennsylvania’s most durable school-health funding pathways because qualified LEAs can recover Medicaid funding for covered services and allowable administrative work while building a recurring school-health financing base.
N9+ Direct Vendor Fit: 35/100 conditional. PDE’s ACCESS-fund guidance permits multiple technology and equipment categories, but connected clinical-exam hardware is not specifically named. Any N9+ strategy should be applicant-led, tied to a legitimate special-education or covered-service need, and confirmed against current PDE/DHS rules before purchase or claiming.
QC Healthcare Fit: 30/100 conditional. SBAP can reimburse qualifying health-related school services when provider, service, authorization, documentation and Medicaid requirements are satisfied, but it is not a generic outsourced physician-coverage fund.
Implementation Readiness
Participating LEAs should finalize the October-December RMTS participant list by September 11, prepare the April-June MAC CPE package for the September 18 release and September 30 due date, clear all remaining 2025-26 CPE forms by September 30, and verify MA provider enrollment/revalidation, the LEA Agreement to Participate, student eligibility, parental consent, practitioner authorization, provider logs, service documentation and audit readiness.
Official source: Pennsylvania Department of Human Services — School-Based ACCESS Program.