Due to recent changes in the Individuals with Disabilities Education Act (IDEA), school districts are required to provide annual notification regarding school-based Medicaid and obtain a one-time consent from families whose students qualify for Medicaid.

Parental Consent

Parental consent means the following:

  • To receive annual notification regarding the Medicaid SBS program so that parents/guardians are fully informed of its provisions.
  • To provide consent to release school records containing the student's information to Michigan Medicaid and billing agencies for the purpose of participating in the School-Based Services program.
  • To understand that consent is voluntary and may be withdrawn at any time.

Medicaid Annual Notification Regarding Parental Consent - Posted 03/18/13

Medicaid Annual Notification Regarding Parental Consent - Arabic Version

Medicaid Annual Notification Regarding Parental Consent - Spanish Version 

Parental Consent Form - Posted 08/08/14

Parental Consent Form - Arabic

Parental Consent Form - Spanish    

School-Based Services

The Medicaid School-Based Services Parental Consent form is a "separate consent form" to be signed by the parent/guardian.  Effective March 18, 2013, this is a one-time consent which may be withdrawn at any time.  It is up to each district to decide whether this form should be signed for all special education students. This form, however, should be signed for ALL center-based students. It is the responsibility of each special education office to maintain these consent forms to ensure that a signature is obtained at the time of the IEP meeting. Feel free to print this form on the district's letterhead.

If no signature is obtained from the parent/guardian at the IEP meeting, that does not relieve the district from this requirement. Each district should establish a procedure for obtaining permission when the parent/guardian does not sign the consent form at the IEP meeting.  If a parent/guardian refuses consent,  contact RESA's Medicaid office immediately.

Updated School-Based Services Brochure - Now Available! 

SBS Brochure - English

SBS Brochure - Arabic

SBS Brochure - Spanish    

The School-Based Services brochure describes the program in detail while offering answers to "common parent/guardian questions". The brochure is to be distributed at the IEP meeting to all parents/guardians, not just the parents/guardians of Medicaid eligible students. This PDF document is "open" on the first page for each district to type in the name and phone number of the district's special education contact. This allows the district to customize this brochure with their specific information.

Parental Consent Cover Letter District may use this cover letter when requesting parental consents via U.S. Mail.  


Updated Parental Consent Cover Letter

Updated Parental Consent Cover Letter - Arabic Version  

Updated Parental Consent Cover Letter - Spanish Version 

Kathleen Cummins Merry
Executive Director - Legislative Affairs, Medicaid
(734) 334-1820
Lisa Newton
Assistant, Internal Operations
(734) 334-1821
Leanne Smith
Assistant, Internal Operations
(734) 334-1464
Debra Walters
(734) 334-1823
Tia Williams
Special Programs Consultant
(734) 334-1397

Office Hours 7:30 am-4:00 pm

Fax: (734) 334-1824

To help a student or family apply for Medicaid in Michigan, call your local Department of Human Services Office.