Toolkit for Schools

school medicaid toolkit

Children’s Health SC and our schools know that healthy kids come to school and are better learners. By working together, we can identify children who may be eligible for South Carolina Healthy Connections Medicaid coverage to get kids enrolled and keep them enrolled.


(Documents are either in MS Word or Adobe PDF. If you need a PDF Reader, please visit

Strategy 1: Emergency Cards

Proactively utilize information submitted on emergency cards to ensure your students are connected to primary and preventive health care services.

Each year, parents are asked to complete new emergency cards, providing information about where their children go for health care, who their pediatrician or family doctor is, or what type of health insurance they have for their children. But most schools do not have the resources to contact each family who returns a card with these fields empty, or who simply answers that they have no place to go for regular medical care.

Palmetto Project is ready to partner with school districts to connect families to opportunities for health coverage for their children, including SC Healthy Connections, our free Medicaid program for children. Click here to review a sample form that gives parents the option to request assistance in applying for SC Healthy Connections Medicaid or connecting with other health resources, such as community health centers, free clinics and prescription assistance programs.

Strategy 2: Health Insurance Status

How many of your students have health insurance right now? How many are eligible but not enrolled? 

Here are some examples of questions that can be added to health information cards or asked independently of other requested information:

1. Does your child currently have health insurance? Yes No

2. Would you like information on health insurance options for your family? Yes No

By answering yes, your name will be forwarded to [school nurse, social worker, guidance counselor, etc.*]

* Fill in with whichever person in your district or a community partner who is best suited to provide families with health insurance

If someone in your family does not have health insurance, you may go to or call 1-888-549-0820 to see if your family is eligible for coverage.

Common questions about Health Insurance Status (HIS)

What is Health Insurance Status (HIS)?
Simply stated, Health Insurance Status is whether or not a student is covered by health insurance.

Are school districts in South Carolina required to collect Health Insurance Status (HIS)?
No. However, those districts that do collect it have reported value in knowing this information and are able to more easily identify and assist those students who do not have coverage.

How should this data be collected and stored?
The easiest way is to ask the question on an existing school form and add a field to the district’s student information system. It can also be asked on  a new form and collected and stored by a community partner, if both parties agree on how that will be done and if parents consent to such sharing of protected student information.

Can the school district share student HIS information with other non-district persons or entities?
No, not without written permission. According to the U.S. Department of Education ( under the Family Educational Rights and Privacy Act (FERPA), generally schools must have written permission from the parent or eligible student in order to release any information from a student’s education record. FERPA does allow schools to disclose those records, without consent, to the following parties or under the following conditions: school officials with legitimate educational interest, other schools to which a student is transferring, specified officials for audit or evaluation purposes, appropriate parties in connection with financial aid to a student, organizations conducting certain studies for or on behalf of the school, accrediting organizations, to comply with a judicial order or lawfully issued subpoena, appropriate officials in cases of health and safety
emergencies, and state and local authorities, within a juvenile justice system, pursuant to specific State law.

Once a district collects Health Insurance Status (HIS), what’s next?
That decision is up to each district. There are several options, including:
1) School staff can follow-up with families who indicate they lack health insurance and offer to help them with coverage.
2) Districts may elect to partner with community organizations, such as Palmetto Project, that can follow up with families.
This requires written consent to comply with privacy laws (FERPA) (as explained in the previous question).
3) Use the question itself as an opportunity for outreach by adding a statement such as “If someone in your family does not have health insurance, you may go to or call 1-800-318-2596 to see if your family is eligible for coverage.”
4) Simply collect the information for demographic purposes and to follow trends over time.

Strategy 3: Immunizations

Give your families resources to meet the SC’s immunization requirements at kindergarten and 7th grade.

State law requires all children entering public school to provide proof of immunization status. But not all families have the financial resources to get their child covered. Click here for 2016-2017 immunization guidelines.

New rules implemented in 2013 require that all 7th grade students show proof of Tdap (whooping cough) booster. Click here for more information about the new rule and other suggested vaccines for pre-teens, teens, and adolescents. 

Palmetto Project assists families in applying for SC Healthy Connections, our free Medicaid program for children, to ensure all of your students start the year off ready to learn. Contact us to learn more about how Palmetto Project staff can work in partnership with your health services staff and school community to help families get their children covered.

Strategy 4: Free or Reduced Lunch

Students who are eligible for free or reduced lunch (FRL) are usually eligible to receive free or low cost health insurance.

– FRL income limits are 185% of FPL. SC Medicaid for children is 208% of FPL. (Click here for the income chart.) This means that students who are FRL eligible and US citizens or Legal Permanent Residents are most likely also eligible for SC Healthy Connections (Medicaid).

– The USDA, which oversees the FRL program, outlines the use and disclosure of FRL eligiblity information for the purpose of assisting schools who may wish to work with community organization to assist families in applying for other health and/or nutrition program (click here).

– The USDA also prepared a suggested agreement (click here) that schools and community organizations can sign which outlines the responsibilities of each party in properly using eligibility information to assist families in applying for other health and/or nutrition programs. This agreement  between your school district and Palmetto Project outlines each parties’ responsibilities for and disclosure of protected student information. This does not take the place of a parental consent.

– Once the USDA Limited Disclosure of FRL Eligibility Information has been signed by the school district and Palmetto Project, this Opt Out flyer can be used to give parents the choice to be excluded from any partnership activities. The flyer can be attached to paper FRL applications, attached to FRL approval notifications, and used at school and community outreach events. It was also designed by the USDA. 

Strategy 5: School Health Services

Schools can file for Medicaid reimbursement of health services — such as daily medication administration for chronic conditions — when they are delivered to Medicaid beneficiaries. 

– Did you know that every time your school nurse administers a prescribed medication to a student who is enrolled in Medicaid that you could be filing for reimbursement of approximately $8.00? x 180 school days? x #Medicaid beneficiaries requiring medication administration during school hours? But continuous Medicaid enrollment is key to a solid reimbursement program.

– Medicaid can provide you with the eligibility dates for children so you will know when children are approaching the end of their 12 month Medicaid enrollment period. This would allow you to alert the parent to the upcoming renewal requirement. But what if the parent needs help completing the renewal? With parental consent, you could refer parents to Palmetto Project for assistance with either an initial or a renewal application.

Share this:
Share this page via Email Share this page via Stumble Upon Share this page via Digg this Share this page via Facebook Share this page via Twitter