School Health Services Program FY 2022-23 Reimbursement Spending Report to CDE

Form Login Account:
New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form. Enter numbers only in fields requesting a number, do not type words. Use tab key or mouse to move to next box. Select the categories where your district spent funds, this will populate the forms with the items you need to answer. If no funds were spent on a category, do not select it. No need to enter zeros.
 

Administrative Expenditures

Instructions
 
Select the administrative category that received reimbursement funds in the section below. If there were no administrative expenses, do not select any category. By selecting an admin category, you will be required to provide the total expenditure amount and a brief narrative of what is included in the total amount.
 
As a reminder, it is recommended that total administration costs not exceed 20% of total expenditures for a program. This is exempt for new districts/BOCES participating in the School Health Services program. For questions or concerns, contact Omar Estrada (Estrada_O@cde.state.co.us).
Program Administration Category Expenditures 🛈
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Total Administrative Expenditures:
$0.00

Health Services Expenditures

Instructions
 
Select the Health Service category that received reimbursement funds in the section below. If there were no Health Service expenses, do not select any category. Selecting a Health Service category will populate only relevant questions that require a response which includes providing a narrative. If you need further assistance, please contact Omar Estrada (Estrada_O@cde.state.co.us)
Select the Health Service Category(s) in which your district/BOCES spent money:

Nursing

Nursing Category Expenditures * 🛈
Total Nursing Expenditure 🛈
$0.00

Mental Health

Mental Health Category Expenditures * 🛈
Total Mental Health Expenditure 🛈
$0.00

Student Health

Student Health Category Expenditures * 🛈
Total Student Health Expenditure 🛈
$0.00

Special Services Provider

Special Services Provider Category Expenditures * 🛈
Total Special Service Providers Expenditure 🛈
$0.00

Outreach & Enrollment

Outreach & Enrollment Category Expenditures * 🛈
Total Outreach & Enrollment Expenditure 🛈
$0.00

Transportation

Transportation Category Expenditures * 🛈
Total Transportation Expenditure 🛈
$0.00

Summary of Expenditures

Total Administrative Expenditures: 🛈
$0.00
Total Health Service Expenditures: 🛈
$0.00
Total Health Service FTE: 🛈
0.00
Total Funds Expenditure for FY 2022-23: 🛈
$0.00

Annual Notifications & Intent to Continue Participation

1. Public agencies (e.g. public school districts) must provide written notification to parents prior to accessing a child's public benefits for the first time, and annually thereafter. Satisfying this requirement may vary by public agency. 

The full list of requirements for the annual notification to parents may be found on the U.S. Department of Education website. Please consult your district's legal team concerning questions related to the relevant regulations of the annual notice.
 * 🛈
2. Does your district intend to continue its participation in the School Health Services program for the next fiscal year (FY 2024-25)?

If the "NO" option is selected, the medicaid coordinator listed on this report will receive a follow-up for confirmation.
 * 🛈