About Children Youth Behavioral Health Initiative (CYBHI)

NUSD is now part of the Children Youth Behavioral Health Initiative (CYBHI) program. The program allows school districts to be reimbursed for socio-emotional mental health services they provide to students. While not all services that the school district provides are eligible for reimbursement under this program, school districts will continue to provide access to existing support services in accordance with state and federal laws. Reimbursement comes from families’ private health insurance providers, including Medi-Cal. 

About the Children and Youth Behavioral Health Initiative

The Children and Youth Behavioral Health Initiative (CYBHI) requires health insurers to reimburse school districts for a specific scope of services that are provided to students under the age of 26, including:

• Social-emotional lessons in the classroom
• Behavioral health screenings
• Teen Mental Health First Aid for peer educators and student interns
• Substance use screening and counseling
• Individual and group counseling for lifestyle topics such as friendship and social skills. executive functioning, stress, anxiety, grief, etc.

The CYBHI program prohibits health care plans and insurers from passing any of the costs of these services to families. It provides other protections for families, as well. For instance, our reimbursement request will not affect your insurance coverage (i.e., you will not pay co-pays, higher premiums, or deductibles). Receiving services at school will not reduce or impact students’ or their families’ ability to obtain care outside of school. 

CYBHI’s “Fee Schedule” sets the reimbursement rate for different types of school-related services. 

What do families need to know about the CYBHI fee schedule program?

Eligibility for Services: This program will not change students’ eligibility to receive behavioral health services. Rather, the program will expand the availability of services by creating a new, sustainable method for providers to be reimbursed. Services delivered to students covered by Medi-Cal MCPs and Medi-Cal FFS, most commercial health plans, or disability insurers, with certain exceptions, are eligible to be reimbursed at the CYBHI fee schedule rate.

• CYBHI Covered Services provided to students under the age of 26 who are enrolled in a participating Medical Covered Program (MCP) or insurer are eligible for reimbursement. 
• In accordance with state law, the following entities are mandated to reimburse school districts and designated community-based school-linked providers and practitioners for the provision of services to a student as part of the CYBHI Fee Schedule program: 
  • Medi-Cal MCPs. (Welfare and Institutions Code § 5961.4)
  • Medi-Cal FFS. (Welfare and Institutions Code § 5961.4)
  • Commercial health care service plans (i.e., commercial health plans) are regulated by the Knox Keene Health Care Service Plan Act. ( Health and Safety Code §1374.722(a))
  • Disability insurers that cover hospital, medical, or surgical benefits. (California Insurance Code § 10144.53)

-Students are also eligible regardless of academic status (i.e., there is no requirement to be in academic good standing to receive CYBHI Fee Schedule program-covered services).

Privacy and Consent: All health information will be securely stored and only shared in alignment with existing state and federal laws. This health information will be used to verify insurance coverage and eligibility with DHCS, DMHC, CDI, and your existing insurance provider.

Billing: The CYBHI fee schedule program is designed to complement existing insurance coverage, and participation in the program will not affect a family’s insurance (e.g., premiums or deductibles). 

• Receiving services at school will not reduce or impact students’ or their families’ ability to obtain care outside of school.

• This program will not affect your insurance coverage (i.e., no co-pays, no higher premiums or deductibles). 

• There will be no cost to parents or caregivers for students who receive services eligible for reimbursement under the CYBHI fee schedule program (no co-pays). 

• This reimbursement will come directly from the insurance companies that cover the students at our schools, at no higher cost to the parents or caregivers. 

Please note that some insurance plans, such as high-deductible health plans and Medi-Cal Share-of-Cost plans, may require additional verification for program eligibility.

Resources

CA Dept Of Health Services: Multi-Lingual Flyer Options
 Spanish | Vietnamese | Simplified Chinese | Traditional Chinese | Arabic | Farsi

CA Dept Of Health Services: CYBHI Fee Schedule Program
Parent Caregiver Flyer 

 

Contact:

Ashley Acosta, MBA 
Manager of Parent Engagement and Health Services | Email: aacosta@newarkunified.org