Mental Health Services in North Carolina IEPs
What mental health services are available through an IEP in North Carolina?
Mental health-related services for exceptional children in North Carolina are delivered primarily through three categories of IDEA related services: counseling services, psychological services, and social work services in schools, all defined under 34 CFR 300.34 and incorporated into NC practice through the NC Policies Governing Services for Children with Disabilities. Counseling services may be provided by qualified social workers, psychologists, or guidance counselors and are included in the IEP when determined necessary for the exceptional child to benefit from special education. Psychological services include administering psychological and educational assessments, interpreting evaluation results, developing behavior support strategies, and consulting with families and educators — coordinated statewide through NC DPI's Psychological Services unit. North Carolina's school mental health framework is further supported by the NC School Mental Health Initiative (NC SMHI), a multi-disciplinary partnership of stakeholders — including community mental health providers, educators, advocates, and parents — operating through eight regional networks aligned with State Board of Education districts. For billing purposes, NC Medicaid Clinical Coverage Policy 10C (Outpatient Specialized Therapies — Local Education Agencies) allows LEAs to seek Medicaid reimbursement for a range of school-based services provided to Medicaid-eligible students, including psychological and counseling services as well as physical, occupational, and speech-language therapies, helping sustain services without additional cost to families.
What North Carolina Requires
Counseling services are a required related service under IDEA when necessary for an exceptional child to benefit from special education; may be delivered by qualified social workers, psychologists, or guidance counselors and must be specified in the IEP (34 CFR 300.34(c)(2); NC Policies Governing Services for Children with Disabilities)
Psychological services for exceptional children include assessments, behavioral analysis, consultation with families and educators, and support strategy development — coordinated statewide by the NC DPI Psychological Services unit (34 CFR 300.34(c)(10); NC DPI EC Programs and Services)
Social work services in schools are a related service under IDEA that may be included in an IEP; includes helping address problems in a child's home, school, and community environment that affect school adjustment (34 CFR 300.34(c)(14))
When a mental health-related service (counseling, psychological services, social work) is necessary for an exceptional child to benefit from their special education, it must be provided at no cost to the family as part of the IEP (34 CFR 300.17; NC Policies Governing Services for Children with Disabilities)
NC Medicaid Clinical Coverage Policy 10C (Outpatient Specialized Therapies — Local Education Agencies) provides a reimbursement mechanism for LEAs to bill Medicaid for school-based services for Medicaid-eligible students; covered services include psychological and counseling services, physical therapy, occupational therapy, speech-language therapy, audiology, and nursing services (NC Medicaid Clinical Coverage Policy No. 10C, amended April 1, 2023)
The NC School Mental Health Initiative (NC SMHI) is a multi-disciplinary stakeholder partnership that operates eight regional networks aligned with NC State Board of Education districts to support coordinated mental health service delivery in schools (NC DPI Healthy Schools)
Key Timelines
Mental health-related IEP services (counseling, psychological, social work) must begin as soon as possible following IEP development and must be reviewed at least annually as part of the IEP annual review (34 CFR 300.323(c)(2); 34 CFR 300.324(b)(1))
If mental health needs trigger a behavior support review, the IEP Team must consider whether a Functional Behavioral Assessment (FBA) and Behavior Intervention Plan (BIP) are needed at the next IEP Team meeting or sooner (34 CFR 300.324(a)(2)(i))