Unlocking the Power of Medicaid Funding for School-Based Services
Did you know that the federal government provides billions of dollars annually in Medicaid funds to schools? These funds are designed to increase access to quality physical, mental, and behavioral health services for eligible students. This support is crucial for students with disabilities served under the Individuals with Disabilities Education Act (IDEA) and students from low-income families enrolled in Medicaid or CHIP programs.
Medicaid funding can cover a wide range of school-based services, including routine health screenings, preventive care, and therapies such as physical, speech, and occupational. Despite the availability of these funds, only 16 states have plans that allow for the reimbursement of services to Medicaid-eligible students beyond those receiving services under IDEA. This gap represents a missed opportunity to extend essential health services to thousands of additional students.
Steps to Expand Medicaid School-Based Services
States have the power to broaden the scope of Medicaid school-based services to all Medicaid-enrolled students. Here’s how:
- Collaborate with Agencies: Your State Educational Agency and State Medicaid Agency should review the latest State Plan approved by the Centers for Medicare & Medicaid Services (CMS) to discuss necessary changes for expanding Medicaid reimbursement.
- File a State Plan Amendment (SPA): The State Medicaid Agency can file an SPA with CMS, detailing the kinds of reimbursable school-based services and the requirements for service providers.
- Utilize Resources: Engage with the federal Medicaid and School-Based Services Technical Assistance Center for efficient service delivery and reimbursement, and learn from other states’ best practices.
The Benefits of Medicaid Funding for Schools
Nationally, more than half of all school-aged children are covered by Medicaid. Providing health services in schools for all Medicaid-enrolled students can significantly increase access and reduce family burdens. For instance, students are six times more likely to receive mental health care when these services are offered at school.
Medicaid contributes $4-6 billion annually to school districts for school-based services, serving as a major funding source for many Local Educational Agencies (LEAs). For example, Chicago Public Schools receive $35-40 million each year in Medicaid reimbursement, with expectations of an additional $10 million due to recent federal flexibilities.
State Success Stories
States that have expanded Medicaid school-based services have witnessed significant increases in federal resources:
- Colorado: A pilot project estimated an additional $8 million in federal Medicaid funds annually by including more school behavioral health providers in its State plan.
- Georgia: The expansion to include school nurses is projected to generate $48.6 million in federal revenue for its school-based Medicaid program.
- Michigan: The state expects a $14 million increase by allowing reimbursement for services from master's degree-level school psychologists.
Call to Action
As of January 2024, only 16 states are fully leveraging available Medicaid funding by allowing reimbursement for school-based services beyond those provided to students with disabilities under IDEA. Other states have the opportunity to amend their State plans to include services for all Medicaid-enrolled students. This expansion can directly address student needs, enhance achievement, and improve life outcomes.
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