Comment: School is where children’s health care is provided. Changes to Medicaid can help

Schools are the places where health care is provided, and they are an essential part of the country’s public health infrastructure. During COVID-19, schools across the country have responded to call to action To vaccinate students and members of the community and provide nutritious meals and Mental health counseling services For children – although the classrooms are closed. Even before the pandemic, schools were providing care that supports classroom learning to 14% of public schools Children with special health care needs, including those with chronic physical, developmental, behavioral, or emotional conditions.

A recent study in JAMA Pediatrics found that schools “De facto mental health system“, providing services to 57% of adolescents who needed care prior to the pandemic. In 2019, Centers for Disease Control and Prevention It found that 37% of high school students consistently reported feeling sad or hopeless. 19% have seriously considered suicide; and 9% attempted suicide. The need is deeper now. From April to October 2021, pediatric emergency room visits related to mental health increased by nearly a third for ages 12-17 and 24% for children ages 5-11.

As always the challenge in public education, the need far outweighs the resources available. But changes to the federal Medicaid payment policy paved the way for schools to access millions of dollars in funding for school nursing, behavioral health and other services in schools.

For example, in 2014, the Centers for Medicare and Medicaid Services expanded for a long time Policies To allow schools to reimburse for the provision of covered services to any child eligible for Medicaid. but only 17 states They took advantage of this funding stream by adjusting their Medicaid status plans (the document that specifies what types of services and providers are eligible for reimbursement) to reflect the new policy.

Michigan She changed her plan for the state To include behavioral health analysts, school social workers, and school psychologists as covered providers, while the state legislature has approved $31 million to fund behavioral health service providers in schools. Since this change, there have been about a 6% increase In the amount of Medicaid reimbursement that is directed to the schools. Louisiana revised its state Medicaid plan in 2015 and saw a 30% increase in Medicaid revenue as its nursing workforce. grew 15%. Last year, Georgia changed its plan to allow Medicaid to pay for more school health services. Half the children of Georgia It’s covered by Medicaid or the state’s PeachCare system, so this shift is exciting and creates an opportunity to bring hundreds of millions of dollars into Georgia school districts to support the most vulnerable students.

More states can prepare to take advantage of Medicaid funding for schools by clarifying and expanding the coverage of covered school health services and providers in their Medicaid plans. But, some schools face additional hurdles, such as complicated billing processes. This issue is addressed in The Bipartisan Safer Communities Act, which directs federal policymakers to issue guidance, launch the Help Center and release $50 million in planning grants in the next 12 months to help state Medicaid agencies and local education entities overcome these challenges. These supports will likely include strategies and tools to reduce the administrative burden of billing, especially for rural schools, and best practices that schools and state Medicaid agencies can use to adjust state plans so that they become the services students need and the providers who provide them. Eligible for Medicaid reimbursement.

National Health Cooperative Schools A ten-year roadmap for healthy schools It prioritizes improving schools’ ability to pay the Medicaid bill for school health services, and most importantly, recognizing that when health and education officials fail to cooperate, it makes it very difficult to achieve that end. School nurses, county and state education officials should be prepared to collaborate with state Medicaid agencies to take advantage of the support the law will provide — preparing data about the health needs of their school communities, the types of services provided in schools (and those schools can begin to provide if reimbursed), and the types of licenses and credentials Required for employees who provide services in schools. State Medicaid officials can then ensure that state plan adjustments reflect the exact types of services students need and that schools are able to provide them.

Otherwise, how can school nurses, district officials, and state education officials prepare?

  • Discover which provides for Medicaid compensation. Sharing information about upcoming support to increase access to Medicaid funds for school health services and providers.
  • Engage with the school or district Student health advisory committees To gather community input about the health services they wish to access, understand the unmet health needs of school communities and raise awareness of the availability of Medicaid services in the school.
  • see the Assessment of community health needs From local hospitals to more understanding of the important health needs of the community and the resources available to meet those needs.
  • Make connections in State Medicaid Agency and advocating that school providers be reimbursed for specific services (eg, counseling, personal care, case management, immunizations) that are a priority for students.

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