"Free Care" Policy Archive

Key opportunities exist for education, healthcare and public health sectors to improve both health and education outcomes by focusing on school-based health services. This brief addresses the opportunity in Illinois to expand on Medicaid-funded health services delivered within a school by school nurses and other district-employed providers.

Colorado conducted a pilot study in 2019 to better understand the financial impact of expanding its school Medicaid program and make data-informed decisions about how best to move forward with a state plan amendment. This case study details Colorado’s path toward expanding its school Medicaid program and highlights key lessons learned from this work. The Centers for Medicare & Medicaid Services approved the amendment in 2020.

In April 2020, the Centers for Medicare & Medicaid Services approved California’s Medicaid state plan amendment, allowing school districts to access more federal funding for school-based health services. This report describes using this opportunity to increase access to services that help students heal from trauma — including the trauma caused by exposure to domestic violence and pervasive bias and crises such as COVID-19.

This case study examines the implementation of Medicaid managed care school-based behavioral health services in South Carolina and highlights key lessons learned that can inform the efforts of other states choosing to coordinate school-based health care with Medicaid managed care programs.

This case study provides an overview of trauma-informed schools and highlights California’s approaches for supporting safe and supportive learning environments by increasing access to trauma-informed services and supports in schools.

This comprehensive guide provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds. It is designed for anyone working to expand access to school health services, including state and local education agency staff, state Medicaid agencies, school health providers, public health professionals and children’s health advocates.

Key opportunities exist for education, healthcare and public health sectors to improve both health and education outcomes by focusing on school-based health services. This national policy brief primarily addresses the opportunities to expand on health services delivered within a school by school nurses and other district-employed providers (school psychologists, social workers, counselors, occupational therapists, physical therapists and speech-language pathologists), using the "free care" policy clarification issued by the Centers for Medicare & Medicaid Services.

This Healthy Students Promising Futures Learning Collaborative case study highlights Michigan's work to leverage the reversal of free care policy to expand the state's school-based Medicaid program.

As of October 2019, school districts in Michigan are able to seek Medicaid reimbursement for services provided to all Medicaid-enrolled students (not only for health services included in a student's Individualized Education Program). This change presents an important opportunity to expand access to and resources for school health services, particularly behavioral health services.

This activity brief, maintained by Healthy Schools Campaign and Community Catalyst, outlines state actions to implement the reversal of the free care policy. Some of the information in this brief is based on informal conversations with policymakers and advocates. This document is updated as changes are known to the HSPF team.

This guidance, issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare & Medicaid Services (CMS), includes examples of approaches for mental health and substance use disorders related treatment services in schools. It also describes some of the Medicaid state plan benefits and other Medicaid authorities that states may use to cover mental health and SUD-related treatment services.

"Presentation delivered by CMS for the Healthy Students, Promising Futures Learning Collaborative providing an overview of Medicaid reimbursement in the school setting. The presentation addresses issues including the free care policy, certified public expenditures and telehealth.
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Presentation from the December 2018 Healthy Students, Promising Futures symposium on MA’s school-based Medicaid program and their plan for expansion following approval of their free care policy reversal SPA.