New HSC Tools Help States and School Districts Measure Progress and Bolster Support for Comprehensive School Medicaid
June 30, 2026
Healthy Schools Campaign (HSC) has developed a school Medicaid module that has been added to the Health services Assessment Tool for Schools (HATS), an online self-assessment developed by the American Academy of Pediatrics (AAP) to help states and school districts evaluate the quality and comprehensiveness of school health services, as well as the underlying infrastructure, policies and protocols.
The assessment tool is one of two new HSC resources designed to help states and school districts leverage additional funding for student healthcare through a comprehensive school Medicaid program. These resources can be used at any stage of school Medicaid expansion, from exploring which health services and providers are eligible for Medicaid reimbursement to identifying ways to measure progress and outcomes.
Assessing Opportunities for Improvement and Expansion
States and school districts can now use HATS to review a state’s school Medicaid program and identify opportunities for improvement and expansion. While either the state Medicaid agency (SMA) or the state education agency (SEA) can initiate the process on its own, working together with school districts, associations and other agencies will help provide a fuller picture and a shared understanding of gaps and opportunities.
HSC conducted several years of testing the initial tool with its Healthy Students, Promising Futures Learning Collaborative. The tool’s companion resource provides the rationale for included questions, highlights promising practices from the field and offers resources to help states address areas needing improvement.
Instructions on how to register for HATS and use the various modules are available at AAP’s website.
Evaluating Comprehensive School Medicaid Expansion
As more states and school districts implement policy changes to fully expand school Medicaid, it’s important to continue evaluating the school Medicaid program. HSC’s new report, “Evaluating School Medicaid Expansion: A Resource for Measuring Progress & Demonstrating Impact” outlines key steps and recommendations for regularly tracking health, education and financial outcomes.
These evaluations can encourage greater participation in the school Medicaid program, boost program transparency and accountability, foster collaboration among school districts, state agencies and other partners and build support for future modifications.
HSC’s companion worksheet supports evaluation teams at each step outlined in the report, providing space to brainstorm and chart a plan to complete the evaluation process and lay the foundation for continuous improvement.
The resources are intended to help state teams of any size collect and share information to enhance the health and well-being of all students. They may be especially useful for school Medicaid programs with limited resources that cannot hire outside evaluators or commit significant staff time.
The School Medicaid Opportunity
Medicaid funding is essential for school-based health services. In fact, Medicaid provides more than $8 billion annually to support school-based services, reimbursing school districts for the physical, behavioral and mental health services they deliver to students enrolled in Medicaid. This support is critical to the sustainability of school health programs and to state education budgets overall, particularly at a time of heightened budgetary constraints and student need.
Recent national data shows steep declines in child well-being, with a majority of states faring worse today in child health, education and economic stability than before 2020. As states and schools seek opportunities to improve student well-being, school Medicaid provides a funding source to help meet the needs of this moment, easing some of the budgetary burden and supporting reinvestment in school health.
HSC advocates for states to take full advantage of available federal funding through comprehensive school Medicaid expansion. The more covered services and providers included in the state Medicaid plan, the more money school districts can receive through federal reimbursement. It’s an opportunity to bring in additional, sustainable resources to expand access to health services and improve child health and educational outcomes. Many states that have done so are reaping the financial benefits.
As states and school districts advance school Medicaid expansion, it’s important they assess the impact on student health, educational outcomes and school health financing. Building in evaluation processes can identify areas for improvement, improve effectiveness and further maximize federal reimbursement. And leveraging school health, state agency and community partnerships can also help demonstrate impact and bolster support for comprehensive school Medicaid programs.
Visit START: State Tools and Resources to Advance School Medicaid for additional materials designed by HSC to help states and school districts implement, improve and sustain effective school Medicaid programs.
To learn more about technical assistance and opportunities available through the Healthy Students, Promising Futures Learning Collaborative, email: info@healthystudentspromisingfutures.org
