Resources

The Healthy Schools Campaign School Medicaid Database is a text-searchable collection of publicly available documents pertaining to school Medicaid programs (as of 2022) in all 50 states and the District of Columbia.

Developed to assist state education agencies (SEAs) and state Medicaid administrators in creating resources to support school districts with expanding Medicaid reimbursement for school health services, the database features links to state Medicaid and education agency websites and to specific documents related to school Medicaid billing.

To assist Healthy Schools Campaign in advising states and stakeholders on how to strengthen Medicaid coverage of crisis services in schools, Aurrera Health Group conducted research on Medicaid coverage of school-based behavioral health and physical health crisis services in eleven states: Arkansas, Alaska, California, Georgia, Idaho, Indiana, Maine, Massachusetts, Michigan, Missouri, and North Carolina.

This memorandum describes Aurrera's findings from this research and provides recommendations for states seeking to establish or strengthen their coverage of crisis services.

In August 2022, the Center for Medicaid and CHIP Services at the Centers for Medicare and Medicaid Services released an informational bulletin, "Information on School-Based Services in Medicaid: Funding, Documentation and Expanding Services." This brief highlights key points and suggests how school Medicaid stakeholders — including school districts and state Medicaid and education agencies — can use the bulletin to assess where they can strengthen their programs. The brief also provides a high-level overview of the bulletin's School-Based Health Services Checklist, which feature strategies and guidance to implement or enhance school-based health services.

This brief details how a school Medicaid technical assistance (TA) center can play a key role in ensuring states and school districts have access to the support needed to implement, strengthen and expand their school Medicaid program to meet the needs of children and youth.

As young people across the country experience unprecedented levels of mental and behavioral health needs, it is important for states and school districts to understand the types of funding available to pay for appropriate services. This brief considers the circumstances under which school districts can bill their state Medicaid program for sudden and acute mental health crises that students may experience.

Expanding school Medicaid programs presents an important opportunity for states to support school districts in drawing down additional, sustainable federal Medicaid funding for school health services. Estimates suggest that states can expect to see significant increases in new federal resources. This brief includes five state examples.

The policy brief explains the importance of using a plan of care to document medical necessity, which is required for all school health services submitted for Medicaid reimbursement, and offers guidance on implementing plans of care for students without an IEP or 504 plan.

School Medicaid programs must comply with federal, state and local school district requirements. This policy brief includes information on how third party liability (TPL) applies to school-based health services and offers resources for additional reading.

"A Guide to Expanding Medicaid-Funded School Health Services" provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds.

The Guide covers best practices for bringing state Medicaid plans into alignment with federal policy; designing the administrative processes; and tackling other obstacles to improving student access to care. It also addresses building a sustainable funding structure and offers concrete lessons for collaboration among agencies.

This report reviews 33 audits of school-based Medicaid programs conducted by the Office of the Inspector General (OIG) and summarizes key findings. Prepared by Sarah Broome and Healthy Schools Campaign, the report highlights what OIG looks for during audits and can be used to help states and school districts prepare for future audits. Sample checklists are included to help guide states toward developing robust internal guidance and policies that meet OIG expectations.

In order to encourage school districts to maximize resources for school-based healthcare, state Medicaid programs must ensure that school healthcare providers are eligible for Medicaid reimbursement. That may sound simple, but there’s often a disconnect between the state education and state Medicaid agency’s licensing requirements and policies.

This policy brief explains how states can resolve identifying school health personnel as Medicaid-qualified providers and shows how six states improved alignment.

"State Medicaid & Education Standards for School Health Personnel: A 50-State Review of School Reimbursement Challenges" demonstrates how alignment between state Medicaid and education standards for school health personnel can reduce barriers to Medicaid reimbursement for school health services.

Prepared by Aurrera Health Group for Healthy Schools Campaign, the report analyzes data in all 50 states and the District of Columbia and outlines key recommendations for states to consider as they attempt to improve access to student health services covered by Medicaid.