Federal Guidance Resources

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.

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.

Developed by the Council for Chief State School Officers, Healthy Schools Campaign and National Center for School Mental Health, this guidance highlights how state education agencies can use Elementary and Secondary School Emergency Relief (ESSER) funds to support student and staff wellbeing and connection. It also explains how to leverage these one-time-only funds to access additional funding streams, such as Medicaid, to ensure efforts are sustained.

This guidance provides an essential roadmap for strategic and sustainable investment that can help advance student and staff wellbeing and connection for years to come.

Developed by AASA, FutureEd, Healthy Schools Campaign and Kaiser Permanente, this guidance offers concrete steps school districts can take to make data-informed decisions about investing COVID-relief funding to support student and staff health, including COVID-prevention, mental and physical health and well-being, social drivers of health, physical and health education, and family engagement and community involvement.

This issue brief examines the challenges schools have encountered while providing physical, behavioral and mental health services during the Covid-19 pandemic. It considers the impact of state and federal policies, including how state Medicaid programs are responding to ensure reimbursement and funding, and it documents emerging best practices and guidance, especially around telemedicine and parental consent.

The extensive recommendations for state and federal agencies are designed to support the continuous delivery of school-based health services during this time of partial school reopenings and in the case of future health crises and natural disasters.

Healthy Schools Campaign and Trust for America’s Health are monitoring the impact of the COVID-19 pandemic on students and schools and highlighting guidance from our federal and national partners on how to support access to behavioral and physical health services.

Under a Healthy Students, Promising Futures technical assistance contract, Rebecca Gudeman from the National Center for Youth Law developed this tool (Appendix C) to support efforts to share school health information and data for the HSPF state team in Colorado.

Also see:
Main Tool: Legal Guide to School Health Information and Data Sharing in Colorado
Appendix B: A Quick Reference Chart to Confidentiality Laws

Under a Healthy Students, Promising Futures technical assistance contract, Rebecca Gudeman from the National Center for Youth Law developed this tool (Appendix B) to support efforts to share school health information and data for the HSPF state team in Colorado.

Also see:
Main Tool: Legal Guide to School Health Information and Data Sharing in Colorado
Appendix C: A Quick Reference Chart to Confidentiality Laws

Under a Healthy Students, Promising Futures technical assistance contract, Rebecca Gudeman from the National Center for Youth Law developed this tool to support efforts to share school health information and data for the HSPF state team in Colorado.

Also see:
Appendix B: Colorado Minor Consent and Confidentiality Laws
Appendix C: A Quick Reference Chart to Confidentiality Laws