Resources

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.

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.

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.

This case study provides an overview of the Children’s Regional Behavioral Health pilot project and highlights key lessons learned from this work. As states consider innovative methods for improving cross-sector collaboration, coordination of care and financing for school health services (especially behavioral health services), Washington’s model and experience provide valuable insights that can inform future efforts.