Many partners belong at the organizing table and bring tremendous value to the process. The information below can help you decide which stakeholders can help your group address pressing issues. Some possibilities include:
State Agencies
In addition to working with state health and education agencies, it’s important to identify decision-makers in state government who care about both health and education outcomes, including state legislators, the governor’s office, and representatives from the various health, mental health, and alcohol and substance use agencies.
These individuals can play an important role in building broad support for policy implementation and also have a significant influence on state budget matters.
State public health departments can be good partners because of their depth of experience in state and local prevention, health promotion and needs assessment.
State Stakeholder Organizations
State stakeholder organizations — such as state chapters of teachers’ unions, parent-teacher associations, primary care organizations and associations for school-based health centers — can play an important role in supporting state-level changes that are needed to expand and implement changes in school-based Medicaid.
State provider organizations — including state associations of school nurses, speech-language pathologists, occupational therapists and physical therapists — are essential participants as well. These organizations also play an important role in spreading the word about changes in school-based Medicaid policy and building on-the-ground support for implementation.
Local Agencies
At the local level, the mayor’s office may be interested in discussing the importance of increasing access to school health services and the opportunity at hand. In addition, city council members can serve as important advocates for implementing this change, especially if the schools in the area they serve stand to benefit from increased access to school health services.
The local public health department is uniquely positioned to leverage public health data linking the top two to three health conditions from the State Health Improvement Plan (SHIP) to the delivery of Medicaid services in school settings.
Key allies could also include local health providers, local United Ways, and other local advocacy and social service organizations.
Advocates
State and local advocates bring the perspective of the community and the students and families to the table. Their involvement ensures active consumer engagement and a transparent process along the way.
National advocacy organizations are excellent sources of data, best practices and support for states. While national organizations are not likely to be a member of any state-based organizing table, engaging with one or more of these organizations can add depth and support — and a national perspective — to the work of the state team.
Health Providers and Insurers
Including health providers, local hospitals, pediatricians and managed care organizations in initial conversations can help ensure their support for this work as well as leverage the expertise and resources they bring to the table.
Funders
Many state-level funders, especially those who sit at the intersection of health and education, are well poised to support — and, in some instances, catalyze — a robust coalition in support of school-based Medicaid.
Who Should Be at the Table?
Here’s a list of government agencies, advocates and others to include in discussions around core policy questions.
Financing school-based Medicaid services
Make sure to include …
· State Medicaid agency
· State education agency
· School district (local education agency, or LEA) and superintendent
· Managed care organizations
· Provider organizations
Expanding Medicaid under the CMS “free care” policy reversal
Make sure to include …
· State Medicaid agency staff with experience in submitting Medicaid state plan amendments (SPAs)
· Medicaid staff with experience in coverage
· State education department and local school district staff who have knowledge of the various health-related services available to students served by the school
· Parent/advocacy organizations
Untangling privacy or parental consent
Make sure to include …
· Legal counsel
· LEA
· Parent organizations
· Children’s advocacy organizations
The role of managed care
Make sure to include …
· Medicaid department staff who handle managed care
· Representatives of managed care organizations
· LEA claiming/reimbursement departments
Credentialing
Make sure to include …
· Provider organizations
· Key state education and state Medicaid staff who work on credentialing and licensing providers
