School health services and supports are funded through a variety of mechanisms, including funding streams from health care, education, mental health and public health. Medicaid is the primary source of funding for school health services and supports. This includes through school districts billing Medicaid for health services delivered in the school setting, through community providers working in and with schools and billing Medicaid for the services delivered, and through established partnerships with other health care providers and organizations, such as managed care organizations.

Funding to support this work is also available through the education sector. For example, the nation’s education law, the Every Student Succeeds Act (ESSA), includes designated funding for activities that support safe and supportive school environments. In addition, ESSA funding can be used to hire school health providers, such as school nurses and mental health providers. 

Federal grant opportunities from key agencies play a role in financing school health services and supports. These agencies include the Department of Education and the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services. Supporting states and school districts in understanding how to braid and blend these different funding streams is a key strategy for sustainability and scalability.

Featured Resources

resources Medicaid Reimbursed Rehabilitative Behavioral Health Services in Schools: A South Carolina Case Study
May 13, 2020

This case study examines the implementation of Medicaid managed care school-based behavioral health services in South Carolina and highlights key lessons learned that can inform the efforts of other states choosing to coordinate school-based health care with Medicaid managed care programs.

resources Expanding Michigan’s School-Based Medicaid Program
October 8, 2019

This Healthy Students Promising Futures Learning Collaborative case study highlights Michigan's work to leverage the reversal of free care policy to expand the state's school-based Medicaid program. Beginning in October 2019, school districts in Michigan will be able to seek Medicaid reimbursement for services provided to all Medicaid-enrolled students (not only for health services included in a student's Individualized Education Program). This change presents an important opportunity to expand access to and resources for school health services, particularly behavioral health services

resources Opportunities in Medicaid to Improve Access to Behavioral Health Care for Children and Youth
July 16, 2019 Presentation PDF

Kirsten Beronio, Centers for Medicare and Medicaid Services

resources Understanding the Role of Random Moment Time Study in School Based Medicaid Programs
July 16, 2019 Presentation PDF

Melinda Hollinshead, Public Consulting Group

resources Innovation and Opportunities to Address Social Determinants of Health in Medicaid Managed Care

This report outlines the opportunities for managed care to address the social determinants of health, provides examples of state-led initiatives and health plan best practices, and reviews the barriers and challenges.

resources Medicaid 101 for School Superintendents

This brief for school superintendents provides an overview of how school districts can leverage Medicaid to support children's educational and health outcomes.

resources Understanding Medicaid Reimbursement in the School Setting

"Presentation delivered by CMS for the Healthy Students, Promising Futures Learning Collaborative providing an overview of Medicaid reimbursement in the school setting. The presentation addresses issues including the free care policy, certified public expenditures and telehealth.

resources Understanding the Early and Periodic Screening, Diagnostic and Treatment Benefit

This webinar provides an overview of the Early and Periodic Screening, Diagnostic and Treatment Benefit (EPSDT) requirements.

resources Understanding the Early and Periodic Screening, Diagnostic and Treatment Benefit

This webinar provides an overview of the Early and Periodic Screening, Diagnostic and Treatment Benefit (EPSDT) requirements.