The following links provide you with the major topics impacting Medicaid in schools over the next year. Read on and join the conversations:

The bipartisan Safer Communities Act that passed to prevent gun violence last week included language requiring CMS to issue new school-based Medicaid guidance before June 2023. The guidance does EXACTLY what we have been asking CMS to do for years and even does more than what we had hoped for in that it provides direct grants to states to start the hard, but meaningful work of changing how they process Medicaid claims, find ways to dramatically expand Medicaid-reimbursable services to schools, and generally take advantage of the new flexibilities that they will be granted via updated guidance to expand healthcare, particularly mental health services, to millions more children.

 

This is going to be totally game-changing for states, for districts and most importantly for KIDS.

 

Here are the specifics (which you can also find starting on page 11 here)

  1. Update the Medicaid guidance from 1997 and 2003
  2. Clarify that a State should take steps to allow a district to bill for any EPSDT service they provide
  3. Outline strategies/tools that reduce the administrative burdens on, and simplify billing for local educational agencies, in particular small and rural LEAs, and support compliance with Federal requirements regarding billing, payment, and recordkeeping, including by aligning direct service billing and school-based administrative claiming payments
  4. Include a comprehensive list of best practices and examples of approved methods that State Medicaid agencies and local educational agencies have used to pay for, and increase the availability of, assistance under Medicaid, including expanding  State programs to include all Medicaid-enrolled students, providing early and periodic screening, diagnostic, and treatment  (EPSDT) services in schools, utilizing telehealth, coordinating with community-based mental health and substance use disorder treatment providers and organizations, coordinating with managed care entities, and supporting the provision of culturally competent and trauma-informed care in school settings; and
  5. Provide examples of the types of providers (which may include qualified school health personnel) that States may choose to enroll, deem, or otherwise treat as participating providers for purposes of school-based programs under Medicaid and best practices related to helping such providers enroll in Medicaid for purposes of participating in school-based programs under Medicaid. (note: this is essential for ensuring critical school personnel like school psychologists can bill Medicaid and was NOT something CMS was planning to clarify in their guidance based on our most recent conversations with them).
  6. Create a NEW TA Center—in consultation with ED—with $8m in seed money so districts and states aren’t lost about how to do school-based Medicaid any more. Further, the TA Center has to report to Congress on the areas where the most TA was requested to ensure that CMS is accountable and responsive to stakeholder needs.
  7. $50m in grants to States for the purpose of implementing, enhancing, or expanding the provision of assistance through school-based entities under Medicaid or CHIP.

 

Despite this amazing victory-- the work continues. We must continue to urge ED to reduce barriers to accessing Medicaid services in schools through changes to FERPA and parental consent requirements as well as urge CMS to follow this law (I love writing that!) and be more aggressive in promoting free care, removing TPL barriers, and more, but this is a great and unexpected new policy that we should all be proud of and celebrate.

Districts across the country are using federal COVID relief aid to bring mental health professionals into schools. But this unprecedented infusion of federal aid also creates a challenge: how to sustain new school staff positions when the funding expires at the end of 2024. In this analysis, Phyllis W. Jordan and Bella DiMarco of FutureEd, an independent, nonpartisan think tank at Georgetown University’s McCourt School of Public Policy, and Anne Dwyer of the McCourt School’s Center for Children and Families explain how Medicaid, the federal-state partnership that already provides health care for millions of public school students, could be part of the solution - as long as states take the necessary steps to use it and federal agencies back them up.

 

For resources to help organizations address the youth mental health crisis, check out the most recent Campaign Notes eNewsletter from CMS and the Connecting Kids to Coverage National Campaign:

https://www.insurekidsnow.gov/newsletter/2022/05/26/index.html. 

The National Alliance for Medicaid In Education is pleased to announce the selection of our new Executive Director, Jenny Millward, ED. D. 

Jenny brings with her 29 years of experience in special education and childhood disability advocacy in such roles as a special education teacher, Program Specialist for Speech Language Pathology and Director of Student Services at Houston County Schools in Georgia. In addition to her impressive career experience Jenny has also been an active member of G-CASE, CASE, and CEC since 2004, including holding the Legislative Committee Chair position for G-CASE since 2018.

NAME eagerly anticipates a thriving partnership with Jenny to promote integrity, collaboration, and success for its members. Welcome Jenny!

To connect with Jenny:

Dr. Jenny Millward, Executive Director

National Alliance for Medicaid in Education

This email address is being protected from spambots. You need JavaScript enabled to view it.

478-808-1021

 

 

Embed School-based Services into a Unified, Comprehensive, and Equitable System of Student/Learning Supports 

Last week we noted that the increased concern about the impact of the COVID-19 pandemic has resulted in many well intentioned initiatives and policy reports that, unfortunately,  limit discussion to integrating and expanding school‑based health services. The latest push is seen in the federal launch of a joint‑department effort to expand school‑based health services.

We raised the following caution:

While the focus on school‑based services is a necessary piece of addressing barriers to learning and teaching, it is just one facet of what schools need. And focusing on it in isolation of what else is needed has unfortunate consequences for students and schools.

This caution produced queries about what we think needs to be done. Recent reports and other resources may be accessed HERE in the Online Resource Catalogue. Below is a sample of the most recent reports:

How School Boards Can Pursue New Directions to Help Schools Address Barriers to Learning and Teaching http://smhp.psych.ucla.edu/pdfdocs/boardrep2022.pdf. 

We won't Argue Against Adding More Counselors,

     BUT ...

Addressing Student Mental Health Concerns Involves Much More than Increasing the Number of Mental Health Providers http://smhp.psych.ucla.edu/pdfdocs/morethan.pdf. 

2021‑22: Addressing Learning, Behavior, and Emotional Problems Through Better Use of Student and Learning Support Staff http://smhp.psych.ucla.edu/pdfdocs/supports.pdf. 

For free access to three recent books detailing the policy and practice changes that can transform how schools address barriers to learning and teaching and reengage disconnected students and families, visit:

http://smhp.psych.ucla.edu/improving_school_improvement.html. 

 

CMS guidance on telehealth (December 2021)

CMS has updated the State Medicaid and CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth (Covid-19 Version) with guidance to states on telehealth. Notably, this guidance clarifies that states may cover Medicaid services delivered via audio-only technologies—and will continue to do so after the end of the COVID-19 public health emergency.

FAQ from U.S. Department of Education

The updated Frequently Asked Questions on Use of Funds to Prevent, Prepare for, and Respond to the COVID-19 Pandemic provides updates and guidance that reinforces that states can take a broad approach to using ESSER funds to support school health.

Other Resources

Advancing Comprehensive School Mental Health Systems: A Guide for State Education Agencies

CCSSO and the National Center for School Mental Health

This guide outlines five key steps state education agencies can take to support a comprehensive approach to school mental health, alongside state examples and relevant resources.

The Kids Are Not All Right: The Urgent Need To Expand Effective Behavioral Health Services For Children And Youth

Health Affairs

This article highlights the need to spread and scale proven interventions throughout the health, public health and education systems in response to the current behavioral health crisis facing children and youth.

How to Sustain Telehealth Within Your Pediatric Practice

American Academy of Pediatrics

This toolkit includes several new resources for pediatricians and other pediatric care providers on telehealth implementation.

Six Questions State Boards Should Ask about Student Mental Health

National Association of State Boards of Education

This resource highlights specific questions for state board discussions on promoting student mental health.

Announcing this year’s focus for the National Initiative for Transforming Student and Learning Supports.

The COVID‑19 pandemic has made it inevitable that public schools will change in fundamental ways over the next few years. This is particularly the reality for how schools address barriers to learning and teaching and for efforts to reengage disconnected students and families.

See http://smhp.psych.ucla.edu/newinitiative.html to see suggestions for some first steps that can be taken to improve student/learning supports and for resources to assist in moving forward.

Aurrera Health Group and Healthy Schools Campaign has released a new report which demonstrates how alignment between state Medicaid and education standards for school health personnel can reduce barriers to Medicaid reimbursement for school health services. This report outlines key recommendations for states to consider as they strive to improve access to student health services covered by Medicaid. The report may be reviewed here: https://healthystudentspromisingfutures.org/wp-content/uploads/2021/10/State-Medicaid-Education-Standards-for-School-Health-Personnel.pdf. Click or tap if you trust this link.">State Medicaid & Education Standards for School Health Personnel: A 50-State Review of School Reimbursement Challenges

According to our partner @ModernMedicaid’s updated #MedicaidDashboard, over 6.7 million children are enrolled in the Children’s Health Insurance Program (CHIP).  Learn more here: http://data.modernmedicaid.org/.