NCSSLE Bringing Into Focus - Opportunities to Leverage Medicaid and CHIP

Mental health challenges in children, adolescents, and young adults are widespread, and have long been established as a detriment to students’ learning and success in school. Challenges today’s young people face are unprecedented and, in the words of the U.S. Surgeon General, uniquely hard to navigate. As 2021 came to a close, Vivek Murthy, MD advised our nation that the effect those challenges have had on students’ mental health has been devastating – both preceding, and then compounded by, the COVID-19 pandemic’s dramatic insults to young people's experiences at home, at school, and in the community. Importantly, Dr. Murthy has reminded us that mental health challenges in young people are both treatable, and often preventable. And our national health systems are recognizing the unique opportunity schools offer for access to and utilization of vital health care and mental health supports for children and adolescents.

In light of U.S. Surgeon General Murthy’s December 2021 advisory, Protecting Youth Mental Health, national lawmakers and executive leaders have recommended several key actions to strengthen and expand access to high-quality, comprehensive health care for America’s children. The U.S. Department of Health & Human Services [DHHS] has issued new guidance to remind states of their mandate to cover behavioral health services for children enrolled in Medicaid and CHIP, two complementary health care programs which, combined, cover more than half the nation’s K-12 students. DHHS Secretary Xavier Becerra and Education Secretary Miguel Cardona co-signed a July 2022 letter to governors calling on them to invest more in mental health services for children, and both long-standing options and relatively recent opportunities are available to states to strategically leverage Medicaid and CHIP reimbursements to provide, expand, strengthen and positively transform comprehensive mental health supports and treatment to address students’ needs.

FEATURED RESOURCE

Information on School-Based Services in Medicaid: Funding, Documentation and

Expanding Services

This document offers detailed, technical guidance to support expanded access to Medicaid and CHIP-funded school-based health and mental health services for enrolled students. Noting that schools are uniquely positioned to increase health equity and to help ensure that all children have access to necessary health care services, this informational bulletin precedes additional guidance for states the Centers for Medicare & Medicaid Services (CMS) will issue in the coming months in accordance with the Bipartisan Safer Communities Act.

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ADDITIONAL RESOURCES

Medicaid State Overviews

Source: Medicaid.gov

Every state’s Medicaid and CHIP program is unique, and virtually all state Medicaid plans are changing and improving. The State Overviews page links to resources that highlight the key characteristics of each state’s Medicaid and CHIP programs, including eligibility and enrollment details, information about performance on frequently reported measures of health care quality, and complete, detailed Medicaid program documents (e.g. state Medicaid plan, waivers, amendments, covered services, and provider qualifications).

Connecting Kids to Coverage National Campaign

Source: InsureKidsNow.gov

The Connecting Kids to Coverage National Campaign, a national outreach and enrollment initiative, is currently funded through HEALTHY KIDS Act to reach families with children and teens who are eligible for Medicaid and the Children's Health Insurance Program (CHIP). The Campaign lets families know who is eligible, what benefits children can get and how to apply for coverage. Specific resources support school-based efforts to enroll and maintain coverage for eligible students.

School Medicaid Fact Sheets: Details on All 50 States

Source: Healthy Schools Campaign

These fact sheets, prepared by the Healthy Schools Campaign for all 50 states and Washington, D.C., note whether the state has expanded its school Medicaid program to include all health services delivered to all students enrolled in Medicaid, and lists the health services eligible for Medicaid reimbursement. Each fact sheet also identifies the nursing and behavioral health provider types eligible to bill Medicaid for services delivered in a school setting. For more information, visit the site’s school Medicaid map (May 2021).

State Medicaid & Education Standards for School Health Personnel: A 50-State Review of Reimbursement Challenges

Source: Healthy Schools Campaign and the Aurrera Health Group

Improving alignment between state Medicaid/CHIP and education standards for school health personnel is critical for fully realizing the recent gains made by state expansions of student eligibility for Medicaid coverage of school health services. This report sheds light on how alignment between these two areas of state law can reduce barriers to schools billing Medicaid.

State Funding for Student Mental Health (2021)

Source: Education Commission of the States

This policy brief from the Education Commission of the States describes common sources of funding, including Medicaid/CHIP, that states use to support K-12 school-based mental health programming. The brief is predicated on findings of a 50-state scan exploring how each state funds student mental health services.

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Health Report Card (2022)

Source: Hopeful Futures Campaign

This website includes a “report card” on standard dimensions of every state’s policies relevant to school-based mental health services, pointing out positive policy opportunities and providing legislative guides specific to each state.

NEED MORE INFORMATION

National Center on Safe Supportive Learning Environments | https://safesupportivelearning.ed.gov

The contents of the National Center on Safe Supportive Learning Environments' Bringing Into Focus were assembled under a contract from the U.S. Department of Education, Office of Safe and Supportive Schools to the American Institutes for Research (AIR), Contract Number 91990021A0020. The contents of this product do not necessarily represent the policy or views of the U.S. Department of Education, nor do they imply endorsement by the U.S. Department of Education.