The Benefits of Medicaid Funding for School-Based Services Nationally, more than half of all school-aged children and youth are covered by Medicaid. Making health services available in schools for all Medicaid-enrolled students can significantly increase the number of students accessing them and reduce burdens for families. For example, students are six times more likely to access mental health care when these services are offered in school. Medicaid pays for $4-6 billion to school districts for providing school-based services each year and is a large source of funding for many LEAs. For example, Chicago Public Schools receives $35-40 million annually in Medicaid reimbursement. The district expects $10 million more as a result of the federal flexibilities offered in the 2023 CMS claiming guide. Medicaid can contribute more federal funds toward physical and behavioral health services that students need. States that expand school-based Medicaid to provide crucial physical, mental, and behavioral health services to all Medicaid-enrolled students may expect to see significant increases in new, sustainable federal resources.
Consider these examples :
Colorado ran a pilot project that estimated the State would receive an additional $8 million in federal Medicaid funds per year by allowing for the claiming and billing of additional school behavioral health providers in its State plan.
Georgia’s expansion to allow claiming and reimbursement for school nurses is estimated to result in $48.6 million in federal revenue to its school- based Medicaid program.
Michigan projects it will see an increase of $14 million after expanding its program to allow for reimbursement of services provided by master’s degree- level school psychologists .
Take Action Now!
Currently, only 16 States 1 are maximizing available Medicaid funding by allowing for the reimbursement of school-based services provided to more than just students with disabilities under IDEA who are Medicaid-enrolled. All other States have the opportunity to amend their State plans to include school-based services for all students who are Medicaid-enrolled.
1 As of January 1, 2024. States with approved plans that provide for reimbursement of school-based services to all Medicaid-enrolled students include: Arizona, California, Colorado, Illinois, Kentucky, Louisiana, Massachusetts, Michigan, Nevada, New Mexico, North Carolina, Oregon, and Virginia. States with approved plans that provide for reimbursement of some school-based services or for some students beyond those with IEPs who are enrolled in Medicaid include: Connecticut, Georgia, and Indiana.
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