04/10/2024 | News release | Distributed by Public on 04/10/2024 08:05
Schools offer an invaluable opportunity for providers of mental health services to meet young people where they are - approximately 49.4 million young people were enrolled in public school in fall 2021 and seven of 10 public schools report that the number of students seeking mental health services has increased since 2020. But to address students' needs, our schools require comprehensive mental health programs, qualified staff, and adequate funding.
Medicaid and the Children's Health Insurance Program (CHIP) insure more than 41 million children in the United States, providing them with necessary physical and behavioral health services. With a streamlined program that is not prohibitively burdensome to administer, Medicaid could provide a sustainable funding source for schools to build comprehensive mental health programs.
School-based mental health programs can provide a supportive environment that recognizes and responds to the needs of young people. These programs are designed to be comprehensive, inclusive, and accessible, and offer a range of services interwoven throughout the school community. School-based mental health programming can:
To support school-based mental health programs, schools must creatively braid funding from federal, state, and local sources; insurance payments; grants; and partnerships with mental health clinics. According to the School Superintendents Association (AASA), Medicaid pays about $4 billion a year in school-based services. This is an essential funding source for public schools, but reimbursement is complicated and administratively burdensome, particularly for small and rural districts, and in some cases, districts do not seek reimbursement because of this burden.
To leverage Medicaid reimbursement and increase access to services, some states have enhanced their Medicaid school-based program. For example:
On June 25, 2022, President Biden signed into law the Bipartisan Safer Communities Act, which required the Centers for Medicare and Medicaid Services (CMS) to provide additional guidance to states on Medicaid school-based services. The guidance aims to: increase access to Medicaid-funded, school-based health services (SBS), including mental health services; reduce administrative burden; support federal compliance with billing and payment; and set up a technical assistance center to support the administration of school-based Medicaid.
In compliance with this legislation, CMS issued a comprehensive guide on Medicaid school-based services in May 2023, meant to clarify aspects of the program and encourage states to expand SBS beyond individualized education program (IEP) services. Shortly after, CMS launched the Medicaid and School Based Services Technical Assistance Center. Both are steps in the right direction to expanding funding, but states and districts still face challenges.
While there are opportunities for leveraging Medicaid for SBS, barriers remain that deter states from expanding their programs and some school districts from participating at all. These include:
States and districts have a unique opportunity to increase school-based mental health programming and repair inequities in access and delivery. They can support such efforts in the following ways:
For more state examples, historical context, and a detailed exploration of barriers and opportunities, please read our report, Leveraging Medicaid to Enhance School Based Mental Health Services.