How Medicaid can help schools support students' mental health |
Among the COVID-19 pandemic’s most pernicious aftershocks is its impact on student mental health. About 44% of adolescents experienced persistent feelings of sadness or hopelessness during the pandemic, compared with 37% in 2019, according to a recent survey by the Centers for Disease Control and Prevention. Recognizing this, districts across the country are using federal COVID relief aid to bring mental health professionals into schools and to expand social-emotional learning. This also creates the challenge of how to sustain new school staff positions when the funding expires at the end of 2024. Medicaid, the federal-state partnership that 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. In 2014, the federal government opened up a new avenue for support when it reversed what’s known as the free care rule and allowed schools to seek Medicaid reimbursement for certain health services provided by school employees, including mental health counselors, for all students enrolled in Medicaid. Previous guidance limited reimbursement to services included in a student’s Individualized Education Plan or Individualized Family Service Plan under the Individuals with Disabilities Education Act. Currently, 16 states — Arkansas, Arizona, California, Colorado, Connecticut, Florida, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Missouri, North Carolina, New Hampshire, Nevada and South Carolina — have expanded their programs to allow qualified school providers to bill for covered behavioral health services for Medicaid-enrolled students beyond those with IEPs, according to the Healthy Schools Campaign.