Public Payers News

KY Proposes Medicaid Coverage for School-Based Care Access

The proposal would grant schools access to Medicaid funds, allowing for expanded school-based care access.

school-based care access medicaid

Source: Thinkstock

By Sara Heath

- A proposed regulatory change in Kentucky would allow schools to access Medicaid funding, better equipping them to deliver school-based care to students.

The state governor announced this week that the Cabinet for Health and Family Services (CHFS) and the Kentucky Department of Education (KDE) submitted the amendment to CMS in late April, seeking to expand patient access to care services within their schools.

“The importance of school-based health services is proven, and I am grateful that our state agencies are partnering to implement this amendment, which will benefit thousands of students across Kentucky,” said Governor Matt Bevin. “This is an example of state government working across cabinets to find solutions to address the growing need for increased access to mental health services, preventive care, and other health services in our schools.”

Specifically, the amendment would allow schools to access some Medicaid funds. That increased funding would allow the schools to offer certain treatments to students who are already enrolled in Medicaid.

Currently, only patients registered on an Individual Education Plan (IEP) are qualified to receive school-based care covered by Medicaid.

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Covered services would include mental health services, health screenings, diabetes care, and asthma management, the state governor’s office said.

These proposed amendments come as a part of Kentucky’s efforts to address physical, mental, or behavioral health issues with children before issues grow too serious and potentially too costly.

“Given Medicaid’s historic role in supporting children’s health and educational outcomes, ensuring that all eligible students are enrolled in Medicaid and have access to the school-based health services they need are key strategies to supporting a healthy learning environment and academic success,” said Commissioner Wayne Lewis, KDE commissioner.

"Many Kentucky school districts have significant financial challenges,” he continued. “The ability to further leverage federal resources to meet students' health needs permits districts to target teaching and learning with state and local resources."

Essentially, the proposed amendments would allow schools to access Medicaid funding to provide better care for more students who are also enrolled in Medicaid. This will give schools more resources to increase patient access to care, as well as the quality of that care.

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For example, there are currently 1,688 students to one school psychologist in Kentucky, a ratio that is considerably out of whack, state policymakers say. The recommended ratio is between 500 and 700 students to one school psychologist.

Access to Medicaid funding will allow schools to hire more psychologists, or other relevant healthcare providers, to meet student demand. Furthermore, in acquiring these service providers, schools can increase the number of patients they allow to access care.

Although the plan amendment would allow for acute care services – the asthma management treatment, for example – the biggest benefit at stake is improving patient access to behavioral and mental health, according to Kristi Putnam, the deputy secretary for CHFS.

“As a former classroom teacher, I know how valuable it is to have health services and behavioral health services for kids right there at the school,” Putnam stated. “For many years, schools have struggled to find funding for provision of health services in schools, even though education leaders realize the importance of having these providers on site. More than two in five students are covered under Medicaid, so this initiative will have a tremendous impact within our schools.”

Bringing care into the classroom will also be essential for students who may not receive care outside of the classroom. Due to transportation issues, costs, a family’s social circumstances, or challenges finding a provider who accept Medicaid, some students may not receive care if they do not receive it at school.

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“This is an opportunity to reduce barriers for families so that children can be connected to critical health services, which also can raise awareness with the adults in the home about the importance of seeking care when needed,” added Putnam.

The state submitted the plan to CMS on April 28, where it awaits final approval.

Area advocates have come out in support of the proposal. Terry Brooks, PhD, executive director of Kentucky Youth Advocates, said the proposed amendment is an instrumental overhaul of education.

“That is no mere regulatory revision; it is a game changer for kids and the role that schools play in their lives,” Brooks said in a statement. “The importance of preventive health and behavioral health services is undeniable as is the wisdom of placing those services in schools to maximize access. Ensuring children have those services not only positively impacts health, it is a catalyst to better academic achievement and even better school environment.”