In a new guidance letter sent to governors, chief state school officers and state health officials, the departments of Education (DoEd) and Health and Human Services (HHS) underscore the critical role that health services play in ensuring top student achievement.
The guidance is meant to help states and local school districts partner with their communities to support best practices.
“Healthy students are better learners and better positioned to thrive in school and later in life,” said Acting Education Secy. John King Jr. “The opportunities we highlight in our new toolkit are happening already in some schools, but we need more action. Our hope is this call to action is a new day for collaboration.
Over the past several years, major advances in laws and policies have created new opportunities to support our nation’s children. For example, as a result of the Patient Protection and Affordable Care Act (ACA), many more students and their families are now eligible to obtain insurance through Medicaid, the Children’s Health Insurance Program (CHIP), or a Qualified Health Plan (QHP) in the Health Insurance Marketplace, the letter said. The ACA also invested $200 million to modernize or build new facilities, purchase much-needed equipment, and increase access to health services for children at school-based health centers throughout the country, the letter said.
Partnerships are critical. Schools, for example, can provide on-site screenings to catch health concerns early and health providers can ask questions about school attendance and success during routine physicals and regular checkups, the letter said. School districts can partner with public health agencies and local hospitals to ensure that all children receive preventive and necessary health care in order to attend school regularly and stay on track toward high school graduation, the letter said.
The guidance include suggestions on high-impact strategies:
- Health coverage. Schools should help eligible students and family members enroll in medicaid, chip, or the marketplace. Research strongly suggests that when young people have insurance and receive necessary and preventive health care, their academic and other important life outcomes improve. One recent study, for example, found that children who gained access to Medicaid as a result of coverage expansion are more likely to do better in school, miss fewer school days due to illness or injury, finish high school, graduate from college, and earn more as adults.
- It is helpful to families registering a child for school to have the opportunity to enroll in health insurance programs at the same time. As one example, local educational agencies (LEAs) can use school registration processes to help eligible students and family members enroll in Medicaid or CHIP, or receive financial assistance for a plan in the Health Insurance Marketplace
- In-school services. Administrators should provide and expand reimbursable health services in schools. Schools and LEAs are now eligible, subject to an approved state plan, for reimbursement for many Medicaid services provided to students enrolled in Medicaid. This includes services provided by school-based health centers, which can significantly improve key educational outcomes among students. State Medicaid agencies, state educational agencies and LEAs can work together to explore opportunities for reimbursement of Medicaid-covered services for Medicaid-enrolled students.
- Recent guidance from the Centers for Medicare and Medicaid Services (CMS) explains changes in the federal “free care” policy, which addresses Medicaid payment for services available without charge to the community at large (“free care”). This CMS guidance identifies the Medicaid requirements that must be met in order for Medicaid reimbursement to be available. As a first step in this process, state and local health and educational agencies can come together to identify the scope of allowable school-based services under the state’s Medicaid plan.
Finally, schools need to work with local hospitals to address student needs. One new opportunity resulting from the Affordable Care Act is that hospitals claiming 501(c)(3) status must identify area health needs in a Hospital Community Needs Assessments and adopt strategies to address them. LEAs can partner with local hospitals and identify the health care needs of children, especially at-risk youth.
This process could involve hospitals working with school districts to decide how they can contribute resources and services to promote student health.