CMS Removes Key Barrier to Funding School Health Services

December 16, 2014

For the past three years, Healthy Schools Campaign (HSC) has been working with advocates from across the country to change the way school health services are funded. We’re proud and excited to say that yesterday — as the result of a lot of  hard work and persistence — we succeeded in doing just that. Yesterday afternoon, the Centers for Medicare & Medicaid Services (CMS) removed a key barrier to funding school health services: schools are now eligible to receive reimbursement funding for health services provided to Medicaid-eligible students.

We’ve written blogs, sent emails and issued sign-on letters with the hope of getting the attention of the U.S. Department of Health & Human Services (HHS) to change the so-called “free care” rule, which had been inappropriately applied to schools, denying funding to school districts for health services provided to Medicaid-eligible students. Yesterday’s announcement changes that.

Before we go on, we’d like to take a moment to say thanks to our friends and readers who have taken time to sign on to our petitions and letters, or have reached out to CMS to share their thoughts and concerns. We’re excited to finally say that our voices have been heard. We’d also like to offer a sincere word of thanks to our colleagues at various organizations that have worked with us, and on their own, to make this change a reality, including Trust for America’s Health, School-Based Health Alliance, National Association of School Nurses, American Federation of Teachers, National Education Association and the Childhood Asthma Leadership Coalition.

The change was announced in a letter from CMS Director Cindy Mann [PDF] to state Medicaid directors reading, in part: “We are issuing this guidance to ensure that Medicaid payment is allowed for any covered services for Medicaid-eligible beneficiaries. … The goal of this new guidance is to facilitate and improve access to quality healthcare services and improve the health of communities.”

This change is especially critical in light of the nation’s vast health disparities. Low-income and minority students are at increased risk of health problems that hinder learning and are more likely to attend schools with unhealthy environments. Left unaddressed, health disparities will continue to undercut any meaningful progress in closing our nation’s achievement gap.

Said HSC President and CEO Rochelle Davis: “This guidance by CMS helps address many of the health disparities that exist in communities across the country. Low-income and minority students are at increased risk of health issues that can hinder their learning. By making Medicaid funding available to more schools, school health services can provide better care for the students who need it the most. This will help more students be healthy and ready to learn.”

Through our Health in Mind program, we, along with Trust for America’s Health, have called for HHS to “reduce barriers that schools face when seeking reimbursement for health services delivered to Medicaid-eligible students.” We also organized a series of letters and formal requests to HHS, urging the Secretary to address the free care rule. Most recently, we received a letter of support from new HHS Secretary Sylvia Burwell expressing her commitment to addressing the free care rule.

Burwell wrote: “I agree that Medicaid services delivered in schools play a critical role in improving the health of our nation’s children… CMS is currently reviewing policies on the role of ‘free care’ in determining the circumstances in which Medicaid reimbursement is available. I agree that clarifying this definition would help ensure a consistent approach to service delivery and reimbursement in our nation’s schools, and CMS is working toward that goal.”

We commend HHS and CMS for making this important change to support increased access to school health services and recognizing the key role that schools can play in meeting the health needs of students. We look forward to working these agencies to ensure schools have the information and resources needed to access this new funding.