Q&A: Kim Silvey, Illinois State Board of Education’s Principal Consultant on School Medicaid

The Illinois State Board of Education (ISBE) recently hired its first-ever school Medicaid consultant, Kim Silvey, to help school districts leverage Medicaid as a sustainable funding source for student health services. 

Healthy Schools Campaign interviewed Silvey about the position (see below), which involves acting as a liaison between school districts and the state on Medicaid guidance and instructing districts on how to bill effectively for Medicaid-covered health services.

In 2023, Illinois received federal approval to expand the state’s school Medicaid program to permit billing for all covered health services delivered to all Medicaid-enrolled students, including an expanded list of services and providers. Previously, billing was allowed only for students with an Individualized Education Plan (IEP), which in Illinois limited reimbursement to just 14% of the 800,000 students enrolled in Medicaid. Two dozen other states have also expanded their school Medicaid program.

During the first two years of Medicaid expansion, Illinois school districts brought in more than $40 million in additional funding, joining other states that have benefited from school Medicaid expansion. 

Still, the billing process can be complex, and many school districts have requested support. 

“If we could learn how to bill for services students receive in an efficient way, we may be able to better sustain our current programming and also increase service provision by billing for other health and mental health-related services,” a school district employee shared with Healthy Schools Campaign (HSC) during a statewide learning collaborative focused on school Medicaid.

States that have added a school Medicaid-specific position are following best practices for implementing and expanding school Medicaid and are better able to leverage the financial opportunity school Medicaid presents for school and education budgets.

Healthy Schools Campaign’s work with states has shown that states that have added a school Medicaid-specific position are better able to leverage the financial opportunity school Medicaid presents for school and education budgets.

The following interview has been modified for length and clarity.

Kim Silvey (KS): I am deeply honored to serve in this inaugural role at ISBE. My primary goal is to establish a strong, sustainable framework that improves understanding of the school Medicaid program and helps Illinois districts access and maintain long-term financial stability. 

A key priority is educating stakeholders on state plan amendment (SPA) updates. These changes present a meaningful opportunity for schools to increase Medicaid revenue by leveraging Medicaid expansion and transitioning to a cost-based reimbursement model.

One of the most significant challenges I anticipate is navigating the complexity of administrative requirements and addressing long-standing compliance concerns. The intersection of education and healthcare policy can be difficult to navigate, particularly for busy school leaders balancing competing priorities. I see my role as helping translate these complex regulations into clear, practical guidance and streamlined processes that districts can confidently implement.

Looking ahead one to two years, I hope to see measurable growth in Medicaid participation and revenue across Illinois districts, particularly under the expanded program. Success, to me, means having a standardized and accessible technical assistance framework in place — one that ensures every district, regardless of size or capacity, feels supported and equipped to manage their Medicaid program effectively. 

Ultimately, I want to see these resources translate into tangible outcomes for students, including sustained funding for critical services such as mental health supports, nursing care and overall student wellness initiatives.

KS: What drew me to this work is the profound connection between financial stability and a district’s ability to fully support its students. We know that students cannot learn effectively when their physical or mental health needs go unmet, but schools also cannot address those needs without reliable, sustainable resources. School Medicaid serves as a critical bridge, transforming the delivery of required health services into a consistent and dependable revenue stream that supports student success and provides a valuable pathway for families to access necessary benefits.

What excites me most is the untapped potential of Medicaid as a sustainable funding source. Too often, essential student health initiatives rely on short-term grants that eventually expire, leaving districts to make difficult decisions. Medicaid reimbursement provides a more stable and predictable funding mechanism, allowing districts to move from a reactive approach to a more strategic, long-term investment in student health and wellness.

I am particularly motivated by the opportunity to help districts reframe their view of school Medicaid; not as an administrative burden, but as a powerful tool for financial sustainability. Supporting districts as they build capacity, strengthen their programs and realize the full impact of these resources on student outcomes is incredibly rewarding and energizing.

KS: Partnerships are the foundation of an effective school Medicaid program because this work exists at the intersection of two large, complex systems: education and healthcare. Neither sector can fully optimize the program in isolation. Sustainable success depends on strong collaboration, shared understanding and aligned goals to ensure districts can effectively understand, access and utilize the funding available to them.

I am particularly committed to working closely with our state agencies, especially the Department of Healthcare and Family Services (HFS), to ensure that policy guidance, reimbursement processes and implementation supports are aligned, understandable and accessible for school districts. Equally important is collaboration with agencies and organizations that support direct service providers, as their insights are critical to ensuring that guidance is both practical and meaningful for those delivering services to students every day.

Partnerships with organizations like Healthy Schools Campaign are also incredibly valuable. Their deep expertise and strong connections to school communities provide an important perspective on the real-world challenges districts face. Together, we can create a continuous feedback loop — listening to district needs, identifying barriers and using those insights to inform more effective state-level guidance, training and resources. Ultimately, these collaborative efforts strengthen the program and help ensure that it works as intended to support both schools and students.

KS: Participating in school Medicaid expansion is one of the most impactful steps a district can take to strengthen long-term financial stability. It’s not just about recovering costs for services already being provided — it’s about unlocking sustainable resources that support a comprehensive system of student care.

By participating in Medicaid expansion, districts can leverage federal funding to support essential health and mental health services that might otherwise be at risk during budget constraints. This creates a more stable foundation for caring for the “whole child” and helps protect critical services from economic uncertainty.

I also recognize that navigating the school Medicaid process can feel complex and, at times, overwhelming. However, with the right foundational steps and access to technical support, the process is very achievable. My role is to partner with districts — breaking down that complexity, providing practical guidance and offering ongoing support.

The investment districts make in building their Medicaid programs today will yield lasting benefits, supporting both financial sustainability and improved outcomes for students for years to come.

Ed. note: HSC provided free training, technical assistance and peer-learning opportunities to help Illinois school districts expand Medicaid billing for school health services and reinvest new funding in services and supports for students. View Illinois resources.