Case Studies: How States Are Expanding School Health Services Using Medicaid

In December 2014, the Centers for Medicare and Medicaid Services clarified Medicaid reimbursement in school-based settings, opening the door to more funding. The following case studies reflect the work states have completed, and the success they have achieved, in leveraging federal Medicaid policy to expand physical, behavioral and mental health services.

These case studies are published at Healthy Students, Promising Futures, a learning collaborative led by Healthy Schools Campaign. 


Expansion of School-Based Health Services in California: An Opportunity for More Trauma-Informed Care for Children

In April 2020, the Centers for Medicare & Medicaid Services approved California’s Medicaid state plan amendment, allowing school districts to access more federal funding for school-based health services. This report describes using this opportunity to increase access to services that help students heal from trauma — including the trauma caused by exposure to domestic violence and pervasive bias and crises such as COVID-19.


Understanding the Financial Impact of Expanding Medicaid Funded School Health Services in Colorado

Colorado conducted a pilot study in 2019 to better understand the financial impact of expanding its school Medicaid program and make data-informed decisions about how best to move forward with a state plan amendment. This case study details Colorado’s path toward expanding its school Medicaid program and highlights key lessons learned from this work. The Centers for Medicare & Medicaid Services approved the amendment in 2020.


CMS Approves State Plan Amendment for Massachusetts, Creating New Opportunity for School-based Medicaid

This brief provides an overview of the Massachusetts Medicaid state plan amendment, approved by Centers for Medicare & Medicaid Services in 2017, enabling schools to bill for Medicaid services provided to all Medicaid-enrolled students.


Expanding Michigan’s School-Based Medicaid Program

This case study highlights Michigan’s success in expanding the state’s school Medicaid program to seek Medicaid reimbursement for health services provided to all Medicaid-enrolled students. Approved in 2019 by Centers for Medicare & Medicaid Services, the state plan amendment presents an important opportunity to expand access to and resources for school health services, particularly behavioral health services.

South Carolina

Medicaid-Reimbursed Rehabilitative Behavioral Health Services in Schools: A South Carolina Case Study

This case study examines the implementation of Medicaid-managed care school-based behavioral health services in South Carolina and highlights key lessons learned — information that can inform the efforts of other states choosing to coordinate school-based health care with Medicaid-managed care programs.