Advancing Equitable School-Based Substance Use Prevention & Early Intervention Approaches

Many young people in the United States face a range of substance use, behavioral health and well-being challenges — sometimes all at once — without equitable access to and outcomes from effective support. This mismatch is not new, but the magnitude of these challenges has increased in recent years, particularly since the pandemic.

Schools are uniquely positioned to promote healthy behaviors and drive better outcomes for young people and their communities. They offer opportunities to connect with youth and to understand the context in which substance use decisions are made and whether a student’s substance use may be connected to their mental health.

Healthy Schools Campaign launched a project to help states and school districts leverage Medicaid as a sustainable and scalable funding source to support school-based substance use prevention and early intervention health services — and convened a community advisory board and focus groups to identify how school-based substance use programming could better meet the needs of young people, their families and communities.

Reports, related resources and a school action tool, all published in 2024, are outlined below.

This project was produced with generous support from the Foundation for Opioid Response Efforts (FORE).

A New Framing For Addressing Youth Substance Use

Report: Advancing School-Based Substance Use Prevention & Early Intervention Approaches: A Community-Informed Vision to Strengthen Equity, Access and Supports

Webinar: Advancing an Equitable School-Based Health Approach to Address Youth Substance Use

What does a community-centered vision for substance use prevention and early intervention services in schools look like? Community advisory board members — including education, healthcare and community leaders and youth advocates — tackled this question while developing a new framing for addressing youth substance use that focuses on achieving positive and equitable outcomes through non-punitive supports and policies and culturally and linguistically responsive services.

Alongside their work, HSC held a series of focus groups with students, parents, caregivers and educators to discuss in more detail how schools can build trust and increase student engagement. Findings from the community advisory board and focus groups are included in the report.

A companion action tool offers guiding questions to help schools align their policies and programs with the vision outlined in the report. It’s intended for anyone to use, including students, parents, educators, school administrators, healthcare and community leaders, and others who work to support student wellness.

HSC also published examples of programs that align with recommendations developed throughout the project and federal funding opportunities.

Maximizing School Medicaid

Report: Maximizing School Medicaid for Substance Use Prevention, Early Intervention & Treatment: 10 Actions States Can Take Now

Webinar: Strategies for Funding Substance Use Prevention in Schools: 10 Actions States Can Take Now

How can schools fund more substance use prevention in schools? Drawing on recent legislative and regulatory policy changes, and new guidance from the Centers for Medicare and Medicaid Services, HSC developed a report with specific actions states can take to eliminate barriers to reimbursement for school-based substance use services and help school districts get reimbursed for all services, including EPSDT services, already covered in the state Medicaid plan.

Recommendations include providing clear guidelines for covering substance use prevention (in addition to screening and treatment) and ensuring that providers specializing in school-based substance use prevention are included in the list of qualified Medicaid providers.

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Top photo by Allison Shelley for EDUimages