An innovative data-sharing agreement in Washington, D.C., is helping health and education leaders identify student health needs—and make sure those needs are met. It has improved coordination and delivery of services between the city’s schools, the public health department and the Medicaid agency. The collaboration enables D.C. Public Schools to more effectively collect student health information from families, supports healthy students in developing healthy habits, and ensures that students with the greatest needs have the services that meet those needs. Working together, the three agencies are able to identify schools with the greatest number of unmet student health needs, and effectively target interventions.
This pilot began when key staff from each agency acknowledged that the lack of data sharing resulted in a duplication of efforts and mountains of paper—and still failed to present an accurate picture of unmet student need. They committed to change and began a deliberative process to move forward.
Each agency holds critical student health data and has an important incentive to ensure that students receive health services:
- D.C. Public Schools has an institutional requirement to collect health information, including oral health information, for each enrolled student; the forms collected help schools plan for the medical needs of students while at school. D.C. Public Schools also holds student enrollment data.
- The Department of Health requires that all students complete school health forms and have required immunizations to enroll in school, which means each student must go to their primary care provider for a well-child visit and dentist for a dental exam within the year.
- The Department of Health Care Finance (the District’s Medicaid agency) is required to document that the city’s Medicaid-enrolled students receive appropriate health care services; it also has data showing what services were paid for and to what managed care organization the student is assigned.
When pieced together, the data identify the schools with high Medicaid populations, with high unmet need, and where students are not receiving annual well-child or dental visits. Together, the agencies developed a Memorandum of Agreement (MOA) that allows them to share data in a way that helps them target outreach and resources to schools and students with the greatest unmet needs. The current MOA went into effect Jan. 1, 2014 and remains in effect until Dec. 31, 2019.
The MOA took three years to develop and finalize. Staff from each agency worked to develop the language and helped to shepherd the MOA through agency approval. Of note, privacy officers and general counsels were included from the beginning to ensure compliance with the Family Educational Right and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA).
Today, the three agencies share data.
D.C. Public Schools uses the student enrollment file, and also has records of health form submissions. Medicaid cross-references the student enrollment list with Medicaid enrollment status, as well as the date of the last well-child visit and dental visit. The Department of Health provides the student immunization data. These data sources are combined into one document to identify the schools with the greatest gaps in service utilization and highest Medicaid enrollment.
Based on the data, target schools receive increased outreach about the importance of well-child visits and oral health services. Principals and school nurses receive information about their schools and how they can increase efforts to improve health and wellness. Medicaid managed care organizations provide health promotion and education events that are targeted for the schools with the greatest unmet need.
D.C. Medicaid uses this data to develop school health snapshots for each managed care organization highlighting how their D.C. Public Schools-enrolled Medicaid beneficiaries are using services and whether they have submitted the necessary health forms to their school. Additionally, the managed care organizations receive school enrollment information for each of their Medicaid beneficiaries to help inform their outreach efforts to students, including those who attend schools with school-based health centers.
While the pilot is still evolving, the agencies continue to work together to support data sharing and to identify how the combined dataset can be used to help improve the health of students attending D.C. Public Schools. But it is clear that, working together, this more complete picture of student health needs has the power to transform student health in Washington, D.C.
Sharing data between the health and education sectors has emerged as a key issue in Healthy Schools Campaign’s work at the national, state and local levels. Through the Healthy Students, Promising Futures learning collaborative, we are working to support states and school districts in addressing the challenges related to sharing data in order to support increased access to school health services. Whether it’s understanding the health-related causes of chronic absenteeism or identifying the types of school health services needed in a school, we understand the powerful role of data in supporting the connection between health and learning and commend these agencies in Washington, D.C. for their innovative work.