The TAC seeks to assist and expand the capacity of State Medicaid agencies, local education agencies (LEAs), and school-based entities to provide greater assistance under Medicaid. This will include convening small group stakeholder calls with target audience members, including a special emphasis on schools located in small, rural communities. The TAC also seeks to develop specific resource materials tailored to the specific needs of LEAs and their communities. The primary “target audience” for the TAC is made up of State Medicaid Agencies and their directors/designees, State Education Agencies, LEAs, and School-Based Entities.
CMS and U.S. Department of Education (ED) share a commitment to children and youth by launching a joint-department effort to expand school-based health services, ensuring children have the health services and supports necessary to build resilience and thrive. Therefore, CMS and ED have joined together to provide additional technical assistance (TA), resources and support on the federal funding available for school-based physical and behavioral health services, including how the Government can:
- Support the delivery of these services.
- Help reduce:
- federal administrative burden for states and localities, including local educational agencies (LEAs), and
- barriers to the provision of school-based physical and behavioral health services.
- Improve and strengthen access to physical and behavioral health services for students.
The Bipartisan Safer Communities Act (BSCA) has provided resources to improve access to health care in schools.
With this new comprehensive guide, CMS and ED strongly encourage States and schools to expand their offering of school-based services (SBS) as a way to increase crucial health care access to children enrolled in Medicaid and CHIP and meet Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements. Preliminary CMS data indicates that the volume and rate of primary, preventive, and mental health service use declined during the pandemic and have not yet rebounded to pre-pandemic levels. Additionally, the Centers for Disease Control and Prevention reports that from 2011 to 2021, poor mental health and suicidal thoughts and behaviors increased for nearly all youth groups. SBS play an important role in the health of students. Health care services delivered in schools are an opportunity to meet children where they are and deliver services to children in a setting where they spend a majority of their time – in school. SBS can include all services covered under EPSDT, which provides a comprehensive array of preventive, diagnostic, and treatment services for eligible individuals under 21 enrolled in Medicaid. These services include, but are not limited to, preventive care, mental health and substance use disorder (SUD) services, physical and occupational therapy, and disease management.
As listed in Public Law 117-159, June 25, 2022, section 11003 (a)(2), the TAC shall:
- Assist and expand the capacity of State Medicaid agencies and local educational agencies and school-based entities to provide assistance under Medicaid.
- Reduce the administrative burdens for such agencies and health centers or entities.
- Support State educational agencies, local educational agencies, and school-based entities in obtaining payment for the provision of assistance under Medicaid.
- Ensure ongoing coordination and collaboration between the Department of Health and Human Services and the Department of Education with respect to the provision of, and payment for, assistance under Medicaid by local educational agencies.
- Provide information to State and local educational agencies and the target audience States on how to utilize funding from the Department of Health and Human Services and Department of Education, and other Federal agencies to ensure payment under Medicaid for assistance in school-based settings.
The TAC will continue to be updated with additional resources over the coming months. Future resources will include more in depth guidance on various aspects of billing for school-based Medicaid for both state Medicaid agencies, state education agencies, local education agencies, and schools. CMS welcomes input on what future content should be developed for the TAC. Please email any TAC suggestions to the SBS mailbox at firstname.lastname@example.org