A KFF survey of state Medicaid programs examined initiatives promoting access to school-based behavioral health services. Medicaid covers nearly four in ten children and adolescents nationwide and provides significant financing for behavioral health delivery through schools. A total of 44 states responded; 41 addressed school-based care questions.
Nearly all—96%—public schools offer mental health services, though student utilization remains unclear. By 2014, nearly nine in ten school-based health centers reported billing Medicaid. Programs rely on Medicaid through reimbursement for medically necessary services in Individualized Education Plans, eligible student health services, and administrative activities. Since the 2014 reversal of the free care policy, the Centers for Medicare and Medicaid Services permits Medicaid payment for services to covered children regardless of whether schools provide them universally at no charge.
State Medicaid programs vary in promotion strategies. Some states strengthened local education agency collaboration (Alabama, Massachusetts, Tennessee, Vermont). Others expanded Medicaid reimbursement for school-based services to children without IEPs (Arizona, Kentucky, Michigan, Virginia). Several states increased reimbursements to attract providers (Arizona, California, South Carolina). Arizona expanded mental health and suicide prevention trainings with local education; California’s Children and Youth Behavioral Health Initiative offers managed care incentive payments for expanding school-based access; South Carolina modified policy allowing districts to contract with mental health providers or hire counselors directly, with Medicaid billing.
The Bipartisan Safer Communities Act allocated $50 million in planning grants; the Consolidated Appropriations Act requires 12 months of continuous Medicaid eligibility for children and mandates updated provider network directories including behavioral health practitioners and cultural competencies.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.kff.org/mental-health/leveraging-medicaid-for-school-based-behavioral-health-services-findings-from-a-survey-of-state-medicaid-programs/