The state budget bill that was passed by the House this week contains a provision that, if enacted, would be a boon to some of Ohio’s most vulnerable children and a vital support to the schools that serve them.
Currently, Ohio’s Medicaid Schools Program (MSP) blends state and federal dollars to pay for physical and mental health services provided in schools for Medicaid-eligible students. This is good as far as it goes, but is limited only to those students with an individualized education plan (IEP) and the services called for in their plans. Pandemic disruptions to school, family, and daily life have increased the need for services for mental health care, behavioral health care, and other medical issues. The amended state budget bill would direct the Ohio Department of Medicaid to seek permission from the federal government to expand the state’s MSP to allow payments for any covered services for all Medicaid-eligible beneficiaries when delivered by qualified providers in schools. As Sarah Broome explained in a 2021 post for the Fordham Institute, tapping this federal “Free Care Reversal Policy” is a particularly effective way to ensure sustainable funding for student mental health services.
The upsides are fairly clear: Reaching more children in need more easily, no IEP required; remuneration to schools for many services already being provided without dedicated funding; no state money needed to generate the new/additional federal reimbursement; and a sustainable funding source for essential mental and physical health services in places where they are most needed. Additional funding for supporting the health needs of low-income students would also be another tool in the box for charter and district schools to help address important community needs. Research has shown positive benefits of school-based and Medicaid-supported healthcare on attendance, persistence, graduation rate, future healthcare utilization, and long-term earnings.
This funding structure is already in place in seventeen states, with another nine currently in the approval process. Two of Ohio’s neighbors, Kentucky and Michigan, are among those with an established track record of expanding Medicaid-funded services in schools, both beginning in 2019. Ohio, which ranked a lowly thirty-first in the country for child well-being in 2022, needs to join their ranks. We must change that narrative—our students deserve nothing less—and boosting Medicaid funding for health services in schools is a step in the right direction.
