New Report Highlights Role Medicaid Can Play in Advancing Comprehensive School Mental Health Services

Last month, the Healthy Schools Campaign and Mental Health America released a new report titled, “State Policy Opportunities: Advancing Comprehensive School Mental Health Systems to Support Students”, which provides a new perspective on the key actors that can play a role in advancing comprehensive school mental health systems for students.

But what counts as a “comprehensive school mental health system” you may ask? Also referred to using the abbreviation CSMH, these systems take mental and behavioral care administered in schools a step further by using a multi-tiered system of support to promote school climate and students’ social and emotional learning. According to the report, in addition to the multi-tiered supports, core components of CSMH systems include well-trained educators, family-school-community collaboration, needs assessment and resource mapping, mental health screenings, evidence-based best practices, data, and funding.

CSMH systems have historically been crafted by decision-makers at the school district level. However, operating through individual school districts brings challenges such as staffing shortages and a lack of funding. The report calls for greater collaboration on the part of state leaders to support school districts’ ability to develop CSMH systems. It not only provides a matrix of recommendations for decision-makers who would normally be thought to be called upon such as governors and state legislators, but also broadens it out to roles such as the insurance commissioner and state public health officer.

The recommendations are grouped into three main buckets focused on establishing foundational infrastructure, building scale, and bringing resources to the table to sustain new policy changes. The need for integration and collaboration is apparent throughout; there is much overlap in the recommendations for key state leaders.

But for the fun part — what role can Medicaid play? (This is Say Ahhh!, after all). Within the three main buckets, the report urges state Medicaid directors to prioritize enhancing network adequacy, parity, and quality, implement value-based payment strategies, and of course, allow for Medicaid reimbursement of school mental health services. It further maps out how leaders can achieve these goals by providing sample policies and additional resources for each of the recommendations. Highlights include:

  • Bolstering use of presumptive eligibility to ensure all eligible students and staff are enrolled in Medicaid
  • Recognizing school mental health and substance use providers as Medicaid-eligible providers
  • Issuing guidance that promotes partnerships between schools and culturally effective community-based providers
  • Providing school districts with training and template materials on billing for mental health and substance use services and legal issues such as privacy and liability
  • Adequately reimbursing for culturally and linguistically effective prevention programs such as youth peer support interventions in schools
  • Establishing a multi-payer collaborative to align payments across insurers for culturally competent CSMH systems

While building and sustaining comprehensive school mental health services is no small feat, this recent report from the Healthy Schools Campaign and Mental Health America helps lay the groundwork with specific recommendations and examples for pivotal state health leaders to get the ball rolling.

To find out if your state has expanded its school Medicaid program, check out our state data hub here.

Margaux Johnson-Green is a State Health Policy Analyst with the Georgetown University Center for Children and Families.