The Centers for Disease Control and Prevention calls integrating health and education initiatives “an untapped tool for raising academic achievement and improving learning.” A new report by Georgetown University’s Center for Children and Families lays out ways for educators and health care providers and advocates to pursue that important goal.
The first step is for schools to engage actively in enrolling eligible students in health coverage. It’s goes without saying that children with coverage are more likely to receive the screenings and health care they need to succeed in school—whether that’s developmental screening to identify learning delays for kindergartners or asthma plans for high school students. There are about 3.9 million uninsured children across the country, and an estimated half of them are eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Schools can help enroll them.
School districts can ask about insurance status on student health forms and direct families to agencies that can sign them up for coverage. When North Carolina schools tried this approach, they witnessed a 12 percentage point increase in health insurance enrollment rates and a 9 percentage point increase in the rate of kindergarten-age children receiving well-child exams. This sort of outreach is also important for teenagers, who are less likely to be insured than younger children.
Schools can also work with health advocates to take advantage of the new opportunities that the federal Every Student Succeeds Act (ESSA) provides. Given that many states are using chronic absenteeism as an accountability metric under the law, it’s important to document the role that illness plays in students missing school. The law also calls on schools to perform “needs assessments,” which offer an opportunity not only to identify unmet health needs but also to catalog efforts already underway in schools.
In addition, the education law’s Student Support and Academic Enrichment Grants program, with its emphasis on “safe and healthy students,” offers a funding source for health-related initiatives. In California, the state legislature voted to dedicate its $44 million in funding under the initiative to two priorities: visual or performing arts education and physical and mental health care. Beyond the grant program, ESSA provides funds for training teachers to support students struggling with trauma, depression or behavioral issues.
But the dollars from the ESSA grant programs are dwarfed by Medicaid, which reimburses schools and communities $4 billion to $5 billion annually for services delivered at school. Currently, most of those dollars support personnel and equipment for students identified with disabilities.
But a rules change announced in 2014 allows schools to charge a broader array of services to the federal-state partnership. In Missouri, Medicaid is now paying for much-needed mental health services. In Louisiana, school nurses are among the providers eligible for Medicaid payments. Several states are in the process of changing their own Medicaid plans or state law to allow their state to bill for more services provided to meet the unmet health needs of Medicaid eligible students.
[Read More: How Can Schools Lift Health Barriers to Learning?]
That said, billing for Medicaid is often complicated and time consuming, especially for smaller districts. A recent national survey of superintendents found that 37 percent of rural districts don’t seek reimbursement because of the costs of complying with the paperwork and administrative requirements. A quarter said they had actually lost money trying to comply with the requirements. Streamlining the paperwork would get more money to needy students. State education agencies need to provide support and assistance school districts need to receive these payments.
Schools can also improve student health by becoming a resource hub for families, especially in disadvantaged or remote areas. Using the Community Schools model, many schools now provide access to dental and medical services not just for students but also for families.
ESSA offers grants specifically for Community Schools coordinators. The CDC provides grants to school districts to support school health coordinatorsas part of its Whole School, Whole Community, Whole Child framework. Some schools are opening school-based clinics to entire communities. Others are expanding access to health providers through Telehealth, allowing students to talk to a doctor without leaving school.
These efforts underscore that schools are among the most effective places to promote student health. A wealth of research shows that connecting students to health services or expanding such services on campus pays dividends in better attendance, better focus and achievement, and ultimately, higher graduation rates.
Jordan is editorial director of FutureEd. Webb is a senior state health policy analyst at the Georgetown University Center for Children and Families.