This school year, pending federal Centers of Medicaid and Medicare approval, local school districts will have the opportunity to expand health and behavioral health services already offered to students in schools by leveraging federal Medicaid dollars.

By expanding health services to all students and billing services for Medicaid-eligible students, schools can help address immediate health care needs, connect students to quality health providers, and keep students learning. Additionally, this opportunity, called free care, creates a sustainable funding source to hire much needed qualified health professionals to meet the school-based health provider requirement of the past session’s Kentucky’s School Safety and Resiliency Act, Senate Bill 1.

As the Cabinet for Health and Family Services and local school districts leverage this new opportunity, questions may arise from parents, health providers, and advocates.

What is the free care policy?

In 2014, the federal Centers for Medicare and Medicaid Services (CMS) issued a reversal of the long-standing free care policy. This change allowed states more flexibility regarding their school-based programs by allowing local school districts to bill federal Medicaid for any health service currently covered by Medicaid inside the school setting for students enrolled in Medicaid. In order to implement this policy, states need to submit a Medicaid state plan amendment (SPA) to CMS. Kentucky submitted a SPA to expand school-based services through free care in April of 2019 and is awaiting approval.

Who will be eligible?

For several decades, Medicaid has played a critical role in providing school-based health services for students with an Individualized Education Program (IEP). The Cabinet for Health and Family Services and local school districts will be able to leverage the free care policy to expand school-based health services to any student that is enrolled in Medicaid, rather than just to students with an IEP. Children covered by Medicaid are less frequently absent from school and are more likely to graduate from high school. Ensuring children are in school, healthy and ready to learn is especially important with the passage of the Every Student Succeeds Act.

What services will be offered at schools?

Local school districts can offer any health and behavioral health service currently covered by Medicaid inside the school setting for students enrolled in Medicaid. Additionally, health services that are offered are required to be available to all students for free. Find out more about current school based Medicaid covered services here.

What types of healthcare providers can schools hire and bill for services?

A licensed health professional that is enrolled as a Medicaid provider can be hired or contracted with local school districts. A full list of providers will be shared by the Cabinet for Health and Family Services in the near future. Some common health and behavioral health providers in a school setting are:

  • Licensed Psychologist
  • Licensed Clinical Social Worker
  • Licensed Physical and Occupational Therapists
  • Licensed Advanced Practice Registered Nurse

Examples in the school setting:

  • Licensed psychologist or psychiatrist that is contracted or hired by a school, who is an enrolled Medicaid provider, preforms a mental health screening of an individual student as part of a threat assessment team referral. This is a billable service through the free care opportunity.
  • An advanced practicing nurse hired or contracted by a school, who is an enrolled Medicaid provider, performs the required dental screening for all incoming kindergarten students.

Over the months ahead, we will provide updates as the Medicaid state plan amendment process moves forward and schools utilize this exciting opportunity to provide expanded health and behavioral health services to Kentucky students.