Elisabeth Wright Burak  Reading, Writing, and Medical Check-ups? Schools as Health Care Providers Elisabeth Wright Burak This half-day workshop is being co-hosted by the Education Writers Association and the Association of Health Care Journalists. It will explore issues at the intersection of the health and education beats. Participants will learn about promising sources of data while gaining insights and fresh story ideas for their beats. 1:30 p.m. – 2:30 p.m. Reading, Writing, and Medical Check-ups? Schools as Health-Care Providers Many underserved children fail to receive regular medical care and face elevated risks of developing chronic health problems. To respond, a growing number of public schools are looking beyond their traditional role to become primary providers of medical, dental, and vision care through school-based health clinics. Katherine Bissett, Johns Hopkins Rales Center Kelli Caseman, West Virginians for Affordable Health Care Meredith Liu, The Primary School (East Palo Alto, Calif.) Elisabeth Wright Burak, Georgetown University Naseem Miller, Orlando Sentinel (moderator) 72nd Annual Education Writers Association National Seminar Reporting at the Crossroads of Education and Health Pre-Conference Workshop May 5, 2019

Good Health Helps Kids Reach Their Full Potential Medicaid Matters for Schools video (.mp4 file), 51 seconds Benefits of health/education partnerships Healthy students are better students Sicker children miss more school School is a good place to reach kids and families Schools often a community HUB, especially in rural communities

Growing Awareness of the Nexis Every Student Succeeds Act (ESSA) emphasis on safe and healthy students, chronic absenteeism Federal regulatory changes now allow states to help schools bill Medicaid directly for services to more eligible children Importance of social-emotional learning/mental health and their role in academic success

Medicaid is a key financing source Education and Health All schools play a role in the health of their students – nutrition, school nurse services Many schools provide health screenings AND services to students Growing interest and reach of school-based health centers (SBHCs) Medicaid is a key financing source

School-based Health Center Movement OUTCOMES: • More regular receipt of immunizations and other preventive health care • Fewer emergency room visits • Better grades • Lower retention rates • Higher attendance rates • Better graduation rates WHO THEY SERVE: disadvantaged students • 76.5% of SBHCS are in schools where more than 50% of students were eligible for free or reduced-price lunch. • Still many schools with concentrated poverty have no clinic 50,000+ schools have 40 percent or more of their students living in poverty 50,000 divided by 2,300 = >5% • In some communities, particularly in rural areas, the clinics serve families as well as students. Source: School Based Health Alliance: https://www.sbh4all.org/school-health-care/national-census-of-school-based-health-centers/

Expanding SBHCs Post 2014 growth with ACA… Most comprehensive school/health care – SBHC ”movement” a growing national trend • 2,300+ in 49 states and DC (only ND has none—this is 2013-14 census, latest one they have) - Post 2014 growth with ACA…now 2315++++ (less than 1200 in 98/99 • Up 20 percent since 2011 • Doubled since 1997 • The largest growth is coming in rural schools, accounting for about 60% of new centers in recent years

How are Children Covered? 37% of school-aged children in Medicaid and CHIP (almost 40)- ALONG WITH PRIVATE COVERAGE 5.4% Source: J. Alker and O. Pham, “Nation’s Progress on Children’s Coverage Reverses Course” (Washington: Georgetown University Center for Children and Families, November 2018), available at https://ccf.georgetown.edu/2018/11/21/nations-progress-on-childrens-health-coverage-reverses-course/.

Medicaid Serves Millions of Children CHIP 9.5 million Marketplace 1 million Sources: Georgetown CCF analysis of SEDS FY 2017 Ever-Enrolled in Medicaid/CHIP. CMS state-level public use data as of 4/17.

Medicaid Helps Kids Succeed in Life Source: Georgetown University Center for Children and Families. “Medicaid is a Smart Investment in Children.” March 13, 2017.

Many Schools Receive Medicaid Dollars Directly U.S. schools receive $4B - $5B in Medicaid annually for: Staff - school nurses, social workers, mental health professionals Health services and supports -preventive screenings, learning aides for students with disabilities, service referrals, etc. Medicaid-funded screenings and services can help schools meet IDEA requirements Add a better picture http://aasa.org/uploadedFiles/Policy_and_Advocacy/Resources/medicaid.pdf https://www.cbpp.org/research/health/medicaid-helps-schools-help-children https://www.cbpp.org/blog/medicaid-continues-to-help-schools-help-children

Opportunities: Medicaid and Schools Ensure every eligible student has health coverage. Help schools support and prioritize the comprehensive health needs of students as a pivotal factor in learning. Increase access to school- based or school-linked preventive health care. Help schools serve as resource “hubs” for families and caregivers especially in underserved or remote areas. Key question to ask state or district officials: Have you opted new opportunity to allow schools to bill for eligibly students beyond special education (free care rule)? How are schools ensuring children have insurance, get check ups? https://ccf.georgetown.edu/2019/04/24/how-medicaid-and-chip-can-support-student-success-through-schools/

Additional Resources Twitter: @GeorgetownCCF @ewburak @candancewebbCCF Sign up for our newsletter! ccf.georgetown.edu State Coverage Data: https://ccf.georgetown.edu/state- childrens-health-facts/ Medicaid/CHIP by school district: https://ccf.georgetown.edu/medicai dchip-coverage-by-school-districts/ Series: Future of Children’s Health Coverage: https://ccf.georgetown.edu/2016/08 /09/the-future-of-childrens-health- coverage/ Twitter: @GeorgetownCCF @ewburak @candancewebbCCF