Two Oklahoma Republican lawmakers hosted an interim study Monday discussing expanding Medicaid-billable services in schools. State agencies are laying the groundwork to help schools better address students’ health.
School-based Medicaid services include preventative health care, behavioral health and physical and occupational therapy for students on Medicaid. The students who receive them have an individualized education program, which plans education and support services for kids with disabilities and health conditions.
The Centers for Medicare and Medicaid Services describe them as a way to meet children where they are and deliver care where they spend most of their time.
Rep. Daniel Pae (R-Lawton) thanked Oklahoma Turning Point Council Chair Melissa Simms for reaching out in the summer to raise awareness on this topic.
“(I) think that this is a wonderful issue to see how we can meet the needs of children and families in our communities, especially in our rural communities,” Simms said.
Oklahoma is behind surrounding states in its provision of school-based services. Kellie Carter, the manager of school nursing programs at the Oklahoma State Department of Education (OSDE), said in 2016, surrounding states like Arkansas, Colorado, New Mexico and Kansas saw $40-80 million in reimbursements for their school-based services.
Oklahoma's reimbursements were a little over $500,000 that year.
“Last year, we were a little bit over $4 million in billing for Medicaid services, and that is probably about 70 to 100 districts in our state, out of the over 500 districts that we have, that are currently billing for Medicaid,” Carter said. “So, as you see, there is room for advancement and room for us to continue to support schools with these services.”
Oklahoma Health Care Authority (OHCA) Chief of Staff Christina Foss said her agency is working with OSDE on a state plan amendment to expand eligibility to all students who are on Medicaid. The agencies also hope to provide new offerings, including dietician and nutrition services, and substance abuse services. The timeline for that is in early 2025.
OSDE is working on resources, like Medicaid manuals and billing guides to give schools more support to start Medicaid billing or increase it. Both state agencies will identify 10 school districts already successfully billing for school-based services and divide them into six regional support groups, including tribal and rural communities.
Those districts will provide mentorship, training and support to other smaller districts that may not have had the opportunity to bill for these services. Carter said OSDE will offer them extra funding for the support they will provide.
Their work is supported by a recent $2.5 million grant from CMS. The grant funding started July 1 and will go through June 30, 2027.
OSDE is bringing on new staff members to support the expansion of these services, including a program specialist and one responsible for working on the new grant. OSDE will also host an annual conference for school districts and community members to learn more about school-based services.
In the second and third year of the three-year federal grant, Carter said OSDE will also offer competitive grants to support 35 districts each year in implementing Medicaid reimbursements or increasing their services.
Stormy Bullard, who primarily works in outpatient therapy in southeast Oklahoma, said school-based services are important in reaching kids — especially those in rural areas.
“I feel that we have a lot of really good resources already set up, but there's just so many areas that we're missing the mark. And so, how do we address those?” Bullard said. “And I think this is a great opportunity for those lawmakers to get in there and see, really, where we are lacking.”
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