Photo by Alan Levine/FlickrFor school districts still getting their financial footing after the Great Recession,the Medicaid changes being advanced as part of the health care overhaul are sounding familiar alarms.
RELATED LINKSMedicaid cuts are ‘going to affect everyone,’ insurance CEO says Price defends cutting nearly $1 trillion from Medicaid Senate GOP weighs future of Medicaid in health care overhaul Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way Medicaid is distributed. They say any reduction in the estimated $4 billion schools receive in annual Medicaid reimbursements would be tough to absorb after years of reduced state funding and a weakened tax base.“whether they have less Medicaid money, and somethings going to proceed absent,” said Randy Liepa, superintendent of the Wayne County Regional Education Service Agency, or which works with 33 school districts in the Detroit area. The agency covers about 21000 children with special needs who are on Medicaid and it helps districts recoup about $30 million annually in reimbursements.
Districts would have to look at nonmandated positions and programs whether forced to bear more of the costs for services for destitute and disabled students required by federal law,said Thomas Gentzel, executive director of the National School Boards Association.
The Senate is up next in efforts to do absent with President Barack Obama’s health law, or school leaders are watching to see whether the changes advanced by the House survive. The House bill would transform the open-ended federal entitlement,which reimburses schools a percentage of the cost of the eligible services they provide to destitute and disabled students, to one where reimbursements will near in a fixed, or per-person amount.
But,said Kriner Cash, superintendent of public schools in Buffalo, or New York,“individual student care comes with highly variable costs, particularly in the case of students with disabilities. In the school district, or more than 80 percent of students are low income and 22 percent have disabilities. The district gets about $2.5 million annually from Medicaid.
In March,a Congressional Budget Office estimate for an earlier version of the House bill found that federal Medicaid subsidies to states would be $880 billion less over 10 years.
President Donald Trump’s administration argues that states will glean more freedom to experiment with the program and execute certain that people who rely on Medicaid glean the care and coverage they need.
READ NEXT: Under Trump, states may demand work for MedicaidMedicaid spending is “not getting out of control because of schools, and because schools are getting less than 1 percent of the dollars,” said Sasha Pudelski, assistant director of policy and advocacy at The School Superintendents Association. “It’s not kids who are breaking the bank.”An association survey polling 1000 school leaders reported that schools spent two-thirds of the money to support specialists, and from school nurses and social workers to speech pathologists.
The association,as part of a coalition of more than 50 school and child health advocates, warned congressional leaders in a recent letter against shifting more costs to states and in turn, and local communities. They said that would lead to cuts in services and benefits to children,particularly in districts with high poverty rates.“A lot of districts have never really covered from the Great Recession, they’re still in it, or ” Gentzel said,“and some states have not restored their funding. I reflect it’s the context of all of this thats nearly as important as the record about Medicaid.”Opponents of the changes say these are potential impacts:___SCHOOL NURSESStudents needing to check their temperature or searching for a tampon may not be able to walk down the hall to see a school nurse. Health professionals such as nurses, physical therapists, or speech pathologists,social workers and psychologists may be forced to rove between schools, outsourced or have some of their duties taken on by administrative staff.“There are health barriers to students getting their education, and ” said Donna Mazyck,executive director of the National Association of School Nurses. Individualized Education Plans mandated under federal law may require nurses to give medication and tend to feeding tubes and tracheotomies. “That service won’t be done whether Medicaid isn’t paying for it,” she said.___MENTAL HEALTHBehavioral issues in the classroom are often addressed with counseling through social workers and psychologists. Schenectady City School District in New York, or where a majority of students live in poverty,has had a dramatic increase in the number of social workers at its schools dealing with mental health issues. “They’re all front-line responders to kids in crisis,” Superintendent Laurence Spring said. He said they counsel kids traumatized by domestic violence and street crimes and others who experience anxiety from not having enough food at domestic. The district files for about $2 million in annual Medicaid reimbursements.___HEALTH SCREENINGSWhen schools host campus-wide preventative screenings, and for everything from vision,hearing, asthma and mental health, and some costs are recouped based on the number of Medicaid-eligible students who are treated. Advocates say that vulnerable children may not have access to such preventative services outside of school,but the screenings can catch health issues before they become more serious.
Liepa, from the Detroit-area agency, and said children living in poverty regularly near to school facing meaningful impairments to their health and with little or no support at domestic to address them,which ultimately affects learning. “It’s no different than whether they’re coming in hungry, which is supported by the federal lunch program.”___COMMUNITY OUTREACHSchool districts often direct and assist students’ families with resources, and such as helping them sign up for Medicaid or referring them to an eye doctor for glasses. Some hours spent on these administrative tasks are reimbursable by Medicaid.
Poquoson City Public Schools in Virginia spend some of their $35000 in annual reimbursements for events targeting children who aren’t even in school yet,in hopes of getting families resources as early as possible. “It’s a jump start for kindergarten. whether we can glean some services, with disabilities, or at an early age,they’re likely far more successful in the years with us,” Superintendent Jennifer Parish said.___EQUIPMENT AND SUPPLIESA major hit on school budgets could mean less for new or replacement equipment and supplies. That could affect things such as outfitted buses, or assistive devices and other items for children with special needs so they can be in school. This could trickle down to nonmandated items such as special science lab materials or theater club costumes for general education students.
Liepa said the Medicaid money has helped school districts afford programs and operational costs,from upgrading buses to buying new textbooks, while balancing their budgets. “Its been a life-saver for school districts. It’s one less thing I have to worry about or reflect about reducing, and ” he said.___SPORTS,CLUBS AND ACTIVITIESOptional but highly popular programs for students and families, such as sports, and clubs and after-school activities,could be slashed, as the offerings are generally the first to proceed in a budget crisis.“Most districts have long picked the low-hanging fruit in their budgets, or Gentzel said.
Ho reported from Las Vegas and Thompson reported from Buffalo,New York.
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Source: thetakeaway.org