The Hidden Lifeline: How Medicaid Supports Our Schools

Summary

Summary of "The Hidden Lifeline: How Medicaid Supports Our Schools"
Podcast: School Business Insider
Host: John Brucato
Release Date: April 8, 2025

In this compelling episode of ASBO International's School Business Insider, host John Brucato engages in a vital conversation with Jesse Mandel, the National Program Director for the Healthy Schools Campaign. They delve into the essential yet often overlooked role Medicaid plays in supporting school districts across the United States, especially in the face of potential federal budget cuts.

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1. Introduction to the Episode

John Brucato opens the discussion by introducing Jesse Mandel and setting the stage for a deep dive into how Medicaid funding underpins various health services within schools. He emphasizes the collaboration between ASBO International and other organizations to assess the impact of possible Medicaid restructuring.

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2. Understanding Medicaid: A 101

Jesse Mandel provides a foundational overview of Medicaid, elucidating its history and its significant presence in the American healthcare landscape. She explains:

"Medicaid is a health insurance program that serves one in five people in the United States, covering almost 40% of children through Medicaid and CHIP combined."
[02:43]

Mandel highlights the cooperative nature of Medicaid as a state and federal partnership, allowing states flexibility in structuring the program to meet their unique needs.

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3. The Critical Role of Medicaid in Schools

Exploring Medicaid's integration into the educational system, Mandel outlines its pivotal role in funding:

• Health Professionals: Funding salaries for school nurses, psychologists, and specialized instructional support personnel.
• Mental and Behavioral Health Services: Supporting comprehensive mental health programs within schools.
• Assistive Technology and Equipment: Providing necessary tools for students with disabilities.

She notes the historical context:

"For over 30 years, Medicaid has supported the delivery of health services to students with disabilities by paying for their physical, mental, and behavioral health services."
[05:24]

The bipartisan Safer Communities Act of 2014 further cemented Medicaid's role in expanding mental health services in schools.

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4. Survey Findings: How Schools Use Medicaid

In partnership with organizations like ASBO, NAME, and CASE, Healthy Schools Campaign conducted a nationwide survey to assess Medicaid's impact. Key findings include:

• 86% of Districts: Use Medicaid to fund salaries of health professionals and specialized staff.

  "86% of districts said that they use Medicaid to fund the salaries of health professionals and specialized instructional support personnel."
  [19:25]

• Over Half Use for Mental Health Services:

  "Over half of the respondents said they use Medicaid funds for mental and Behavioral Health Services."
  [19:25]

• 46% Allocate for Assistive Technology:

  "46% said they use Medicaid funding for assistive technology and specialized equipment."
  [19:25]

• 60% Reporting Increased Funding Over Five Years:

  "60% of the districts reported that Medicaid funding has increased over the last five years."
  [19:25]

Surprisingly, the survey garnered over 1,400 responses nationwide, with a higher participation from rural districts, underscoring Medicaid's outsized role in these areas.

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5. The Threat of Budget Cuts

Mandel addresses the looming threat of federal budget cuts targeting Medicaid amid the budget reconciliation process. She explains:

"The budget reconciliation process is directed to cut $880 billion, impacting Medicaid severely because it's one of the largest expenditure areas."
[12:09]

These cuts are not unprecedented. In 2017, similar efforts to restructure Medicaid were met with strong opposition, preserving the program's integrity. However, the current fiscal pressures suggest significant reductions are likely inevitable.

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6. Implications of Medicaid Cuts for School Districts

The potential reduction in Medicaid funding poses dire consequences for school districts:

• Staffing Cuts:

  "80% of districts said they would have to cut staffing, including layoffs or reductions of health professionals."
  [24:27]

• Reduction in Mental Health Services:

  "70% would have to cut mental and behavioral health services."
  [24:27]

• Decline in Student Resources:

  "62% would need to cut student resources, impacting overall student support."
  [24:27]

Moreover, 90% of districts anticipate that Medicaid cuts would necessitate reductions across their entire budget, not just within health services, leading to broader educational repercussions.

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7. Disproportionate Impact on Vulnerable Students

Students with disabilities and those requiring mental and behavioral health support stand to be disproportionately affected:

• Jesse Mandel shares testimonials from affected districts:

  "Students that may have mental health needs that are not on an IEP will not be able to have their needs met."
  [28:41]

  "We would likely cut a program that is having the most significant positive impact on our students with the most challenging behaviors."
  [28:41]

This underscores the critical importance of Medicaid in ensuring equitable educational outcomes for all students, especially those with heightened needs.

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8. Policy Recommendations and Advocacy

Mandel urges school business officials to stay informed and proactive:

• Stay Updated: Follow updates from ASBO, Healthy Schools Campaign, and related organizations.

  "Follow Healthy Schools Campaign and sign up for newsletters and action alerts."
  [32:12]

• Understand Local Impact: Assess how Medicaid currently operates within your district and the number of students enrolled. Utilize resources like the Georgetown Center for Children and Families' data.

• Advocate Actively: Engage with local representatives and policymakers to voice the critical role Medicaid plays in supporting students.

  "School business officials are such important messengers and can be champions for this program."
  [32:12]

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9. Final Thoughts and Call to Action

In conclusion, Jesse Mandel emphasizes the urgency and importance of collective action:

"This is the moment to pay attention, to get involved... Less funds, less opportunities, less support. Cuts to Medicaid would have an impact across all services."
[34:40]

She calls on school business officials to amplify the message about Medicaid's indispensable role and to continue advocating for its preservation to sustain student health and educational success.

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This episode serves as a crucial reminder of the interconnectedness between healthcare funding and educational outcomes. By highlighting the multifaceted support Medicaid provides to schools, Jesse Mandel and John Brucato underscore the immediate need for stakeholders to engage in advocacy efforts to protect this vital funding stream.

Transcript

[John Brucato]

You're listening to ASBO International's School Business Insider. I'm your host, John Brucato. Each week on School Business Insider, I sit down with school business officials and industry experts from around the world to share their stories and explore the topics that matter most to you. Find out what it means to be a school business official and get your insider pass on all things school business.

[Jesse Mandel]

Hello everyone, and welcome back to School Business Insider. Today I'm joined by Jesse Mandel, the national program director for Healthy Schools Campaign. In this episode, Jesse digs into the critical role Medicaid plays in our schools, from supporting health services to funding key personnel and equipment that serve our most vulnerable students. ASBO International has been working alongside Healthy Schools Campaign, aasa, CASC and NAAME to elevate the importance of school based Medicaid as Congress considers potential cuts and restructuring to the program during budget reconciliation. Earlier this year, we distributed a national survey to learn how districts are using Medicaid funding, and today we're diving into the results of that report. Jesse shares insights on what's at stake, especially for rural districts, how how cuts could ripple across education budgets, and what school leaders can do to advocate for this vital funding stream. Jesse, welcome to the podcast. I'm happy to have you.

Thank you so much for having me.

Yeah, absolutely. So to kick it off, maybe you can give our listeners a little bit of your background and what you do at Healthy Schools Campaign.

Sure. Healthy Schools Campaign is a national organization. We're based in Chicago and we advocate for all students have access to healthy, positive learning environments. And really key to that is ensuring that all students have access to comprehensive school health services, including mental and behavioral health services in schools. And key to that is that there's sufficient and sustainable funding for schools to be able to fund those school health services. And so for over a decade now, we've advocated for not only for school health services, but for that sufficient sustainable funding stream. And that's where Medicaid plays a really key role for schools, school districts and states to be able to support students ensure they can all thrive.

Wonderful. So for those maybe not too familiar with the intricacies of Medicaid, can you give our listeners a little bit of a 101 on Medicaid, maybe its history and then what it looks like today in schools?

Yeah, absolutely. Yeah. For those that have not fully gone down the Medicaid weeds or nerdiness, I guess Medicaid at its core, Medicaid is a health insurance program and it serves one in five people in the United States and Medicaid, together with its sister program, the Children's Health Insurance program, or CHIP, covers almost half, about 40% of children in the US and guarantees children comprehensive coverage for all medically necessary services. And school age children, in fact, comprise nearly one third of all Medicaid enrollees. And a really key feature of the Medicaid program is that it's a shared state and federal partnership. And so the total cost of the program is split between federal Medicaid and states. And so this is an important feature to consider when thinking about the impact of potential cuts and just that interplay of how states and the federal government work together. But really a key feature of the Medicaid program is that it's a shared state and federal partnership. And the total cost of the program is split between federal Medicaid and states. And this gives states a lot of flexibility to structure the Medicaid program, their Medicaid program as it works for them. And so currently, because of this partnership, states have a lot of flexibility in how they operate and determine how the Medicaid program is run.

Right now, is that cost sharing ratio the same for every single state or is it differ between maybe states that have higher or lesser wealth or poverty? How is that ratio calculated?

Yeah, it's a little bit of a complicated formula, but it does take into the the per capita income of the states and the population. Each state has a different share. So some states it's a little bit higher, some states it's a little bit lower. But it is determined by the amount of wealth and the kind of population makeup of each state and what typically.

Qualifies a family and students for Medicaid.

So a few things can qualify a family or student for Medicaid. Certainly income is one of those factors. So being low income is a factor that can determine the ability of a student to be eligible for Medicaid. So that's probably the most well known factor is that being low income is a determinant of Medicaid eligibility. But the other piece is also having a disability. And so students with special health care needs or students with disabilities also will be eligible for Medicaid.

And why is Medicaid such a vital funding stream for school districts? I mean, you know, we've been talking a lot about how federal funding really seems to be on the chopping block for education. Tell me why Medicaid is so critical.

Yeah, yeah. So Medicaid plays a really unique role in schools and it's often lesser known because the Medicaid program is huge. You Know, there's many different pieces. It serves children, it serves seniors. But the Medicaid in schools program, while a smaller piece of the overall Medicaid program, really serves a very significant role in schools. So to give a little history. For over 30 years, Medicaid has supported the delivery of health services to students with disabilities by paying for the physical, mental and behavioral health services for students with IEPs or individualized education programs or plans. So historically, that is the role that Medicaid played for students. And then in 2014, there was actually a clarification by the federal government that not only can Medicaid pay for those students, pay for the services that students with IEPs receive in schools, but it can also support all Medicaid eligible students in schools and pay for those services that Medicaid enrolled students receive. So even if a student doesn't have a disability, Medicaid can pay for those, those general education students can pay for the, the physical, mental and behavioral health services that they receive in schools. And this was really cemented actually three years ago, Congress passed the bipartisan Safer Communities act, which included some key provisions making it easier for states to maximize Medicaid funding in schools to support increased access to mental health services. So they really recognized that that critical role that Medicaid funding can play in supporting students mental health needs. And all of this has led to Medicaid being a significant source of funding. As I said, Medicaid supports at least $7.5 million of school based health services every year. And it's among the highest federal top federal funding streams for school districts.

Wow. And so what's kind of the mechanics behind the funding? Is it a direct bill to Medicaid, from districts to Medicaid? Does Medicaid maybe pick up the cost directly from providers? I mean, combination. Like what is a typical kind of funding mechanism with Medicaid?

Yeah, yeah. I'm smiling because Medicaid's an ever simple. Right.

Kind of. I'm kind of like baiting you into this question.

Yeah, exactly how nerdy we're getting. No, well, I guess, you know, kind of, you know, at a, at a high level, I think it's just important to think about kind of different models for delivering health services in schools. And this will. I'll get to your question. But there's, you know, there's different ways that schools deliver health services. So sometimes you'll hear about a school based health center. That is one mechanism that's not what we're talking about today. That's a clinic. That's Co located or located near a school. That's one model. Then sometimes schools will contract with a provider or an agency, a community based provider or social services agency to offer to come into the school and offer services. That's also a separate and distinct system because that provider will bill Medicaid. When we talk about this program, the school based Medicaid program, we're actually talking about how, we're talking about those providers that are employed by or contracted by the school district to offer services. So it's the school district that pays the salaries of these providers and Medicaid is the funding stream to the school district. So we're talking about school nurses, school psychologists. So those school based providers are really where this specific program has the most immediate impact.

Right. And so what are some examples of how districts are currently using these funds? You kind of brushed on a little bit. But what types of services, staff, equipment, what does Medicaid enable districts to do?

Yeah, just a range, a range of things. And I know we're going to kind of talk more about the survey in a minute, but I think at a high level it's staffing, it's those school health staff like school nurses, school psychologists. It is equipment, resources like equipment specifically for students with disabilities, technology in schools. Medicaid funds screenings, asthma screening, hearing and vision screenings. Medicaid also actually supports referral and care coordination. So helping a student not only get that care in a school, but making sure they're then able to connect with providers outside of the school that can help, you know, provide additional support, enrollment services. So if a kid, as we know Medicaid. Well, Medicaid can, it can be common for, for students to drop off of Medicaid for really often, you know, just through for one reason or another or for income levels to change. And schools can help through Medicaid with that enrollment and eligibility re enrollment process. So Medicaid really can play a range of direct services in schools. And what we found too is for schools often what will happen is when they begin to maximize Medicaid funding in schools, that actually frees up additional dollars. Right, because maybe they were using grant funding to pay for mental health services. Now they're better able to use those Medicaid dollars. That frees up funding that can be used elsewhere for other essential services, health services or just other areas to support students health and wellbeing.

Wow. So there's a lot at stake then potentially if the Medicaid program is going to see a cut, whether it be deep or just something. I mean it seems to be a vital service for districts. I had Crystal Fitzsimmons on from the Food Research and Action center and we talked a lot about child nutrition and how that is on the chopping block with budget reconciliation too. You know, we were kind of grousing about it and talking about why it just is such a bipartisan thing. Feels like Medicaid is very similar to that. It benefits blue, red states, purple states. Doesn't really matter why Medicaid and why now? Is it just because it's such a budget behemoth and it's easy, low hanging fruit? Like why is Medicaid in jeopardy?

Yeah, I mean, I think it kind of goes back to. And you might have also chatted about this too. Goes back to just what the kind of budget process that's happening right now. In the budget reconciliation process, Energy and Commerce Committee was directed to cut $880 billion and Senate was directed to cut at least 1 billion. So while these budget negotiations are still underway, that's going to have a significant fiscal impact no matter what. And no matter how you slice or dice it, that puts Medicaid on the chopping block. Right. Because there's really no way to get to that level of cuts without impacting Medicaid. And so I mean, to your question of why Medicaid, I think also this is, you know, we'll talk about advocacy later. But I think it's also just a, I think there's a real need to lift up just the many, many ways that Medicaid affects all levels of, you know, community, students, workforce. So I think, I think maybe there's a need to kind of amplify just how critical role Medicaid plays throughout a whole community. But what we know from the, you know, from the reconciliation process is that those committees are going to have to cut Medicaid. They're, you know, with numbers like that and I know they're just starting those negotiations, nothing's been determined yet. But you know, with numbers like that, there's going to be a dramatic impact on the Medicaid program.

Sure. And is Medicaid and its budget a perennial issue in terms of it being funded? Is this something that comes up every year as kind of we need to restructure, cut whatever you want to do to Medicaid? Or is this something that's relatively new to the budget reconciliation process?

I mean, we saw it in 2017. Actually this came up again that there were, and certainly not to the school based Medicaid program, but to the Medicaid program overall. There were attempts to kind of restructure the Medicaid program, and those were defeated. There was a really strong public outcry about the importance of Medicaid, and that led to Medicaid proposals not passing then. So I think the hope is that. Well, you know, we're already seeing people speak out in defense of Medicaid, but, you know, I think that's. That's what we are. You know, we'd like to see, again, is that level of support, because that's what happened in 2017. And. And while, you know, the. The kind of changes that are on the. The proposals might look a little different. You know, we heard. We hear different terms. You know, block grants, per capita caps, you know, all these different. All these different kind of ways. I think ultimately they boil down to less funding for the Medicaid program, and that means less money for states because of that partnership. And I think that's really a key piece of this, is that when we talk about cuts at the federal level, that has just a direct, direct implication for cuts to the. To the Medicaid program that states run, and it will be up to states to have to figure out how to fill in those funding debts.

Sure. So let's talk survey and survey results. What prompted your team to partner with ASBO and. And the other organizations I named in the intro on this survey?

Yeah, I know. I'm just laughing. So, like, these are. We're already in kind of doom and gloom, and we haven't even.

[John Brucato]

We just started.

[Jesse Mandel]

Oh, my goodness. No. But, yeah, so this survey, I mean, that we. So Healthy Schools campaign has been very active in advocating for a strong school Medicaid program to support students. But we wanted to really get a better sense of the impact that the Medicaid cuts would have on school districts. And actually, in 2017, I just want to give a shout out to ASA Superintendents Association. They conducted a survey along similar lines. They reached out specifically to superintendents, but they said, look, Medicaid's on the chopping block. What impact will this have? So we wanted to sort of draw from the lessons and really the strengths of that survey and. And ask school districts, again, what is the impact of Medicare? How is Medicaid currently being utilized in your school district, and what would be the impact of cuts? So we partnered with ASBO and the national alliance for Medicaid in Education or name. And so. So we wanted to find out and really assess what the impact of Medicaid cuts would be on school districts and really how school districts are currently using Medicaid right now. And so Healthy Schools campaign partnered with aspo, ASA or the Superintendents association, the national alliance for Medicaid and Education, or NAME and the Council of Administrators of Special Education or case. And these were we were just lucky enough to be able to partner with these organizations that work with members that are really keyed into Medicaid's critical role and funding health services and students. So we conducted this survey between January 27th and March 3rd, and it was just we received a tremendous result. And I know we're going to talk about that, but that was sort of the impetus is really just trying to dig into, just trying to dig into the impact of Medicaid role in school districts right now.

You spoke to a little bit earlier. But for those who may not be following as super closely, are there specific Medicaid elements that districts should be keeping their eye on and that's going to potentially be a part of the budget reconciliation process, or is it all we know is that Medicaid in general is in jeopardy.

I think at this point there's so many things that are changing. I don't think it is one specific piece of the Medicaid program. I think ultimately it is less money for Medicaid overall and then it will be up to states to figure out how to fill in those gaps. So certainly it'll affect, you know, Medicaid cuts will affect eligibility, fewer people able to get enrolled. It will affect, could protect, it could impact benefits, it could affect providers. And, you know, so I think we'll see a number of areas that get impacted, but I don't think there's one specific area. I think it's really just keeping an eye on these Medicaid cuts overall because those will all kind of play. We don't have a sense of how those are going to play out. And they'll play out very differently for states, but the bottom line is they'll still be cuts.

So what were some of the most surprising or significant findings from that survey? And is it your organization reviewing it? Are you reviewing it in conjunction with the others that were involved? Tell me about that.

Yeah, so I mean, there were a few things that were really surprising and I can share just about the results. I think one thing from the outset was just that we received over 1400 responses. And I think that alone just speaks to the power of this program. And not only did we receive 1400 fill in the check the box responses, people took the time and I brought some of those quotes to read too, but people took the time to write in comments and really share how Medicaid right now affects their students and has led to just improved student outcomes overall. So it was really moving to see that level of response from districts and we received responses from all 50 states plus DC so this really was a nationwide survey and I think it just spoke to the tremendous importance of Medicaid in schools right now. We also received more responses from rural areas than we did from suburban and urban. And so that surprised us too, just knowing that in rural areas, Medicaid actually often plays an outsized role because more children are actually enrolled in Medicaid in rural areas than in metro areas. And school based health services play such a critical role in rural areas, especially when there's issues like limited connectivity or travel times. School based health services really help address some of those challenges that many find in getting care. But I think to see those numbers, to see that reflected in the survey was also, I think, surprising and also encouraging. I think really it's a testament to just the incredible work that so many people do every day. So I think those are a few of the, maybe the surprising things, but I think also a lot of what we found in the Medicaid really confirmed what we knew. But again, to see just that outpouring, I think it was very, it was very powerful. So just to kind of read you some of the results, so 86% of districts said that they use Medicaid to, to fund the salaries of health professionals and specialized instructional support personnel. So that includes your school nurses, school psychologists, speech language pathologists and occupational physical therapists. So those types of roles. But 86% was pretty significant, was higher than we, higher than I think we were even expecting because it had gone up since the survey I mentioned 2017. So it just shows that Medicaid plays an even more significant role role for school districts. Over half of the respondents said they use Medicaid funds for mental and Behavioral Health Services. 46% said they use Medicaid funding for assistive technology and specialized equipment. So that question you asked earlier about, you know, how, how they're using Medicaid funds, you know, it's almost half of those are used for that type of specialized equipment in those resources. And then what's more is actually 60% of the districts reported that Medicaid funding has increased over the last five years, which we'd also expect. But that kind of goes back to the bipartisan Safer Communities act and other areas helping districts maximize that revenue.

So that data itself really speaks to the vitality of the Medicaid program and why it's so important to schools. I mean, you know, 86% using that to fund paraprofessionals and others is just. Is incredible. So to even think if there is any kind of cut to Medicaid funding, how detrimental that would be. And to your point, the states are going to have to pick that up or the local districts are going to have to figure out how to pick that up in some way. And that's not always easy, especially when you're so dependent on this federal funding. Did you see any trends of, like, how the funding is used across different school types or geographic areas? I know you mentioned that, you know, rural districts were kind of an emerging factor there that you weren't necessarily anticipating. But were there any other trends that you saw kind of come out of this survey?

Yeah, that's interesting. There really weren't. We did look at that to see, like, oh, are more, you know, urban districts using this, you know, services for X. There really weren't. It was very. And I guess that's my other surprising finding really, is that it was so similar across the board. Staffing being the number one area, followed by mental and behavioral health services with some variation, you know, services. Districts that are urban also maybe included a few more services, but the top areas were still the staffing and the services. That's where most districts are using the funds across rural, urban, and suburban.

Sure. So these cuts go through. What are the practical implications to school districts? I mean, what do you anticipate districts having to do or cut first to make ends meet?

Yeah, so we did ask districts, you know, what would happen if there are cuts to the Medicaid program. And as you'd expect, you know, they start with where Medicaid is playing the biggest role right now. And so 80% said they would have to cut staffing, and that would include layoffs or reductions. They'd have to cut staffing for health professionals and those specialized instructional support personnel. And then 70% said they would have to cut mental and behavioral health services. And then another 62% said they would have to cut student resources. And in our analysis, we asked about seven main areas of health area. So we asked about seven main health services areas, and 73% of respondents said they would be forced to make cuts at least three areas or more. So, yeah, so they're anticipating a lot of impacts to their staff and the services that students receive right now.

So it's not just a siloed impact that Medicaid has. It seems to span across every Aspect, if not most aspects of just the student experience at school.

Yeah, yeah. And actually, to that point, I think that was another really important area. Another really important finding that came out of this survey was that across all districts, rural, urban and suburban districts, 90% of the respondents anticipate that Medicaid cuts would lead to cuts across their district's budget. So not just school health services, as you were saying, it would have ripple, negative ripple effects across the district. And this is largely for a number. Well, this is for a number of reasons. So Medicaid reductions would lead to budget gaps in required districts to, to divert funds from other educational programs to cover services mandated under IDEA or the Individuals with Disabilities Education Act. And in order to not eliminate other vital programs, state and school districts, many would be forced to increase taxes or just make drastic cuts to these programs. And so one, actually, one superintendent in this survey is really jumped out just that lower Medicaid reimbursement simply shifts the burden onto local taxpayers. So I think that just really speaks to the negative ripple effects that we'll see across districts and entire communities.

Yeah, and I mean, I, I guess I'll state the obvious here. The, the needs aren't going away along with this funding. Right. We, we still have a duty to provide these services to our kids. Now, to that superintendent's point, we have to continue doing that in some way, but what else is going to, to be cut to allow us to do so? So that, that really puts districts in a precarious position if this funding that they're so reliant on is suddenly gone. Right?

Yeah, yeah, yeah. And other, you know, other themes like that did really emerge, like school districts talked about the staff burnout and just the, the quality of services really declining because they're, they're now trying to do more with less. And just how much that's going to affect just the ability of an already overstretched and burnt out workforce to keep doing the amazing work that they have to do every day. And then they talked about this will also lead to reductions in prevention, which of course we know is a cost saver down the line, but they're going to have to make this cut somewhere. So. Yeah, I think that's absolutely true. It's like these services will continue, but at what cost?

Right. And I mean, you can only do more with less for so long until there's diminishing returns. I mean, that, that is kind of a theme in education and when you're using public money. But I mean, there's, there's a Breaking point. And it sounds like we're, we're getting pretty close to that. You know, equity is obviously a huge factor when it comes to educating students. Can you tell me how students with disabilities or behavioral or mental health needs would be likely disproportionately, proportionately affected by a cut in Medicaid?

We did specifically ask about the impact of cuts on students with disabilities and students with mental and behavioral health needs. So one school business official in, from a suburban district in Indiana wrote in we'll have to cut positions that assist with our students with mental behavioral health needs. Students that may have mental health needs that are not on an IEP will not be able to have their needs met. So one school business official in a rural district in North Dakota wrote, we would likely cut a program that is having the most significant positive impact on our students with the most challenging behaviors. So I think, you know, fortunately, no, no surprises, but that's, we, I think what we know is that it will have the greatest impact on some of the students with the greatest needs. So to your point, you know, school districts provide really a wide range of mental, behavioral and physical health services. And while all school districts benefit from Medicaid funds, this financing mechanism is particularly significant for schools in low income and under resourced communities. And so when these funds are fully leveraged, they can help support the workforce, workforce development, the delivery of additional services, but they can really play the, the, a significant impact for students that do not have the same level of access to health services as those students in more resourced areas. So that's, I think, where we can really see Medicaid play a significant role. And you know, we didn't, we didn't talk too much about this, but just kind of getting into sort of the overall importance of school health services, of course plays such an important role in student outcomes and overall, and not just their health outcomes, but their ability to stay in school. It impacts attendance, it impacts academic outcomes and student success. So I think just from the outside, it's important just to recognize that health services are incredibly important to student success and Medicaid is important to student success overall.

Yeah, well said. So let's get into the weeds a little bit. So for school business officials that are listening, what are the key policy proposals that they should be aware of? Something like rate changes, spending caps? I mean, tell me a little bit more about the technicals that school business officials should. If they hear a term, yellow flag goes up, they should know that's something important.

Yeah, I mean, I think the flag that should go up if there's any, you know, federal matching, provider taxes, spending caps. I think the flag should just be Medicaid cut. That means a Medicaid cut because so many terms will get thrown around, but what it still boils down to is a Medicaid cut. So I think that's what school business officials should be listening for and already starting to think about how Medicaid plays a role in their school district right now. And you know, have that, have that at the ready to share that information because that is so critical to be able to be sharing since like, as we were saying in the beginning, most people don't realize what important role Medicaid plays in schools.

Sure. So if someone listening wasn't part of those 1400 districts that were able to respond but still want to stay informed and get involved, what can they do to make sure they're on the forefront of any changing Medicaid cuts or budget reconciliation changes?

Yeah, I think a few things. I mean, one, you know, ASBO's just been incredible at keeping, you know, keeping your finger on the pulse of a range of issues that are going to affect school districts, including Medicaid. So I think the information that's shared there is a great starting point because because of the recognition, you know, the way that Medicaid is going to impact students and so that's a great starting place is just to, you know, keep track of the latest information coming out of aspo. I would also say follow Healthy Schools campaign and I'll share the kind of way to sign up for our newsletter and kind of action alerts as well as others, the asa, you know, name have other important information. So I think kind of that's one area, two other areas that I just wanted to mention. Keeping, you know, being aware of how Medicaid plays a role in your school district right now is also really important. Not just in the the school, but also how many students are even enrolled in Medicaid in the district. And the Georgetown center for Children and Families just released some updated data that show how many children are enrolled in Medicaid and chip by school districts. So I'll share that as well. It's another great resource. And then finally, I mean, talking to local and talking to your representatives, talking to members of Congress, talking to your local officials, share that word. School business officials are such important messengers and can be such important champions for this program. And so I really think that there that the voice of school business officials is critical at this time to just be able to say, look, this is how Medicaid supports our students right now. It gives us the flexibility to, to serve our students and address students need at the local level. This is how we're using it. And to share those stories and make sure that they're in touch with, they're contacting their local officials. They're increasing awareness. If you can't advocate directly, make sure that you're just educating and sharing that story with those that can.

Great. Any final words of advice for our listeners? If they're hearing all of this and the alarm bells are going off, which I imagine they are, you know, what kind of final words of advice can you offer those tuning in?

Yeah, I mean, I would say this is the moment, you know, I think that's where I'm so glad that, I mean, thank you so much for having me on because I think in this survey really just showed how powerful this program is for schools and that we still have time. This is not, you know, we can still influence, we can still share how Medicaid plays a role for students in schools and amplify the incredible work that our districts, our school business officials, our school staff are doing every day to support students and how Medicaid enables them to really serve more students and address and provide quality care. So I think just know that this is a key moment to pay attention, to get involved. And, and I feel hopeful just with the number of people that came out and spoke about the Medicaid program. I mean, one quote, I think that just really sums it up, that's not exactly hopeful, but I think can be a sort of, it can help sort of motivate us all is just less funds, less opportunities, less support. Cuts to Medicaid would have an impact across all services. And that's from a school business official in a rural district in Wisconsin. And I think just share that message and know that the, the work that, that people are doing now in schools utilizing Medicaid funds is going so far in meeting so many student needs. So I think together we're, we'll just have to, you know, press on.

Right, right. Well, Jesse, thank you for all of your work and the work you do on behalf of Canadian kids and with Healthy Schools campaign. And thanks for joining me today on School Business Insider.

Thank you so much for having me.

[John Brucato]

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