North Carolina Medicaid will update school Medicaid policies, increase interagency collaboration, and expand access to essential health services for students statewide. - The North Carolina state Medicaid agency, known as the NC Department of Health and Human Services Division of Health Benefits (DHB), in collaboration with the Division of Child and Family Well-being (DCFW), and the NC state education agency, known as the Department of Public Instruction (DPI), seek to implement a robust set of activities aimed at expanding Medicaid school-based services (SBS) across the state. Through this grant, using a combination of policy changes and technical assistance, North Carolina endeavors to empower schools to optimize reimbursement for services provided, bolstering capacity to provide needed services to students. The overarching goal of the project is to expand utilization of Medicaid reimbursement for SBS by Public School Units (PSUs), which include both Local Educational Agencies (LEAs) and charter schools. Activities that will be undertaken to achieve this goal include: • Conducting a needs assessment and soliciting feedback from multiple PSUs and school-health related organizations to understand barriers and facilitators to SBS Medicaid reimbursement. • Updating Medicaid policies via a State Plan Amendment (SPA) to implement new Centers for Medicare & Medicaid Services (CMS) guidelines, as well as to expand coverable services to all Medicaid-enrolled students. • Fostering increased communication and collaboration among DHB, DCFW, DPI, and PSUs, relating to SBS Medicaid best practices, and robust technical assistance to PSUs. Funds will be allocated for staffing and contracted support to expand NCDHHS’ capacity and infrastructure related to SBS, thus allowing NCDHHS to expand utilization of Medicaid reimbursement for SBS across the state. These positions will play a critical role in enhancing North Carolina’s school-based Medicaid services by improving program integrity, ensuring compliance, facilitating collaboration between key stakeholders, managing contractors effectively, and providing essential support and development opportunities to PSUs and providers. Total budget for the activities over three years is $2,499,804 dollars. Expected deliverables include: 1) a detailed needs assessment report highlighting gaps and opportunities for Medicaid SBS reimbursement, and 2) an updated SPA submitted to CMS, which expands SBS to all Medicaid enrolled students. Expected outcomes include: 1) sufficient staffing in state agencies to support technical assistance to PSUs, including receiving regular feedback from PSUs about barriers and facilitators, 2) a more effective and comprehensive SBS program with increased Medicaid reimbursement to PSUs for school-based health services, and 3) improved capacity for schools, especially in rural and underserved areas, to provide access for students to school-based health services. The collaborative effort between the North Carolina Department of Health and Human Services Division of Health Benefits (DHB), the Division of Child and Family Wellbeing (DCFW), and the Department of Public Instruction (DPI) is driven by a commitment to meeting the health needs of children and adolescents across North Carolina. The dedication to sustainably increasing staffing and providing ongoing support underscores a long-term commitment to improving health services in schools, ensuring that every student, particularly those in rural and underserved communities, has access to the care they need to thrive in their educational environments.
