N.M. expands Medicaid for school-based health services
Rep. Romero, who is also a teacher, says expansion benefits students, families
Every so often, a student in Andrés Romero’s class at Atrisco Heritage Academy High School will present him with a slip showing the student has an on-site health care appointment.
Atrisco’s clinic, one of more than 10 school-based health centers in Albuquerque Public Schools, is part of a statewide system designed to ensure students receive the care they need — from mental and behavioral health care to treatments required for kids with disabilities — without leaving school grounds, said Romero, a teacher and Democratic state representative.
A change to New Mexico’s Medicaid plan, approved in May, will allow schools to receive Medicaid reimbursements for more students seeking care at school-based clinics, said Marina Piña, a spokeswoman for the New Mexico Human Services Department.
The expansion, part of a broader federal push to ensure Medicaid-enrolled students can receive health care at school — especially mental health treatment — is a welcome change for many policymakers.
Although, some say work remains in increasing New Mexico’s Medicaid reimbursement rates to recruit and retain professionals.
“The expansion of Medicaid into the schools, and certainly beyond students with [Individualized Education Programs], will be to the great benefit of students and services to their families,” Romero said.
An IEP is a federally required plan for each special education student that details the specific educational needs and services the student is entitled to receive.
The health clinics now based in New Mexico schools are a far cry from the traditional school nurse’s office.
A law passed during this year’s legislative session requires these centers to provide primary and preventive health care; treatment of minor, acute and chronic
conditions; mental health care; substance use assessments; crisis intervention; and referrals for additional treatment.
Sen. Nancy Rodriguez, D-Santa Fe, who sponsored the bill codifying and defining school-based health centers, said they provide youth with the care they need, in an accessible setting.
“One of the many positive things that school-based health centers provide is the security and the comfort of knowing that health care is readily available in the vicinity of the school grounds, should a student need to access medical care,” Rodriguez said.
Currently, the state offers Medicaid reimbursements at school clinics for speech therapy, physical therapy, occupational therapy, audiology services, behavioral health services, nursing services and nutritional services, Peña wrote in an email.
The expansion will allow schools to seek additional reimbursements, increasing the pool of eligible students to all 244,779 school-age children in New Mexico covered by Medicaid, Peña wrote.
In particular, schools will be able to receive additional reimbursements for students without IEPs who need behavioral health services.
Why behavioral health, specifically?
Expanding access to behavioral health care is part of a Biden administration strategy to combat the nation’s mental health crisis.
Young people today experience depression and anxiety at much higher rates than previous generations, according to data from the Pew Research Center. And a critical time in their development was derailed by the pandemic.
Responding to that crisis requires federal supports for mental health services in schools, U.S. Education Secretary Miguel Cardona said in a news release announcing the change.
“Students are six times more likely to access mental health when these services are offered in school. … These new resources and proposed rules will help schools live up to the promise that all students, including those with disabilities, receive a free, appropriate public education,” Cardona said in the statement.
New Mexico and Oregon are the latest states to make the change, joining 12 others with the expansion already in place.
Romero sees the expansion as positive change that will help students and their families.
“I think it’s going to open it up to a greater population of students who are on Medicaid and can have these services readily available to them, and the school districts can be reimbursed for those costs,” he said.
However, the work on Medicaid reimbursement — particularly for school-based health centers — is far from complete, Rodriguez said. She argued Medicaid reimbursement rates must increase to attract and retain providers to school clinics.
The most recent rates available on the Human Services Department’s website show providers receive less than $100 for most Medicaid services.
“The rate has been very low for many years, and we are falling behind more and more as health care needs continue to grow and as our population eligible for Medicaid services continues to grow,” Rodriguez said. “We want to make sure Medicaid reimbursement rates are at par in order to maintain adequate services for our students.”