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  • NASW-IL Staff

CMS Approves Illinois Proposal to Expand Access to Care for Kids in Schools

Reprinted from Centers for Medicare & Medicaid Services Press Release


Action by the Biden-Harris Administration will make more Medicaid funding available for school-based health services in Illinois, improving health care access, including mental health services


Photo of father and young daughter speaking to school social worker

Today, the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved a state plan amendment (SPA) that will provide Illinois more Medicaid funding for eligible children receiving Medicaid-covered health care services in schools. This approval advances the expansion of school-based health services, a key priority for the Biden-Harris Administration to improve health care access, especially for youth mental health services. Today’s action is also part of ongoing efforts by HHS in support of President Biden’s call to address the nation’s mental health crisis, including its impact on children.


“Today we celebrate the historic action taken by Illinois to expand access to critical health care services in schools for eligible children,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration is committed to meeting children where they are to provide care that addresses the challenges our nation’s youth are facing, including mental health challenges. I am hopeful additional states will follow Illinois’ lead.”


“We’re thrilled to partner with states like Illinois to seize opportunities in Medicaid to expand access to health care in schools,” said CMS Administrator Chiquita Brooks-LaSure. “CMS encourages all states to consider adopting this flexibility. It just makes sense to deliver health care services and supports to children where they spend the majority of their time: in school.”


Illinois’ newly approved SPA allows schools to receive more Medicaid funding for covered services for all children with Medicaid, rather than only those children with an Individualized Education Program (IEP), which is a plan or program tailored for children with disabilities.

This SPA approval represents one of several steps CMS and HHS are taking to promote access to school-based health services and the availability of Medicaid-covered services, including mental health treatment in schools. Last year, Secretary Becerra and U.S. Department of Education Secretary Miguel Cardona issued two letters (available here and here) to states, encouraging them to leverage federal resources, especially Medicaid, to expand school-based health services for children. In August, the Centers for Medicaid and the Children’s Health Insurance Program (CHIP) Services released additional guidance outlining best practices for the delivery of health services to kids in schools.


Additionally, as part of its implementation of the Bipartisan Safer Communities Act, CMS expects to release a Comprehensive Guide to Medicaid Services and Administrative Claiming, launch a new school-based services Technical Assistance Center in partnership with the Department of Education, and release a notice of funding opportunity for $50 million in grants to states to strengthen school-based health services.


The school setting provides a unique opportunity to deliver health care services to children and adolescents, especially those enrolled in Medicaid. Together, Medicaid and the Children’s Health Insurance Program (CHIP) cover over 41 million children, or more than 50% of all children in the country. School-based health services — which can include preventive care, behavioral health services, physical and occupational therapy, and disease management, among other Medicaid-covered services — are important resources for Medicaid-enrolled children and their families and have been shown to improve health and academic outcomes.


Illinois joins 11 other states that have already expanded Medicaid payment for school-based health care services under their state plans. These include: Arizona, California, Colorado, Connecticut, Georgia, Kentucky, Louisiana, Massachusetts, Michigan, Nevada, and North Carolina. CMS celebrates and supports all states in expanding school-based health care services to more children with Medicaid.


For more information on Illinois’ SPA, please visit Medicaid.gov. For more information on state opportunities to expand access to school-based services in Medicaid, see CMS’ August 2022 informational bulletin.


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