Superintendent Whitney Oakley of Guilford County, N.C., is facing a challenging task of explaining the numerous ways in which Medicaid has been a crucial lifeline for her school district. Like many districts across the country, Guilford County relies on Medicaid to cover a range of special education services, bridging the gap left by insufficient federal funding for students with disabilities.
The looming threat of federal spending cuts, including proposals to cap federal contributions to state Medicaid programs, has Oakley on edge. Any reduction in Medicaid funding would have a significant impact on her district, potentially leading to a decrease in services for students with disabilities as well as a strain on resources needed to support all students.
In a recent survey conducted by the Healthy Schools Campaign, 80 percent of educators expressed concerns about potential reductions and layoffs of school health staff if Medicaid is cut. Additionally, 90 percent of respondents anticipated budget cuts across their districts if Medicaid funding is slashed.
Schools rely on Medicaid to bridge gaps in IDEA funding
Guilford County utilizes Medicaid to bill for services mandated by the Individuals with Disabilities Education Act (IDEA), such as one-on-one nursing supports, therapy, and evaluations. Oakley emphasizes the financial burden that would result from Congress cutting Medicaid funding, stating that the district would struggle to provide necessary services to eligible students with disabilities.
Despite the commitment made by Congress in 1975 to cover 40 percent of special education costs under IDEA, current federal funding only covers about 10 percent of per-pupil expenditures. Medicaid has been instrumental in allowing schools to bill for qualifying services for students with individualized education programs, serving as a crucial resource to bridge the funding gap.
With 25 states already utilizing Medicaid for school-based services, advocates are pushing for more states to take advantage of this federal rule. Medicaid currently provides approximately $7.5 billion in funding for school-based services annually, making it the fourth largest federal funding stream for K-12 education.
Spending proposals raise concerns for district leaders
The uncertainty surrounding how congressional spending proposals could impact Medicaid has left district leaders alarmed. While Republican leaders have stated they do not intend to cut Medicaid, Democrats argue that proposed cost-cutting measures could have serious consequences for the program and state budgets.
One such proposal includes reducing federal contributions to state Medicaid programs or capping them based on population, potentially leading to limitations on Medicaid eligibility and benefits. This could force states to make tough decisions, including cutting K-12 spending to accommodate increased Medicaid costs, as highlighted in a letter from a coalition of education, health, and disability-rights groups.
District leaders navigate a landscape of uncertainty
For district leaders like David Law, the superintendent of Minnetonka, Minn., and president-elect of AASA, the challenges extend beyond Medicaid cuts. Declining enrollment, inflation, the expiration of federal COVID-19 aid, and threats to funding for schools with diversity programs add layers of uncertainty to the budgeting process.
Minnetonka has already made significant budget cuts, with plans for further reductions in the upcoming school year. The combination of these factors leaves district leaders grappling with tough decisions and an uncertain financial future.
As funding shifts in Guilford County, Medicaid plays a crucial role in supporting some of the most vulnerable students in the district. Although it only makes up less than 1 percent of the overall $922 million budget, Medicaid provides essential services that are game changers for these students, according to Oakley.
One of the key benefits of Medicaid funding is the ability to provide on-site clinics at schools, where students can access primary care medical services during the school day. These clinics are run by community organizations and are able to bill Medicaid and private insurance for the costs of these services. Not only does this help to ensure that students receive the care they need, but it also reduces interruptions to the school day, which is a major contributor to chronic absenteeism.
Despite the importance of this funding, Oakley expressed concerns about the impact of any further shifts in funding. The district is already operating on a tight budget, and any additional complexities could make it even more challenging to provide the necessary support and services to students.
In the face of these challenges, it is clear that Guilford County schools are doing everything they can to support their students. By leveraging Medicaid funding and partnering with community organizations, they are able to provide essential services that make a real difference in the lives of vulnerable students. However, continued support and funding are essential to ensure that these programs can continue to thrive and support those who need them most.
