The Patient Protection and Affordable Care Act, also known as the ACA, has far reaching implications for broad health care reform in our nation, including a potentially significant impact upon school-based mental and behavioral health services.
Prior to enacting the ACA, it was estimated that 10.5 million youth under the age of 18 were uninsured (Medical Expenditure Survey Panel, 2010), and community mental health services were often not readily accessible even for those with insurance. As a result, schools had been and remain the de facto mental health provider system for children and youth, with 70% - 80% receiving services directly in the schools (Farmer, Burns, Philip, Angold, & Costello, 2003). The ACA increases the number of families and children that can access to health care insurance, including Medicaid. Schools are permitted to seek reimbursement for specific services delivered to Medicaid eligible students; therefore, school districts may be able seek reimbursement for services already provided by school-employed mental health professionals.
Why Is This Important to School Psychologists?
Research estimates that of the children who receive mental health services, 70% to 80% of them receive those services in schools (Rones & Hoagwood, 2000; Farmer et al., 2003). Currently, many states reimburse schools for specific health and mental health services that are provided to Medicaid eligible students. The ACA expands the Medicaid program by increasing the number of children and their families who are eligible for Medicaid reimbursable services and expanding the availability of preventative services. It is widely believed that the new federal dollars associated with expansion of Medicaid and other authorized programs to address student behavioral and mental health will stimulate renewed efforts at the local level to try and access these dollars by increasing the services delivered in schools and the associated eligible service providers.
There are some states in which a school psychologists are not considered qualifed behavior and mental health professionals, or qualified providers of Medicaid. However, The ACA explicitly states that 'school psychologists who are “certified or licensed” are identified by title as “qualified health professionals” of child and adolescent mental and behavioral health services. (See Title V, Section 5203 identified below). This definition may go unnoticed by policy makers if not brought to their attention and incorporated into federal regulations and state statutes and regulations. Thus, it is of critical importance that school psychologists become active advocates for their services and their qualifications as a school mental health and behavioral health provider for all students, including those who are Medicaid eligible.