Schools, crucial to health care, need state’s help

Our schools are partners in securing the health and well-being of our children. Other than their homes, Sacramento kids spend more time in school than anywhere else. That’s why we, as a community, invest in things like nutritional meals, physical education, and basic health care and counseling at schools—because we know healthy students are better learners.

These programs also keep our kids safe. In California and nationwide, we’re hearing news of measles outbreaks and missed signs in children with mental health needs. School nurses and counselors are our first line of defense in ensuring our kids get preventive services they need. We have a duty to make sure they are fully funded.

For years, Sacramento City Unified, Natomas Unified, and Twin Rivers school districts have been part of the School-Based Medi-Cal Administrative Activities (SMAA) program. Thanks to SMAA, 82,000 students in these three districts benefit from access to health coverage and medical care from school nurses and psychologists. Statewide, more than 700 districts participate in this innovative partnership between school districts and the state, with partial reimbursements from the federal government.

Lately though, the state has not worked directly with school districts to ensure that the program is adequately funded. California school districts are owed more than $500 million from the federal government for this program. About 18 months ago, the federal government suspended claims payments until California’s Department of Health Care Services (DHCS), implemented changes in the program. DHCS, which manages the Medi-Cal program, developed new guidelines and a reimbursement plan for past and future services without input from the school districts that must carry it out.

We recognize that the state was under pressure to meet an unrealistic, federally-imposed timeline. But the solution that DHCS proposed leaves school districts with all financial liability and almost no control over the program. This is not fair to the school districts and the children that they serve. We cannot jeopardize this program because the state was pressured to act in haste to find a one-size-fits-all solution. That is why we support the state’s request to implement the new program in 2015-16.

For the past two years schools budgeted their SMAA reimbursements to cover costs for school nurses, psychologists and other professionals who provide full-scope services to all of our students and have paid for the cost of this work. They had submitted documents for payments, expecting to be paid. The lack of reimbursement has created great financial hardship for California’s school districts. Under the new guidelines instituted by DHCS, many schools could expect as much as a fifty percent reduction of the original invoices submitted to reimburse for their costs.

California’s schools and students need the federal government to step in and release their fair share of the cost of this program. The federal government should immediately agree to pay at least a portion of the money they owe the state and our school districts so we can continue to provide our students with the services they need to succeed.

Otherwise, our children lose out. Schools will have to lay off the health care professionals that provide invaluable services to support our children’s health and education. This includes services to special needs and disabled students. Teachers in our districts will no longer be able to provide referrals to speech, language, mental health, dental and vision services.

Our students deserve better. We urge the state, school districts and federal authorities in reaching a long-term solution that is in the best interest of our students, and to provide interim support for these programs in the meantime.
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Ed’s Note:  Jay Hansen is a trustee on the  Sacramento City Unified School District board, Dr. Susan Heredia is president of the Natomas Unified School District board, Rebecca Sandoval is president of the Twin Rivers Unified School District board and Linda Fowler is a trustee of the Twin Rivers Unified School District board.