Medicaid in Schools Guidance Language is Law

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Medicaid in Schools Guidance Language is Law

The bipartisan Safer Communities Act that passed to prevent gun violence last week included language requiring CMS to issue new school-based Medicaid guidance before June 2023. The guidance does EXACTLY what the Medicaid in Schools Coalition has been asking CMS to do for years and goes further than what we had hoped for by providing direct grants to states to start the hard, but meaningful work of changing how they process Medicaid claims, find ways to dramatically expand Medicaid-reimbursable services to schools, and generally take advantage of the new flexibilities that they will be granted via updated guidance to expand healthcare, particularly mental health services, to millions more children.

This is going to be totally game-changing for states, for districts and most importantly for KIDS.

Here are the specifics (which you can also find starting on page 11 here)

  1. Update the Medicaid guidance from 1997 and 2003
  2. Clarify that a State should take steps to allow a district to bill for any EPSDT service they provide
  3. Outline strategies/tools that reduce the administrative burdens on, and simplify billing for local educational agencies, in particular small and rural LEAs, and support compliance with Federal requirements regarding billing, payment, and recordkeeping, including by aligning direct service billing and school-based administrative claiming payments
  4. Include a comprehensive list of best practices and examples of approved methods that State Medicaid agencies and local educational agencies have used to pay for, and increase the availability of, assistance under Medicaid, including expanding  State programs to include all Medicaid-enrolled students, providing early and periodic screening, diagnostic, and treatment  (EPSDT) services in schools, utilizing telehealth, coordinating with community-based mental health and substance use disorder treatment providers and organizations, coordinating with managed care entities, and supporting the provision of culturally competent and trauma-informed care in school settings; and
  5. Provide examples of the types of providers (which may include qualified school health personnel) that States may choose to enroll, deem, or otherwise treat as participating providers for purposes of school-based programs under Medicaid and best practices related to helping such providers enroll in Medicaid for purposes of participating in school-based programs under Medicaid. (note: this is essential for ensuring critical school personnel like school psychologists can bill Medicaid and was NOT something CMS was planning to clarify in their guidance based on our most recent conversations with them).
  6. Create a NEW TA Center—in consultation with ED—with $8m in seed money so districts and states aren’t lost about how to do school-based Medicaid any more. Further, the TA Center has to report to Congress on the areas where the most TA was requested to ensure that CMS is accountable and responsive to stakeholder needs.
  7. $50m in grants to States to for the purpose of implementing, enhancing, or expanding the provision of assistance through school-based entities under Medicaid or CHIP.

Despite this amazing victory - the work continues. We must continue to urge ED to reduce barriers to accessing Medicaid services in schools through changes to FEPRA and parental consent requirements as well as urge CMS to follow this law  and be more aggressive in promoting free care, removing TPL barriers, and more, but this is a great and unexpected new policy that should be celebrated. 

USED to Hold Public Briefing on Proposed Title IX Regulations

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USED to Hold Public Briefing on Proposed Title IX Regulations

The U.S. Department of Education will be holding a public briefing on the proposed amendments to the Title IX regulations that we released earlier today. The briefing will be held online tomorrow, Friday, June 24 from 2:00 - 2:30 pm EDT.

Registration for the briefing can be found here. After registering you will receive a confirmation email containing information about joining the call. Captioning will be provided.

For more information about the proposed Title IX regulations released today, here are the following resources:

FY23 Appropriations Update

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FY23 Appropriations Update

While we may have thought it was enough to be monitoring 2 SCOTUS cases, the Title IX regulations, the Keep Kids Fed Act and the Safer Communities Act, Congress is all about being busy ahead of the July 4 recess. The House Labor-HHS-Education Appropriations Subcommittee released its FY23 appropriations bill ahead of today’s mark up. We are only going to highlight too take aways here, as it is very early in the process and numbers are subject to change. This is a place holder in the annual appropriations process, and we need to see how the Senate mark compares, if either of the packages are bipartisan (unlikely) and how the two proposals are reconciled to a final place that can garner the votes necessary to get over the finish line.

So what do you need to know for today? 

  • The bill provides a big increase for ED, but less than the even larger increase the President requested.
  • It provides $86.7 billion in discretionary funding for the Department of Education, which is $1.6 billion less than the President’s request and $11.3 billion (15%) above the net level provided for FY 2022 (it is $10.3 billion above the gross level provided for FY 2022, but that total included a $1.0 billion rescission of previously appropriated Pell Grant funding).  
  • Program Highlights (subject to change and update)
    • $3 billion increase for Title I
    • $100 m increase for Title II
    • $75 million increase for Title IV
    • $933 m increase for school based mental health services grants/ mental health services professional demonstration grants 
    • $2.95 billion increase for IDEA Part B
    • $45 million increase for CTE state grants
    • No increase to rural education 
     

 

 

AASA Joins Coalition Letter Supporting Safer Communities Act

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AASA Joins Coalition Letter Supporting Safer Communities Act

It’s a busy week on Capitol Hill, and we are pleased to report that the Senate is now considering the Bipartisan Safer Communities Act.

Following outcries for action from across the country, this legislative package represents a commonsense, bipartisan proposal to protect America’s children, keep our schools safe, and reduce the threat of violence across our country. The legislation, introduced by U.S. Senators Chris Murphy (D-Conn.), John Cornyn (R-Texas), Thom Tillis (R-N.C.), and Kyrsten Sinema (D-Ariz.) is fully paid for and follows their previously released bipartisan proposal supported by Senate leaders from both parties and a bipartisan group of 20 Senators. 

In addition to the gun violence prevention pieces, there are significant legislative accomplishments attributable to AASA that are embedded in this package.

First, there is language requiring CMS to issue guidance on an updated school-based Medicaid program reimbursement system that includes taking steps to dramatically reduce the administrative burden on small and rural districts and the creation of a new TA center for districts to utilize to insure they are billing expansively for healthcare services they provide to students. A complete summary of the Medicaid pieces is here

Second, there is increased funding for the STOP School Violence Act grant program, Project AWARE, and $2 billion in new funding for districts to hire mental health professionals and build a pipeline of mental health personnel. While we know this is not the robust funding we need to address the mental health crisis in our schools, this funding is a good start and will meaningfully increase access to these professionals in some school districts. 

Keep Kids Fed Act

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Keep Kids Fed Act

On June 25, Congress passed the Keep Kids Fed Act. Led by Senate Agriculture Committee Chairwoman Stabenow (D-MI) and Ranking Member Boozman (R-AR) and House Education and Labor Chairman Scott (D-VA) and Ranking Member Foxx (R-NC) this rare, bipartisan, bicameral agreement includes $3 billion to provide relief to school meal programs and other providers beyond the June 30 expiration date of child nutrition waivers without extending all of them. 

Specifically, the bill provides the following assistance: 

  • Increase federal reimbursement rates: 40 cents per meal for lunch and 15 cents per meal for breakfast, above the annual inflationary adjustment scheduled for July 1
  • Extend the USDA's authority for all waivers for 2022 summer meal programs
  • Extend the USDA's authority for no-cost waivers for SY22-23, including those for schools unable to meet nutrition standards due to supply chain disruptions and to reduce administrative and reporting burdens   

On June 23, AASA released a statement with four organizations expressing our support for the package. Most notably for schools, the Seamless Summer Option Waiver - which allowed districts to serve meals to all students at no cost - was not extended. Schools must return to the Free and Reduced Price Lunch Model. 

Here is a breakdown of what waivers USDA has the authority to issue: 

WAIVER

Summer

(Until Sept. 2022)

School 2022-23 (Until June 2023)

Area Eligibility

Yes

No

Meal Pattern Requirement

Yes

Yes

Parent/Guardian Pick Up

Yes

Yes

Non-Congregate Setting

Yes

Yes

Meal Service Times

Yes

Yes


It is important to note that waivers for the summer are only available for the Seamless Summer Option and Summer Food Service Program. The waivers are not applicable for summer schools operating the National School Lunch Program.  

Although USDA now has the authority to issues these waivers, they still must do so. We anticipate USDA will issues these waivers quickly but provide caution that none of these waivers are available until USDA takes the necessary actions. Once USDA issues the waiver and guidance, states will need to opt-in and create the necessary procedures.

 

AASA Joins Letter Asking for Schools to be Added to WH Conference on Hunger

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AASA Joins Letter Asking for Schools to be Added to WH Conference on Hunger

On June 21, AASA joined a group of thirty education, nutrition, and disabilities' rights organizations in calling on President Biden to add a sixth pillar to the White House Conference on Hunger, Nutrition and Health to emphasize the critical role schools play in addressing student hunger and nutrition. Additionally, the letter encourages the administration to not only solicit feedback and input from stakeholders with expertise in education-related disciplines, but also to ensure that students, families, educators, practitioners, and other stakeholders are present and involved in the Conference itself in September. Read the full letter here.

 

SCOTUS Decision in Maine Voucher Case

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SCOTUS Decision in Maine Voucher Case

Earlier today the Supreme Court handed down its decision in the Carson v Makin case, a voucher case from Maine premised on whether or not Maine could deny public funds to schools that promote religious instruction. In a 6-3 decision, the court handed down a predictable decision against the state of Maine, ruling that a Maine tuition program that does not allow public funds to go to school that promote religious instruction was unconstitutional. The decision makes it a bit easier for K12 religious schools to access private funds (continuing a recent trend), but does not require states to fund religious schools if they aren’t already funding private schools.

Background: In November 2021, AASA was proud to join NSBA and other education groups in filing an amicus brief before the Supreme Court in the case Carson v Makin. This case presents a question of vital importance to school superintendents: whether the free public education available to all residents by their local school boards must include the option of a pervasively religious education or whether innovative methods of providing a secular public education that are necessitated by local district circumstances may lawfully exclude the sectarian alternative. We were never expecting a favorable outcome (given the current court) and it was always a question of how far this decision would go beyond 2020’s Espinoza ruling. There is the potential for this case to impact the ability of private religious schools to be eligible for state formula funding as well as other funding that has been traditionally limited to public schools. In terms of the voucher program under question: jurisdictions in rural areas too sparsely populated to support public schools of their own can arrange to have nearby schools teach their school-age children, or the state will pay tuition to parents to send their kids to private schools. But those schools must be nonsectarian, meaning they cannot promote a faith or belief system or teach “through the lens of this faith,” in the words of the state’s department of education. Privatization/voucher advocates argued the policy was discriminatory. 

Today’s decision continues a shift in momentum that reaches back to the earlier Espinoza decision, which found that states much allow religious schools to participate in programs that provide scholarships to students attending private schools.  It reflects a court that continues to grow receptive to claims from religious groups and people, requiring governments to aid religious institutions (albeit however much at odds with the historical separation of church and state). It comes with huge consequences for state funding of religion. The court’s conservative majority holds that the First Amendment requires Maine’s taxpayers to fund explicitly religious education.  Today’s decision continues to open the door to further privatization of education, and raises important questions/considerations:

  • Sotomayor: “Today, the Court leads us to a place where separation of church and state becomes a constitutional violation.’ And ‘A state's effort to preserve the constitutional separation of church and state now qualifies as a violation of free exercise. The majority is repealing the establishment clause.’ And ‘This Court continues to dismantle the wall of separation between church and state that the Framers fought to build. ... The consequences of the Court’s rapid transformation of the Religion Clauses must not be understated.’
  • Breyer, asking the next logical question: Does this ruling mean that states must provide equal funding to private religious schools and public schools? Taken at face value, Roberts' decision has the potential to dismantle secular public education. 

 

 

National Healthy Schools Collaborative Releases Ten-Year Roadmap

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National Healthy Schools Collaborative Releases Ten-Year Roadmap

The COVID-19 pandemic has made clear how connected health and learning are. Districts cannot return to the pre-pandemic status quo which left millions of children and adults in unhealthy schools. 

The National Healthy Schools Collaborative’s Ten-Year Roadmap offers a bold, comprehensive and popular blueprint to create healthy schools over the next decade. AASA is happy to be part of the implementation to better schools across the country.

Informed by the real experiences of students, school staff and administrators, parents, and nonprofit organizations as well as successful policy experiments around the country,  the roadmap offers a bold and practical path forward. This is not just another report telling people in schools what they need to do. This is the beginning of a movement to build and sustain healthy school communities with real resources to get involved:  

  • If you are a district or school, take the NHSC Ten-Year Roadmap Integrated Assessment aligned with the roadmap to assess how healthy your district or school is 
  • If you are an education and health organization consider applying to become part of the NHSC to implement opportunities in the roadmap. 
  • If you are a family member, interested community member, or student advocate for Healthy Schools. 

 

You can find the roadmap here. Learn more on the Kaiser Permanente blog here.

 

EPA Hosts Series of Webinars on the Clean School Bus Rebate Program

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EPA Hosts Series of Webinars on the Clean School Bus Rebate Program

The Environmental Protection Agency (EPA) is hosting a series of webinars about the $500 million Clean School Bus Rebate Program. Application deadline for the program is August 19, 2022. 

  • June 22, 1:00p.m. ET – Joint Office of Energy and Transportation: Electric & Clean School Bus Infrastructure
  • June 29, 1:00p.m. ET – How to Apply with Live Q&A
  • July 13, 1:00p.m.  ET – Office of the Inspector General: Fraud Prevention & Best Practices
  • July 27, 1:00p.m. ET – How to Apply with Live Q&A
  • August 10, 1:00p.m. ET – U.S. Department of Agriculture: Rural Electric Cooperatives Infrastructure Funding
Register for one or all of the webinars here

 

USED Releases Final Maintenance of Equity Rule

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USED Releases Final Maintenance of Equity Rule

Earlier this week, USED released its final rule for the American Rescue Plan’s (ARP) K12 maintenance of equity provision, part of the Elementary and Secondary Emergency Relief (ESSER) Fund.

Background: AASA opposes the maintenance of equity provision. It is a rinse/wash/repeat of the comparability regulations in the 2016 negotiated rulemaking of the Every Student Succeeds Act. The MoEquity provision was inserted to the ARP ESSER language at the very last minute with zero effort made to solicit feedback from the state and local education leader who would have to implement the provision. AASA engaged in subsequent direct advocacy with CCSSO to get significant changes (including those outlined here) made to the law to make it less problematic; that all said, less bad doesn’t make it good; AASA supports ensuring that this provision—intended for only two years under ESSER—dies after ESSER and is not carried into future legislation.

So what’s in the final rule?  

  • The provision includes separate requirements for state and local education agencies. Our advocacy has focused on the requirements for LEAs; one of the important changes is that in addition to the limits established in the statute (the provision only applies to districts enrolling more than 1,000 kids, with more than one building (or building per grade span), USED was forces to further clarify that the provision would only apply to those LEAs facing a net cut in state/local dollars. USED had originally intended the provision to apply to LEAs, regardless of funding level. The final rule clarifies that SEAs need to ensure districts are not making disproportionate budget and staffing cuts at their highest-need schools.
  • The rule extends the timeline by which states must publish information on the LEAs in their state that are exempt from the requirement.
  • The deadline for FY22 reporting remains unchanged: December 31, 2022. Because states may collect/finalize per-pupil expenditure data on varying timelines, states are able to pursue a reasonable extension beyond Dec 31.
  • The timing of this rule and data requirement will burden LEA staff at the end of the school year, who will find themselves facing an additional reporting requirement. 
  • Summary of the Final Regulatory Requirements: By July 8 of this year (for FY 2022) and by November 1, 2022 (for FY 2023), each SEA must post on its website:  
      • The identity of each of its LEAs exempt from the LEA-to-school MOEquity requirements, and why the LEA is exempt.
      • For each LEA that is not exempted, a listing of that agency’s high-poverty schools .
      • An explanation of how the SEA will ensure LEAs that have to comply with MoEquity are protecting their high-poverty schools from disproportionate reductions in funding, in a manner that ensures  the LEAs can make necessary funding adjustments in a timely manner.
      • By December 31 of each applicable school year, each SEA must post the following information for each non-exempted LEA:
        • The per-pupil funding for each high-poverty school for that fiscal year
        • The per-pupil funding in the aggregate for all schools in the LEA, on a districtwide basis or by grade span
        • The per-pupil number of full-time equivalent (FTE) staff for each high-poverty school 
     

17 National Education Organizations Sign on to AASA Statement on Uvalde Response Package in Senate

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17 National Education Organizations Sign on to AASA Statement on Uvalde Response Package in Senate

Today, AASA was joined by 17 organizations representing the full breadth of the national K-12 education community, including school superintendents, administrators, educators, school mental health providers, school staff and parents, to call on Congress to swiftly pass legislation that will address the senseless epidemic of gun violence in this country. Our students deserve to go to school and thrive in communities where they are safe. To achieve this goal, we need laws that address the gun-violence epidemic and ensure our children and educators can learn and work without constant fear for their lives.

Read our statement here.

FY23 Appropriations Children's Budget Coalition Letter

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FY23 Appropriations Children's Budget Coalition Letter

As part of our appropriations advocacy, AASA participates in the Children’s Budget Coalition. We were proud to support a recent letter to Capitol Hill calling on Congress to prioritize children in their annual spending decisions and call their attention to the unique and growing needs of children as much uncertainty remains about the pandemic and our economic recovery. Read the full letter here.

 

USED Releases Final Notice of Requirements

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USED Releases Final Notice of Requirements

Last week, USED sent a letter to grantees announcing the Notice of Final Requirements (NFR) regarding the LEA-level maintenance of equity provisions under section 2004(C) of the American Rescue Plan. The NFR establishes requirements for SEAs to publish LEA-level maintenance of equity data to demonstrate that LEAs are maintaining both fiscal and staffing equity in fiscal years 2022 and 2023.

The Office of State and Grantee Relations will host an Office Hour on Thursday, June 9, 2022, from 1:00 p.m. to 2:00 pm EDT to outline the local maintenance of equity reporting requirements stated in the NFR and answer frequently asked questions from the field. Both SEAs and LEAs are welcome to attend. Attendees must pre-register for the Office Hour by clicking this link: https://ems8.intellor.com?do=register&t=1&p=843399.

 If you have any questions, contact your State program officer through your State mailbox, (Ex. alabama.oese@ed.gov).  

New ED-Commissioned Study on ESEA Provisions that Protect Students

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New ED-Commissioned Study on ESEA Provisions that Protect Students

Earlier today, the U.S. Department of Education (ED) published a study concerning requirements under Section 8546 of the Elementary and Secondary Education Act (ESEA) for states and schools to protect students from the consequences of assisting – or “aiding and abetting” – school employees in obtaining a new job if they are known or believed with probable cause to have engaged in sexual misconduct with a student or minor.

States must comply with these requirements. ED's study, along with a fact sheet and other supporting materials, are available here and may be helpful to states and schools in ensuring meaningful, ongoing compliance with Section 8546 requirements.

To underscore states’ obligations relative to Section 8546, ED will host a webinar for state and local leaders on July 20, 2022, to highlight important practices in the areas of employer disclosure and information-sharing among educational entities. We will update this post as further information including registration details becomes available.

Alongside these efforts, ED will monitor each state’s laws, regulations, or policies to determine compliance as it relates to Section 8546. We stand ready to work with states through training, differentiated technical assistance, and more intensive supports or enforcement actions as needed. These efforts to provide additional assistance respond directly to requests that states made as part of the study for ED to identify and disseminate examples of policies and practices that meet Section 8546 requirements.

The Advocate June 2022

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The Advocate June 2022

May ended on a deeply painful note because of the horrific gun violence in Buffalo and Uvalde. For AASA it meant a return to federal policy and politics focused on the prevention of gun violence and increased discussion about how we can keep our schools and students safe. Prior to Uvalde, there were 27 school shootings in 2022 and if these numbers continue it will be the deadliest year for students and educators on record.

As is unfortunately customary after these terrible acts of violence, Capitol Hill is once again turning its attention to what, if anything, can be done legislatively to reduce gun violence in schools. This month’s Advocate will explore whether this year can produce different outcomes that include any legislation AASA can support.

Since the tragedy at Sandy Hook, AASA has maintained a consistent position that comprehensive federal policy is required to prevent future school violence. This approach includes continued funding to ensure our districts are as safe as they should be coupled with commonsense gun safety legislation. Recent federal data indicates school districts have already taken significant steps over the past 10 years to harden and secure their buildings and deter school violence. Data from 2019 shows that two-thirds of schools reported having a school security or police officer present and that includes more than 80% of middle and high schools and a majority of elementary schools. Half of these schools have at least one officer armed with a gun. Furthermore, nearly all schools report maintaining controlled access to their building during school hours, using security cameras, planning for the possibility of an active shooter, and conducting lockdown drills. More than half say they have controlled access to school grounds, too.

Over the past decade, superintendents have taken aggressive steps to make school buildings and students safer through enormous local and state investments to improve school building security, build threat assessment systems and teams, invest in mental health personnel and programs, and provide professional development programming to identify potential school violence before it occurs.  In the meantime, we continue to wait on Congress to take steps to pass comprehensive legislation that would help ease the gun violence epidemic. As of June 1, it appears that lawmakers will attempt to include legislation that touches on background checks and red-flag laws as part of a broader mental health and school safety package. We are hopeful that this package comes to fruition and that the answer from Washington is not to simply ask schools to do more by themselves to protect students and educators. Specifically, we continue to ask Congress to move forward with legislation that would:

  • Increase law enforcement of existing gun laws
  • Reinstate the ban on the sale, import, transfer and ownership of assault weapons
  • Ban large-capacity magazines
  • Require thorough background checks for all gun purchasers
  • End the “gun-show” loophole
  • Prevent individuals convicted of violent crimes from being able to purchase guns
  • Prevent individuals with mental health issues from purchasing or owning a gun (18 U.S.C. 922 (g))
  • Punish irresponsible gun owners
  • Fund gun-violence prevention research
  • Build the pipeline of mental health personnel and sustainably fund their work in schools through Title IV of ESSA, Medicaid and new standalone funding streams

 As AASA’s Executive Director, Dan Domenech, stated on May 24th: The mass shooting in Uvalde “begs the very fair question, ‘Is school safety on America’s short list of priorities?’ If not, why not? How many more families have to face the reality of a student that doesn’t return home? How many more students have to walk into a school, only to never walk out? Our children have a right to live and learn in a safe environment. If these tragedies do not serve as a serious wake-up call to our nation to take action, I don’t know what will.” 

AASA School and Gun Safety Policy

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AASA School and Gun Safety Policy

AASA has maintained a consistent position that comprehensive federal policy is required to prevent future school violence. This approach includes continued funding to ensure our districts are as safe as they should be coupled with commonsense gun safety legislation. You can read the full policy position here.