Expanding School-based Health Centers for Children

• Engaged policymakers, SBHC providers, and SBHC administrators at monthly meetings to discuss integrating SBHCs into Medicaid managed care reimbursements;
• Developed recommendations to ensure adequate reimbursement and phase in the transition to Medicaid managed care;
• Produced the report, “School-based Health Centers in New York State: Ensuring Sustainability & Establishing Opportunities for Growth;” and
• Established a monthly workgroup meeting with New York State officials to discuss how to effectively integrate SBHC providers into a Medicaid managed care reimbursement system.

The work gained traction in Albany. In reaction to the report, Senator Gustavo Rivera and Assemblyman Richard Gottfried co-hosted a roundtable in Albany in 2014 to examine SBHCs and compare cost-of-care models to support them. Since the report’s release, ongoing workgroup meetings among the New York State Department of Health, managed care organizations, and providers have effectively addressed nuances in credentialing and reimbursement that will guarantee SBHC sustainability and expansion statewide. Transition for SBHCs into managed care is scheduled for completion by July 2017. Until complete transition, stakeholders of the workgroup are committed to meet monthly and negotiate provisions to ensure that SBHCs and services for children and youth can thrive in a managed care environment.

Co-Funding and Additional Funds Leveraged: N/A