"Our nurses have literally saved students' lives over the past few years, lives that we may have lost if we had to call them in from another site"
The Republican health care legislation being mulled over in the Senate at the moment is causing alarm for superintendents of schools throughout the country. If passed, the bill will stop billions of dollars in yearly funding from getting to students with disabilities and children of lower income backgrounds.
Photo source: United States Senate via Wikimedia Commons
This money is used to pay social workers, physical, occupational, and speech therapists, as well as nurses. Not to mention medical equipment like wheelchairs and walkers. The funding also helps pay for comprehensive and preventative health services for low-income children like hearing and vision screening, immunizations, and help for chronic illness also, such as diabetes and asthma.Medicaid has for three decades helped pay for the equipment and services that schools provide to special-education students, along with health screenings and treatments for low-income students which the school administers. School official in both conservative and liberal states are shaking their fingers at the Senate's Republican leaders and their proposed new health care plan. The beef from educators is that shrinking Medicaid spending will eliminate up to $4 billion per year, according to the national superintendents association.
Several districts already on shoestring state education budgets, say they will either need to downsize or flat out cut those services for special education and in school care to fill the gap left in the wake of the Republicans' ideas for restructuring Medicaid.
Paul Gausman, the superintendent of a Sioux City, Iowa school district with 15,000 students said, "We'd have to make a local decision about what services we continue to provide and which we don't." Gausman's district receives roughly $3 million from Medicaid reimbursements every year. He also said, "I haven't met many people who enjoy writing a check for their taxes, and I understand that, but it does not mean taxation is evil, and we've got to consider the most vulnerable of our population."
Since 1988 schools have had the ability to register themselves as Medicaid providers to seek reimbursement, just like hospital and doctors do. Two-thirds of these districts use the funds to employ the therapists and nurses who work directly with children.
The Republican plan to rearrange the healthcare system includes adding a new "per capita cap" for Medicaid instead of matching state spending. The new plan states the federal government will now give a fixed stipend amount to each Medicaid enrollee.
Supporters of the bill claim it will control federal spending which in turn will force the healthcare system to become more efficient with the services they provide.Federal spending will be reduced by $772 billion through the next decade according to the new Senate bill. Over the next decade, the House GOP bill which passed in May will cut federal spending $880 billion according to the Congressional Budget Office.
A committee spokesperson, Katie Niederee said the bill "reflects Republican priorities to bend the cost curve on federal entitlement programs and encourage states that tend to spend beyond their means to actually stay within their budget." However, Democrats believe that the nation's neediest will be denied essential services, including in schools.
The top Democrat on the Health, Education, Labor and Pensions Committee, Washington Sen.Patty Murray said "No matter how they try to spin their massive cuts to Medicaid to make the Senate version look less 'mean,' it is clear that Trumpcare (the proposed new Senate bill) would mean massive cuts to schools and districts and massive pain for students and families."
The Better Care Reconciliation Act (BCRA) is the new name of the new bill does exempt some of the most disabled students from per-capita caps. However, the number of those affected is unknown. Education officials say that no matter the specific number, schools will still be left in the lurch.
The BCRA's plan for Medicaid will more than likely hurt schools in many ways, according to Sasha Pudelski. Pudelski tracks healthcare policy for AASA, which is the superintendents association. She said, "Most directly, states may decide to prohibit schools from receiving Medicaid dollars." because of what is likely to be stiff competition for limited resources.
Indirectly, struggling states that aren't able to cover the costs of healthcare which are currently covered by government funding will need to find or make cuts elsewhere in their budgets.Pudelski also commented, "The kids who will be hurt first and foremost are special ed kids and kids in poverty, but then everybody will be hurt because we'll have to shift dollars from the general education budget."
Scott Bowling superintendent of a Crawfordsville, Ind.District says Medicaid helps pay for a full-time registered nurse at each school.Those nurses provide primary care for many low-income students who don't have a doctor of their own. On top of that school nurses provide mental health first response care while caring for children with special medical needs like tube feeding children with gastric tubes, suctioning tracheostomies, administering breathing treatments, and also emergency medication for those suffering seizures.
In Crawfordsville, Ind., with a district of 2,400 students, Medicaid helps pay for a full-time registered nurse at each school.Those nurses provide primary care for many low-income students who don't have a doctor of their own, Superintendent Scott Bowling said.
They also provide a first response to growing mental-health needs, and they care for children with complex medical needs, suctioning tracheostomies, tube-feeding children with gastric tubes, administering breathing treatments and emergency medication for seizures.
Bowling said without the district's federal Medicare grant they will have to lay off at least one nurse and there be left without the ability to have a full-time nurse on duty. He said, "Our nurses have literally saved students' lives over the past few years, lives that we may have lost if we had to call them in from another site."
Photo source: Ross Griff via Flickr