In the SBO Perspectives – School Medicaid (June 5, 2025) podcast, co-hosts Tera Vandyke, director of fiscal operations at Northwest Regional Education Service District, and Jack "JR" Mitchell, assistant superintendent for business at Valley Stream 24 School District in New York, welcomed special guest Sarah Foster, Medicaid manager at NWRESD, for an in-depth conversation about the critical role of School Medicaid.

Sarah shared insights into how School Medicaid operates at the intersection of health, education and equity, ensuring that students, particularly those in under-resourced communities, have access to the essential health services they need to thrive in the classroom and beyond. 

Medicaid billing allows districts flexibility in reinvestment, while Medicaid Administrative Claiming (MAC) requires 100% reinvestment into health and social services. Funds have been used to fund roles like additional school nurses or adaptive playground equipment. 

Medicaid is one of the few funding sources that reimburses schools for the health services they already provide, offering critical support amid budget constraints. Sarah recommended starting small (for example, with school nurses) to build internal capacity, using well-designed billing software, establishing systems to flag errors, and investing in training for providers, particularly through peer-to-peer sessions, to enhance documentation and awareness. She also stressed the importance of leveraging support from state Medicaid agencies and collaborating with peer districts.

"Schools aren't just about academics," says Sarah. "They're places of care...and we have to care for students’ physical, emotional, and mental health in order for them to succeed in the classroom."

Listen to the podcast