Additional content issues to explore
These are additional broad issue areas that might be on your state’s policy and program development agenda or advancing at the local level, and with which universal school-connected child development initiatives could be allied if you are able to identify common goals and build relationships with other stakeholders.
- While the federal 2010 Patient Protection and Affordable Care Act (ACA, also known as Health Care Reform) may not be as immediately visible to education stakeholders, it is changing how states implement health and mental health systems, including, for many, their Medicaid approaches. There may be opportunities to develop mental health promotion, prevention, and early intervention and student supports. “The Affordable Care Act provides state and local leaders with unprecedented opportunity along with new tools and resources to raise the standard for everyone,” including investing in public health approaches. As states implement their arrangements with insurers and Accountable Care Organizations (ACOs, i.e., the groups of providers that will actually deliver care), accountability for outcomes becomes a major priority. That means that implementation will necessarily have to address prevention, including public health prevention strategies.
- Numerous states that have received Community Transformation Grants under the ACA have identified improving the physical and social environment as elements of their plans. A list of states that have received grants can be found here.
- Federal Cooperative Agreements to State Education Authorities (SEAs) and Block Grants to State Mental Health Authorities, both authorized via the Substance Abuse and Mental Health Services Administration (SAMHSA), have received modestly higher appropriations. Cooperative Agreements under “Now is the Time” Project AWARE appropriations are required to expand SEAs’ capacity to increase awareness of mental health issues among school-aged youth, provide training for school personnel and respond to mental health issues in children and young adults. States are required to use the Block Grants for prevention, treatment, recovery supports and other services that will supplement services covered by Medicaid, Medicare and private insurance. Specifically, State Block Grant funds are directed toward four purposes, one of which is to fund primary prevention, i.e., universal, selective and indicated prevention activities and services for persons not identified as needing treatment.
- Finally, while child welfare and juvenile justice tend to provide remedial and individualized services to children and families whose behavior prompts these systems’ response, at times, states seek to pursue population-based prevention strategies, e.g., community or school-based alternatives to incarceration or substance abuse prevention. They may establish inter-agency initiatives with which you can collaborate.
 As noted in news reports, some states are not implementing health care reform very assertively or doing so without Medicaid.
 Schoen, Cathy, Hayes, Susan L, and Riley, Pamela, “Realizing Health Reform’s Potential: The Affordable Care Act’s New Tools and Resources to Improve Health and Care for Low-Income Families Across the Country,” The Commonwealth Fund, October 2013.