Schools, States Should Use Existing Resources to Improve Student Health and Absenteeism

Lisa-ShapiroIt’s a fairly simple concept: For children to succeed in school, they must be healthy enough to attend class.

But for millions of children, poor health affects their ability to attend school and hinders their path to academic success. In recent years, policymakers have increased their focus on student absenteeism and its link to poor academic outcomes. Their goal is to identify the underlying causes and find ways to better address them. It’s clear from the data that students who suffer from chronic health issues miss the most school and have the lowest graduation rates.

Of those chronic health conditions, childhood asthma is one of the greatest contributors to absenteeism. According to the National Asthma Education and Prevention Program, students miss 14 million days of school every year due to asthma. Asthma is the most common chronic condition among school-aged children, affecting 6.1 million U.S. children, or about 8.3 percent of our nation’s youth.

The good news is that asthma is treatable and preventable. In nearly every instance, when children receive the tools to manage their asthma, they can lead active and productive lives in the classroom and beyond.

So why are so many kids still absent?

Proper asthma management requires a coordinated effort among families, medical providers and schools. Evidence shows that for students with asthma or other chronic conditions to be healthy enough to attend school, they first need access to affordable and reliable health coverage. They need medications that stem the onset of symptoms, as well as support at home and in school to understand and adhere to their medication management plan. The majority of students don’t have that.

Access to school health services are an essential piece of the absenteeism puzzle. While schools play a critical role to keep kids healthy, data suggests there’s more they can do. In January, the U.S. Departments of Education (DOE) and Health and Human Services (HHS) secretaries wrote a letter to state school officers and health officials urging them to take advantage of existing opportunities to screen and enroll eligible children into health coverage and to reimburse schools for the health services they provide.

Identifying uninsured students and providing assistance to connect them to public coverage in Medicaid and the Children’s Health Insurance Program is an important opportunity for schools to improve student health and reduce absenteeism. Research confirms a strong association between health coverage and student success. For example, a 2014 study by the National Bureau of Economic Statistics found that when children gained access to Medicaid they were more likely to do better in school, miss fewer school days, finish high school, graduate from college and earn more as adults.

Beyond schools, states also have a role to play. A policy clarification issued by HHS in January 2015 has the potential to be a game changer when it comes to funding for school-based services. While there was confusion in the past regarding the so-called “free-care rule,” HHS now says schools are permitted to bill Medicaid for the services they provide to eligible students. For students with asthma, this may mean giving medical assistance to students experiencing asthma symptoms or implementing a comprehensive asthma management plan. DOE and HHS are encouraging state Medicaid agencies and education agencies — and local educational agencies — to work together to explore Medicaid state plan requirements and determine the best way for schools to bill Medicaid for the services they provide to qualified students.

It takes many voices to enact change. That’s why groups like the Childhood Asthma Leadership Coalition have been instrumental in bringing state and national partners together from the health, education and environmental advocacy communities to work on common-sense policy solutions that reduce school absenteeism.

Most recently, coalition partners were able to secure a provision in the Every Student Succeeds Act that allows federal education block grants to pay for school asthma management plans.

May is Asthma and Allergy Awareness Month, and we owe it to students with asthma and those with poor health every opportunity to break down the barriers holding back their futures. Now is the time for schools and states to get off the sidelines and let kids breathe easier.
Lisa Shapiro is vice president for health policy at First Focus, a bipartisan child advocacy organization and convener of the Childhood Asthma Leadership Coalition, a multisector coalition of asthma stakeholders dedicated to raising awareness and improving public policy to reduce the burdens of childhood asthma.


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