Health check

New Medicaid rules could threaten funding for New York City’s school-based health centers

PHOTO: Joe Mahoney/The iNews Network

A change in New York state’s Medicaid reimbursement rules could reduce low-income students’ access to healthcare at hundreds of school-based clinics in New York City — and advocacy organizations are looking at ways to mitigate potential funding shortfalls.

The new rules will create a more complicated reimbursement process, which may cause some providers to shut down or reduce the services they offer, said Lorraine Gonzalez, director of health policy for the Children’s Defense Fund New York.

School health providers, for instance, will have to negotiate individual contracts with multiple “managed care organizations” which distribute Medicaid funds, instead of using a “fee-for-service” model. The new rules also create a new credentialing process for school-based health workers.

There are 145 school-based health centers in New York City covering 345 schools, and they offer everything from physicals and vision checks to help managing chronic conditions. In some cases, they are part of the city’s community schools, which offer students extra social services and other supports.

“There’s been a lot of negotiating at the table — the state has done a great job hearing from all parties,” Gonzalez said. But she warned, “If we don’t mitigate the risks of closures, then you’ll have kids living in poverty with fewer resources for pediatric care.”

This week, CDF released policy recommendations to prevent potential closures or reductions in services that could be created by a more complicated reimbursement process. Medicaid is the largest third-party funding stream for school-based health providers, which tend to be stationed in schools with higher proportions of poor students and students of color, Gonzalez said.

The changes in Medicaid rules won’t take effect until July 2017, but the Children’s Defense Fund issued a series of recommendations this week. You can read them here, or read this CDF report for more details.

talking it out

At NAACP hearing on charter school moratorium, foes and fans find common ground

PHOTO: Cassi Feldman
Nyla Jenkins, a first-grader at KIPP STAR Harlem College Prep Charter School

When the NAACP called for a moratorium on charter schools last fall, the group’s president and CEO Cornell Brooks said the group wanted a “reasoned pause,” not a “doomsday destruction” of charters.

Still, it ignited a firestorm among charter school supporters and sparked a series of hearings nationwide, the last of which was held Thursday in New York City. But rather than a heated debate, the panelists and public speakers took pains to find common ground.

“We cannot have a situation where schools are pitted against each other,” Randi Weingarten, president of the American Federation of Teachers, told the packed auditorium at Harlem Hospital Center.

Many panelists said the problem wasn’t school choice, but the fact that too many parents felt compelled to seek alternatives to struggling district schools.

“If you go into communities where education is working, you don’t see people scrambling around, trying to figure out what school to put their child in,” said Lester Young, a member of the state Board of Regents. “We have communities in New York City right now where parents say there is not one middle school I can place my child in. Now, that’s the issue.”

Still, many of the speakers also acknowledged problems with charter schools, particularly in states where the laws governing them are more lax than they are in New York.

“We want to make sure that those schools are going to accept students that have special needs,” said Rebecca Pringle, vice president of the National Education Association. “We want to make sure that we do not create separate systems that are unequal.”

The charter school advocates on the panel seemed to agree that some charters weren’t working. They were quick to denounce for-profit charters, for instance. “For-profit operators have no business in education,” said Katie Duffy, CEO of Democracy Prep Charter School. Our children “are not assets and liabilities and they shouldn’t be treated as such.”

Rafiq Kalam id-Din II, who founded a charter school in Bedford-Stuyvesant, spoke about the need for more schools like his, founded and staffed by black and Hispanic community members. Without naming names, he called out charter schools that believe “if you don’t sit a certain way, you can’t learn” or are using suspension as a “first response” rather than a last resort.

“Criminalizing the behavior of our children — there should be a moratorium on that,” he said.

But it was Nyla Jenkins, 7, a first-grader at KIPP STAR Harlem College Prep Charter School, who drew the most applause of the night when she took the microphone and declared herself a junior lifetime member of the NAACP. “Let’s find a solution for all of us,” she said.

Building Better Schools

IPS broke its own rules to work with a for-profit charter operator. Now it’s having second thoughts.

PHOTO: Scott Elliott
Donnan Middle School was taken over by the state and handed off to be run by Charter Schools USA in 2012. The school now includes an elementary school in partnership with Indianapolis Public Schools.

An unusual partnership between a for-profit charter operator and Indianapolis Public Schools could be on the rocks.

That’s because during its first year of operation, Emma Donnan Elementary School students had some of the lowest test scores in the district and did not make significant gains from the prior year — landing it on the shortlist for district intervention.

If scores are not good this year or in 2018, the district might terminate its contract with Charter Schools USA to operate Donnan, according to Superintendent Lewis Ferebee.

“They struggled in last year’s performance,” he said. “They did not perform at our standard.”

Florida-based CSUSA began managing three Indianapolis schools, including Emma Donnan Middle School, after the schools were taken over by the Indiana State Board of Education six years ago. In 2015, they opened Donnan Elementary as an IPS innovation school in the same building as the middle school. The district is responsible for the school’s — so far low — test scores, but the staff are employed by the charter operator, which handles daily operations.

IPS suspended a policy against working with for-profit operators when it agreed to work with CSUSA to launch Donnan Elementary. The move was intended to give the district more involvement in a building that otherwise would be state-controlled and give CSUSA a chance to work with students earlier. Middle schoolers at Donnan often enroll far behind grade level.

Eric Lewis, a senior official with CSUSA, said the organization is “thrilled to be in partnership” with IPS, and he is not concerned about pressure from the district to improve test scores because “we always intend to improve.”

CSUSA operates 77 schools across the country, many of which also have struggled academically. In the six years since Indiana handed management of three IPS schools over to the charter-manager, those schools have not shown significant improvement.

In recent years, CSUSA has appeared poised to expand in Indiana, but earlier this week the Indiana Charter School Board canceled charters for two schools that were expected to be managed by CSUSA because the company had stopped communicating about its plans.

IPS board members have been skeptical of Donnan Elementary’s progress in the past, but they were relatively quiet during a presentation from CSUSA at their meeting Thursday. (Innovation schools must present their progress to their board twice a year.)

Board member Diane Arnold said the report, which included information on enrollment and scores on tests used to track student progress throughout the year, showed more improvement than the last report school leaders presented to the board.

She is cautiously optimistic Donnan will improve with support.

“We kind of pushed the envelope to give them the elementary school,” she said. “My expectation is we should see results. … And I am hopeful.”

But it’s unclear what help the school will get from the district to improve test scores. Lewis said he did not “have any sense” of what resources the district could provide the school through its new intervention process, but “we look forward to partnering with them.”

Board president Mary Ann Sullivan said she was concerned that Donnan appeared on the list of low-performing schools, and she is relying on the staff overseeing innovation schools to track its progress.

“When we have partners … their purpose is to improve student achievement, and (if) that doesn’t happen, then yes, we will absolutely intervene in those schools,” she said. “We are going to be looking for accountability.”