How to Maintain Mental Health Counseling by Letting Insurance Companies Pay For It
While school districts enjoyed record budgets over the last few years thanks to CARES, ESSER, and ARP dollars, district leaders are now wrestling with the challenge of reduced funding. The reality is that students’ increased needs persist as budgets are decreasing while costs are continually increasing. And, for districts facing declining enrollment, the funding gap is even larger.
Given this, returning to pre-pandemic budgets is not an option. Taking a strategic budgeting approach can help districts navigate and survive the funding cliff while preserving much needed services for students. This following post is part of our series, “Navigating—and Surviving—the Funding Cliff: Strategies for Maintaining ESSER-Funded Services Despite Declining Resources and Increasing Costs,” which shares best practices and actionable strategies for continuing to meet post-pandemic student needs and maximizing the impact of every dollar despite declining resources.
NAVIGATING—AND SURVIVING—THE FUNDING CLIFF
How to maintain mental health counseling by letting insurance companies pay for it
During the pandemic, many schools and districts invested in much needed mental health counseling services for students. In fact, this was one of the most common uses of ESSER funds.
Even as those funds have dried up, the reality is that the need for counseling and mental health services is not disappearing. Unfortunately, it is likely that many districts are cutting back these needed services as they face sharply tightening budgets because they cannot shift enough dollars to sustain all the services beyond the funding cliff.
Interestingly, there is an alternative that is good for both students and for the budget that is already being implemented successfully in a number of districts: district-organized, insurance-funded services.
How district-organized, insurance-funded mental health services work
Third party companies exist that offer virtual telehealth counseling services with licensed therapists and child psychiatrists for students, and these companies secure substantial non-district dollars to fund these much-needed services. Here’s how it works:
Schools and districts can contract with such companies, in advance, for however much clinical capacity they anticipate needing based on their student population.
Students are referred to the telehealth services by school-based guidance counselors or social workers for a range of needs such as anxiety, depression, school avoidance, and more.
Because of the clinical capacity of these telehealth services, students can be seen very quickly , often in less than a week for intake.
Students receive direct 1:1 evidence-based care from licensed providers.
As a community partner to the school, the company takes on the burden of coordinating directly with each student’s insurance provider to handle all billing and contracting.
The outcome is that insurance ends up covering approximately 2/3 the total cost of the care, dramatically reducing the cost to the district and making such services more sustainable.
It might surprise some, but students living in poverty have great mental health insurance coverage under Medicaid. The vast majority of services to these students are fully covered by insurance with no co-pays or deductibles.
Amplify the impact of budget dollars invested and deliver better supports for students
There are lots of reasons this model helps districts better serve students. For one, contracting with a third-party company in this manner guarantees the counseling capacity for students to be seen quickly. Most districts use a mix of existing in-house and third-party counselors. What’s more, districts that have implemented this model have found that they can provide much needed services to as many as three times the number of students as they would be able to reach if the same number of dollars had been invested in hiring only in-district clinical staff. Plus, such companies typically have access to a broader range of interdisciplinary, specialized staff and can match students with providers that can better meet their individual needs; for example, providers that speak their native language. While delivering more specialized and equitable services, these companies still coordinate closely with the in-district referrer and serve as a complement to the school-based team.
Even before the pandemic, remote counseling was becoming the preferred method for many, but its fair to say, Nate, what about the kids that aren’t well-served in virtual format? By enrolling the kids who are well served and open to a virtual format in this model, you can free up capacity of your school-based staff to focus on the kids who need them most.
District-organized, insurance-funded services offer a path for meeting increasing student needs even as funding tightens
The need for mental health services persists now, and will continue to persist, far beyond this funding cliff. Instead of cutting these newly added essential supports when budgets must tighten, schools and districts should consider ways to make the costs more sustainable. Leveraging insurance-funded telehealth services is an opportunity for schools and districts to continue providing much needed mental health support to significantly more students at a more sustainable cost.