Anne Swerlick
May 8, 2017

Florida Missing Opportunity to Boost Health Care Services for School-Aged Children

This post was last updated on September 29, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

Florida is not taking advantage of millions in federal dollars that can be used to support and enhance school-based health services. Other states of comparable size do better for children.

There are 2.3 million Florida children who are covered by Medicaid, representing almost half of all children in the state. In addition to the immediate health and financial benefits for children and their families, multiple studies conclude that Medicaid-covered children experience long term health and economic gains as adults.[1]

Findings in a recent Center on Budget and Policy Priorities (CBPP) report highlight that schools can leverage Medicaid dollars to expand and support a robust set of health services provided inside school walls.[2] This includes vision, dental and other preventive health screenings, behavioral health services, specialized therapies and chronic care management for asthma and diabetes. Federal dollars cover 61 percent of the cost.

Relative to other states, however, Florida’s Medicaid spending on school-based services is curiously low. In 2015, reports CBPP, total Florida Medicaid spending in schools was $124.72 million. Compare this figure to states of comparable or smaller size: Texas’s total was $444.38 million, more than three times Florida’s spending. Spending in Illinois ($286.39 million) and New York ($273.56 million) was more than double Florida’s.

Unquestionably, there is dire need for increased health-related resources for schools. Case in point:  Between 2005 and 2015, while reported student health personnel increased by 68.75 percent nationally (438,545 to 740,041), the number of registered nurses (RNs) providing school health services in Florida increased by only 16.23 percent (992.7 to 1,153.89).[3]  Florida has about 1,300 RNs for more than 4,170 public schools.[4] This is well below the American Academy of Pediatrics’s recommendation that there be a RN in every school.[5]

So, the question must be asked: Why isn’t Florida taking full advantage of this opportunity to enhance and increase crucial health-care services for Florida’s neediest children?


[1] Sarah Cohodes et al., “The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions,” October 2014,; David Brown, Amanda Kowalski, and Ithai Lurie, “Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?” January 2015,

[2]Jessica Schubel. Center for Budget and Policy Priorities. April 2017. Medicaid Helps Schools Help Children.

[3] Florida Department of Health, School Health Program, 2017. Accessed via:

[4] Postal, Leslie. Orlando Sentinel. June 2016. Florida schools fall far short of recommended nurses. Accessed via:

[5] AAP Policy Statement Recommends full Time Nurse in Every School, May 23, 2016. Accessed via:

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