May 8, 2017

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

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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