Student health care will be harmed by a proposed Medicaid carve-out

From ongoing physical and mental health challenges presented by COVID-19 to the resurgence of polio and arrival of monkeypox, protecting the health and safety of students on Long Island and across the state is more important than ever.

The best way to ensure students get the care they require is to meet them where they are — particularly when it comes to underserved populations for whom access to care is a long-standing difficulty. The nonprofit Long Island FQHC meets that need through three school-based health centers in Freeport, Roosevelt, and Westbury high schools.

These centers are open to all enrolled students regardless of their ability to pay and serve more than 1,200 individuals — a number expected to double in the next year. They provide a wide range of primary and preventive services, from vaccines and physicals to mental health counseling and more.

But the future of these and other vital federally-qualified health centers — including our six family health centers — is in question, as Albany pushes to cut $250 million from safety-net providers across the state that provide care to New York’s most vulnerable residents.

The state Department of Health is moving forward with a plan to carve out the Medicaid pharmacy benefit from the 30-year-old federal program known as 340B. The savings realized by 340B provide a predictable funding stream to organizations like ours, enabling us to provide services not covered by Medicaid like mental health and nutrition counseling and dental exams — all at no additional cost to taxpayers.

Unlike most government programs, 340B funding is flexible and can be used for a wide variety of purposes — including support of our school-based health centers. If the state implements the carve-out as scheduled next spring, our centers might be forced to reduce services or even close.

That would be a tragedy, because students desperately need the services we provide, particularly mental health counseling.

According to the Centers for Disease Control and Prevention, 44% of high schoolers said they felt persistently sad or hopeless during 2021, and that number rose among LGBTQ youth. Schools and educators bear the brunt of this public health crisis, with reported upticks in absenteeism, disruptive behavior, violence, bullying, and suicide attempts by students. This could not come at a worse time, as the lockdowns and remote learning implemented during the pandemic had devastating impacts on both reading and math scores, and students and teachers need safe, healthy environments in which to learn.

Long Island students are clearly in crisis. Now is the time to invest in the services necessary to support these at-risk young people and their families.

Grant money and the approximately $700,000 we receive in 340B funding make up half our operating dollars. We started participating in the 340B program just a few years ago, and are on track to increase our funding to $1 million by the end of next year. If we lose this money, we will have to do less with less, and our patients will suffer the consequences.

Our school health centers have been wildly popular, and we are in line to open a fourth at Baldwin High School, pending DOH approval. The state clearly recognizes the benefit of these centers — and all the services provided by safety-net facilities across New York. It should not give with one hand and take away with the other, and must cancel the Medicaid pharmacy benefit carve-out today.

This guest essay reflects the views of David Nemiroff, president and chief executive of Long Island FQHC Inc., a federally qualified health center.