Bill Overview
Title: CHIP School Behavioral Health Incentive Act
Description: This bill excludes expenditures relating to initiatives for school behavioral health services from the administrative spending cap under the Children's Health Insurance Program (CHIP). Currently, states may use up to 10% of their total federal CHIP expenditures on outreach, health services initiatives, and certain other activities (i.e., nonbenefit expenditures). The bill excludes health services initiatives relating to school behavioral health services from this limitation; expenditures for these and other nonbenefit expenditures may not exceed 15% of total expenditures.
Sponsors: Sen. Thune, John [R-SD]
Target Audience
Population: Children and adolescents eligible for CHIP and involved in school behavioral health services
Estimated Size: 6700000
- The Children's Health Insurance Program (CHIP) is designed to provide health coverage to children in families with incomes too high to qualify for Medicaid but too low to afford private coverage. This means the primary individuals impacted are children and adolescents eligible for CHIP.
- School behavioral health services are targeted at addressing mental health issues in a school setting. Therefore, children and adolescents in schools will be directly impacted by increased access to these health services.
- By allowing states to allocate more funds towards behavioral health services in schools, the bill indirectly impacts families and educators who will benefit from improved student wellbeing and potentially improved educational outcomes.
- In the United States, CHIP covers approximately 6.7 million children. Given this context, a significant portion of these children could be either directly or indirectly impacted by enhanced behavioral health services in schools.
- The bill may also impact schools themselves as they will have access to more resources for behavioral health initiatives, thus influencing school environments and operations.
Reasoning
- The population distribution primarily includes children and adolescents eligible for CHIP who are involved in school behavioral health services. These children often belong to low-to-moderate-income families who do not qualify for Medicaid, making them an important group for assessing policy impacts.
- Budget constraints and program size will limit the extent and scale of policy deployment. The $300,000,000 budget for year 1 suggests that not all eligible children will be immediately impacted; rather, implementation may focus in specific regions or states initially.
- We should expect varied levels of impact, ranging from high impacts due to direct involvement in newly funded programs to low or no impact for those not using these services.
- Considerations for duration and scale of impact will likely involve short-term changes to wellbeing scores as programs are funded and initiated, followed by longer-term improvements as programs mature and stabilize.
Simulated Interviews
student (Ohio)
Age: 10 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- Receiving more support at school for my anxiety will help me focus more on studies and play.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
high school student (California)
Age: 14 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- Better access to counseling at school might help me get along better with classmates and focus on sports.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 7 |
high school student (Texas)
Age: 17 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I think having someone to talk to regularly at school could really help handle stress.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
teacher (New York)
Age: 42 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 17/20
Statement of Opinion:
- Extra resources mean I can better support my students and maybe get some training on mental health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 7 |
school principal (Georgia)
Age: 39 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- This policy will allow us to systematically address issues rather than reactively handle crisis situations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 9 | 6 |
student (Florida)
Age: 12 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- Having someone at school to help might make moving less scary.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 7 |
middle school student (Illinois)
Age: 13 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- I hope getting more help at school means I can finally talk about being bullied and not be so sad all the time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 6 |
school counselor (North Carolina)
Age: 37 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 13/20
Statement of Opinion:
- More funding will mean I can potentially give more attention to each student and maybe even reduce caseload burden.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 7 |
parent (Arizona)
Age: 30 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 16/20
Statement of Opinion:
- Improved behavioral services at school means I have one less thing to worry about regarding my kids' education.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
school district administrator (Michigan)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- Having more discretion to use funds for mental health in schools means better student education outcomes in the long run.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Cost Estimates
Year 1: $300000000 (Low: $200000000, High: $400000000)
Year 2: $300000000 (Low: $200000000, High: $400000000)
Year 3: $300000000 (Low: $200000000, High: $400000000)
Year 5: $300000000 (Low: $200000000, High: $400000000)
Year 10: $300000000 (Low: $200000000, High: $400000000)
Year 100: $300000000 (Low: $200000000, High: $400000000)
Key Considerations
- The policy allows states to allocate more funds towards school-based behavioral health services without breaching existing CHIP expenditure limits.
- The focus is on nonbenefit expenditures, meaning the core CHIP coverage remains unaffected.
- States with existing behavioral health needs might take greater advantage of this policy shift, creating variance in impact across the country.
- Indirect benefits related to improved behavioral health in school settings could enhance educational performance, leading to broader social benefits.