A school's primary responsibility is to provide students with a high-quality education. However, children cannot learn to their fullest potential with unmet health needs. For over thirty years, Medicaid has helped cover the costs for certain medically necessary services provided in school-based settings to children eligible for special education services. Medicaid can also reimburse school districts for health and mental health services delivered in schools to Medicaid enrolled students and for providing other screening, diagnosis and treatment services like vision and hearing screenings, and diabetes and asthma management. As districts are faced with more children with critical health and mental health care needs and increasing demands for school personnel to provide those services, the American Association of School Administrators (AASA) has sought a solution that will enable more districts--large, small, urban, and rural, high-poverty and low-poverty--to participate in the Medicaid program. In December 2018, AASA surveyed over 750 school leaders in 41 states about their participation in the school-based Medicaid program and found the complex administrative and paperwork requirements necessary to obtain Medicaid reimbursement significantly hindered school district participation in the program. The AASA report outlines how Congress and the Administration must work together to provide States with the flexibility to reduce the administrative burdens that unfairly diminish the amount of reimbursement school districts receive, or worse, create insurmountable barriers that freeze out schools from even attempting to receive reimbursement. The passage of federal legislation titled "The Improving Medicaid in Schools Act" would allow states to implement a uniform, cost-based reimbursement methodology that would ensure districts of all sizes can be reimbursed by Medicaid for meeting the healthcare needs of their students regardless of their administrative capacity and student population. The proposal leverages an existing and proven process for Medicaid claiming that ensures strong accountability measures are still in place, but that will simultaneously reduce the burden on State Medicaid Agencies and insurance companies to manage and respond to a high volume of Medicaid transactions from districts. At a time when we have an uptick in children who lack health insurance coverage and a surge in children coming to school with unaddressed mental health needs, there is an urgency to improve the reimbursement stream for school-based Medicaid programs so schools can deliver more services to more students. [For the main report, see ED602004.]