As federal lawmakers consider broad changes to Medicaid, school chiefs from across the country are warning that such modifications could have big consequences for students with disabilities.

School districts rely on Medicaid to help pay for everything from nurses and therapists to screening and treatment for students in special education.

This could change if Republicans have their way with the state-federal program.

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President Donald Trump and congressional Republicans have indicated that they support switching Medicaid to a block grant, or per capita cap, system.

Currently, Medicaid benefits are generally extended to anyone who is eligible, with the federal government providing matching grants to states to cover the costs. But under a block grant approach, states would likely receive a set amount of money from Uncle Sam, a move that could lead to more limited eligibility or other cost savings measures.

The prospect of such a significant shift has school district leaders “overwhelmingly concerned” and “deeply worried,” according to findings from a survey of nearly 1,000 superintendents and other administrators released this month by AASA, The School Superintendents Association.

School districts are currently able to seek reimbursement from Medicaid for a variety of medically necessary services provided to children under the Individuals with Disabilities Education Act.

Two-thirds of educators polled said they use Medicaid dollars to pay salaries of health care professionals who work in schools while others said the funds go toward assistive technology, equipment like walkers and wheelchairs, professional development for special educators or transporting students with disabilities.

While it’s unclear precisely how funding levels might change under a block grant approach, AASA asked school chiefs about the impact of a 30 percent reduction.

Those surveyed said such a cut would likely mean fewer paraprofessionals and other staff and districts that are less able to support students with disabilities in mainstream classrooms, potentially falling short of obligations under IDEA.

“This would lead to reduced services for children with disabilities especially children with significant cognitive and motor delays,” one survey respondent said. Another indicated that cuts would “drastically cut back on the individualized supports” that could be provided to children with disabilities.

Officials with AASA said they hope lawmakers will consider Medicaid’s impact on school services as they weigh the future of the program.

“This survey illustrates the growing concern that our school districts have for the communities they serve, especially the families within our communities that need help the most,” said Daniel A. Domenech, the group’s executive director.

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