Medicaid And School Meals: What's Covered?

does medicaid pay for school breakfast and lunch

The National School Lunch Program (NSLP) and School Breakfast Program (SBP) are federal programs that provide free, reduced, or full-priced meals to students in participating schools. While Medicaid does not directly pay for school meals, it plays a role in determining eligibility for these programs. In 43 states, Medicaid household income data is used to directly certify eligible children for free or reduced-price meals. Additionally, children from low-income families, foster children, or those participating in other assistance programs may also qualify for free or reduced-price meals. The specific eligibility requirements and implementation vary across states, with some states offering universal free meals regardless of income.

Characteristics Values
Number of students certified for free meals using Medicaid data through DCM-F/RP in SY 2017-18 1,019,865
Number of students certified for reduced-price meals using Medicaid data through DCM-F/RP in SY 2017-18 258,893
Number of states utilizing Medicaid household income data to directly certify eligible children 43
Number of states approved to participate in Direct Certification with Medicaid Demonstration Projects for SY 2024-25 6 (Arkansas, Idaho, Maine, New Jersey, North Dakota, and Rhode Island)
Total number of states participating in Direct Certification with Medicaid Demonstration Projects 44
Federal reimbursement rate for participating schools per meal $3
Income threshold for a family of four to be eligible for free meals $51,338
Income threshold for children to be eligible for free meals Household income at or below 130% of the federal poverty level
Income threshold for children to be eligible for reduced-price meals Household income between 130% and 185% of the federal poverty level
Maximum amount that can be charged for reduced-price meals 30 cents for breakfast and 40 cents for lunch
States that require all schools to participate in the NSLP Georgia
States that automatically serve one free meal per school day to every student California
States that only require K-8 schools to participate in the NSLP Arizona
States that require all public schools, including high schools, to participate in the NSLP Illinois

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Income eligibility

In the United States, income eligibility for school meal programs is assessed through various methods, including the use of Medicaid data. Forty-three states use Medicaid household income data to directly certify eligible children for free or reduced-price meals. This process, known as Direct Certification with Medicaid (DC-M), matches Medicaid income data with student records to determine eligibility. However, Medicaid is typically used as a last resort, after other direct certification methods have been considered.

In addition to income eligibility, some states have implemented the Community Eligibility Provision (CEP). This provision allows schools in high-poverty areas to serve meals at no cost to all enrolled students, eliminating the need to collect household applications. CEP streamlines student eligibility and ensures that all students in high-poverty areas have access to nutritious meals.

During the COVID-19 pandemic, a federal waiver was provided, offering free meals to all children, regardless of income. Additionally, the Keep Kids Fed Act was extended by Congress in June 2022, allowing some children to continue receiving free meals during the summer months. These initiatives highlight the importance of ensuring that all children have access to nutritious meals, regardless of their family's income level.

While income eligibility is a crucial factor in determining school meal benefits, it is important to note that other factors, such as participation in assistance programs like SNAP or TANF, can also impact a child's eligibility for free or reduced-price meals. These programs work in conjunction with income thresholds to ensure that children from low-income families have access to nutritious meals during the school day.

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Direct certification with Medicaid

The USDA Food and Nutrition Service (FNS) is committed to expanding direct certification with Medicaid to increase access to school meals for students from low-income families. FNS has invited state agencies that administer the NSLP and SBP to apply for participation in demonstration projects aimed at evaluating and implementing direct certification with Medicaid for free and reduced-price school meals. These projects aim to streamline the process, reduce administrative burdens for schools and parents, and improve program integrity.

As of the 2024-25 school year, 44 states have been approved to participate in the Direct Certification with Medicaid Demonstration Projects. This includes Arkansas, Idaho, Maine, New Jersey, North Dakota, and Rhode Island, which were recently added to the list. These states have expanded their projects to include more locations and offer both free and reduced-price meals.

The benefits of direct certification with Medicaid are significant. It maximizes access to school meals by automatically enrolling eligible students, reducing the time and resources required for paperwork and administrative tasks. It also increases schools' ability to implement the Community Eligibility Provision (CEP), further expanding access to nutritious meals for students in need. Additionally, direct certification helps connect children to the Summer Electronic Benefit Transfer Program, reducing food insecurity during the summer break.

The USDA provides comprehensive guidance and support for states interested in implementing Medicaid Direct Certification. This includes assistance with the application process and grants to improve direct certification systems, particularly for states with lower SNAP direct certification rates.

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School Breakfast and Lunch Programs in New York

The School Breakfast and Lunch Programs in New York are federal programs that provide free, reduced, or full-priced breakfast and lunch at participating schools. The New York State Department of Education administers these programs, and local schools operate them. The Community Eligibility Provision (CEP) is a meal service option for schools in high-poverty areas. Thousands of schools in New York State are participating in CEP, providing access to breakfast and lunch meals to all students at no charge each school day. Schools that do not participate in the CEP offer free or reduced meals to students based on family size and income.

Children from low-income families are eligible for free or reduced-price school meals. Children in households with incomes at or below 130% of the federal poverty level are eligible for free school meals. Children in households with incomes between 130% and 185% of the federal poverty level are eligible for reduced-price school meals and can be charged no more than 30 cents for breakfast and 40 cents for lunch. Children in households participating in certain assistance programs, such as SNAP, TANF, or FDPIR, as well as foster youth, migrant youth, homeless youth, and Head Start participants, are also eligible for free school meals.

In New York, the School Breakfast and Lunch Programs are supervised by the New York State Office of Temporary and Disability Assistance, which provides support to families and individuals with low incomes. The New York State Education Department also plays a role in these programs, as they receive federal and state reimbursement for meals served to children who meet the federal meal pattern requirements. The amount of reimbursement is based on the family's eligibility for free, reduced-price, or full-priced meals, which is determined by an annually approved application, direct certification letter, or computer match with the local social services department or the Office of Temporary and Disability Assistance.

The eligibility criteria and reimbursement rates for school breakfast and lunch programs can vary from year to year, depending on factors such as holidays and fiscal year timings. Additionally, schools may obtain an annual exemption from participating in these programs if they can document a lack of need, economic hardship, or other valid reasons.

It is worth noting that New York is not currently listed among the states participating in the Direct Certification with Medicaid Demonstration Projects. However, the USDA Food and Nutrition Service is continuously evaluating and expanding these projects to increase access for low-income children and reduce administrative burdens.

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The Keep Kids Fed Act

The act is a response to the challenges faced by school nutrition professionals, including supply chain breakdowns, rising prices, and labour shortages, which have been exacerbated by the pandemic and have made it difficult for families to afford nutritious meals. The Keep Kids Fed Act aims to address these issues by increasing reimbursements to schools and childcare providers, supporting access to summer meals, and streamlining access to healthy meals for children in family childcare.

One of the key provisions of the act is the elimination of the reduced-price meal category, which will allow children who were previously eligible for reduced-price meals to now receive free school meals. This provision will help to ensure that all children have access to nutritious meals, regardless of their family's income level.

The act has been applauded by hunger-relief networks and anti-hunger advocates, who have emphasized the importance of ensuring that children have access to nutritious meals and the stability and predictability that this legislation provides.

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Community Eligibility Provision (CEP)

The Community Eligibility Provision (CEP) is a federal program that allows eligible schools and districts to provide free breakfast and lunch to all students, regardless of income. CEP is a school meal funding option under the National School Lunch Act, which enables schools to provide free meals to students. Schools receive funding based on a formula that utilizes data from sources such as the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). This means that families are relieved of the burden of submitting applications reporting their household income.

CEP has been shown to increase participation in school meals and supports a holistic learning approach. In the first year of implementation, schools participating in CEP experienced a 6.8% increase in school lunch participation and a 12.1% increase in school breakfast participation. This provision facilitates the implementation of innovative breakfast service models, such as "grab and go" options, which can further boost breakfast participation. Additionally, CEP improves the financial viability of school nutrition programs. As participation increases, school districts benefit from economies of scale, allowing them to reinvest revenue into menu quality improvements and staff training.

To determine eligibility for CEP, schools and districts can utilize tools like the CEP Opportunity Finder, which helps identify eligible schools that are not yet participating in the program. Districts can also use the Identified Student Percentage (ISP) Outreach Calculator to calculate school-level and group-level ISPs and compare them to target values. This information can be used to increase outreach for participation in public benefit programs, such as SNAP and Medicaid, ultimately increasing ISP and boosting revenue in the school nutrition budget.

CEP is just one of several school meal funding options available to ensure that all students have access to healthy meals. Other options include Provision 2 and locally funded universal free meals ("non-pricing"). By offering free meals to students, schools can ensure that children's nutritional needs are met, allowing them to focus on learning and thriving in the classroom.

Frequently asked questions

Medicaid does not directly pay for school meals, but children from families that receive Medicaid may be eligible for free or reduced-price school meals.

Eligibility is typically determined by household income. Children in households with incomes at or below 130% of the federal poverty level are eligible for free school meals, while those between 130% and 185% are eligible for reduced-price meals. Children in households that receive SNAP, TANF, WIC, or FDPIR benefits are also automatically eligible for free meals.

In most cases, families need to fill out a school meal application at the beginning of the school year. However, some children may be directly certified based on their participation in certain programs, such as SNAP or Medicaid, without the need for an application.

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