View in EDS

System-Level, Decision-Making, and Program Operations during the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals

Saved in:
Bibliographic Details
Title: System-Level, Decision-Making, and Program Operations during the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals
Language: English
Authors: Samantha G. Alarcon Basurto (ORCID 0009-0008-4532-200X), Rishitha Reddy Chintala (ORCID 0009-0001-0874-4886), Dorbor Tarley, Julia Gross, Erin R. Hager (ORCID 0000-0002-5499-2952), Susan M. Gross (ORCID 0000-0003-1589-2307)
Source: Journal of School Health. 2026 96(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 11
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Health Services, Federal Programs, State Federal Aid, Eligibility, Disabilities, Economically Disadvantaged, Lunch Programs, Disadvantaged Youth, Poverty, Low Income Students, Disadvantaged Schools, Nutrition, Public Schools, School Districts
Geographic Terms: Maryland
DOI: 10.1111/josh.70096
ISSN: 0022-4391
1746-1561
Abstract: Background: The Maryland Department of Education participated in the USDA's Direct Certification with Medicaid (DC-M) pilot during the 2022-2023 school year. This program lets Medicaid-enrolled students automatically qualify for Free or Reduced-Price Meals (FARM) and incorporates Medicaid data into eligibility calculations for the Community Eligibility Provision (CEP), which allows high-poverty schools to offer free meals to all students. This study assesses how DC-M impacts CEP participation from a systems perspective, using a causal loop diagramming approach across 12 Maryland public school districts. Methods: Semi-structured, in-depth interviews were conducted among stakeholders from school district offices of food and nutrition services. Inductive qualitative coding was applied to interview transcripts, identifying causal relationships among codes using Kumu software. Results: Interview findings (n = 12 interviews) identified 36 interconnected factors organized into five reinforcing feedback loops and one balancing loop, revealing three themes: school district landscape influence on student enrollment, federal and state policies' effects on school meal funding, and school-level meal operations impacted by school meal policies. Implications for School Health Policy, Practice, and Equity: Schools can increase meal participation through DC-M. Conclusions: This study uses a systems approach to pinpoint barriers and facilitators that can inform strategies for improving FARM eligibility and supporting CEP programs.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1492034
Database: ERIC
FullText Text:
  Availability: 0
Header DbId: eric
DbLabel: ERIC
An: EJ1492034
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: System-Level, Decision-Making, and Program Operations during the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Samantha+G%2E+Alarcon+Basurto%22">Samantha G. Alarcon Basurto</searchLink> (ORCID <externalLink term="https://orcid.org/0009-0008-4532-200X">0009-0008-4532-200X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Rishitha+Reddy+Chintala%22">Rishitha Reddy Chintala</searchLink> (ORCID <externalLink term="https://orcid.org/0009-0001-0874-4886">0009-0001-0874-4886</externalLink>)<br /><searchLink fieldCode="AR" term="%22Dorbor+Tarley%22">Dorbor Tarley</searchLink><br /><searchLink fieldCode="AR" term="%22Julia+Gross%22">Julia Gross</searchLink><br /><searchLink fieldCode="AR" term="%22Erin+R%2E+Hager%22">Erin R. Hager</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5499-2952">0000-0002-5499-2952</externalLink>)<br /><searchLink fieldCode="AR" term="%22Susan+M%2E+Gross%22">Susan M. Gross</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-1589-2307">0000-0003-1589-2307</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+School+Health%22"><i>Journal of School Health</i></searchLink>. 2026 96(1).
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 11
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Health+Services%22">Health Services</searchLink><br /><searchLink fieldCode="DE" term="%22Federal+Programs%22">Federal Programs</searchLink><br /><searchLink fieldCode="DE" term="%22State+Federal+Aid%22">State Federal Aid</searchLink><br /><searchLink fieldCode="DE" term="%22Eligibility%22">Eligibility</searchLink><br /><searchLink fieldCode="DE" term="%22Disabilities%22">Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Economically+Disadvantaged%22">Economically Disadvantaged</searchLink><br /><searchLink fieldCode="DE" term="%22Lunch+Programs%22">Lunch Programs</searchLink><br /><searchLink fieldCode="DE" term="%22Disadvantaged+Youth%22">Disadvantaged Youth</searchLink><br /><searchLink fieldCode="DE" term="%22Poverty%22">Poverty</searchLink><br /><searchLink fieldCode="DE" term="%22Low+Income+Students%22">Low Income Students</searchLink><br /><searchLink fieldCode="DE" term="%22Disadvantaged+Schools%22">Disadvantaged Schools</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Public+Schools%22">Public Schools</searchLink><br /><searchLink fieldCode="DE" term="%22School+Districts%22">School Districts</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Maryland%22">Maryland</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/josh.70096
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0022-4391<br />1746-1561
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The Maryland Department of Education participated in the USDA's Direct Certification with Medicaid (DC-M) pilot during the 2022-2023 school year. This program lets Medicaid-enrolled students automatically qualify for Free or Reduced-Price Meals (FARM) and incorporates Medicaid data into eligibility calculations for the Community Eligibility Provision (CEP), which allows high-poverty schools to offer free meals to all students. This study assesses how DC-M impacts CEP participation from a systems perspective, using a causal loop diagramming approach across 12 Maryland public school districts. Methods: Semi-structured, in-depth interviews were conducted among stakeholders from school district offices of food and nutrition services. Inductive qualitative coding was applied to interview transcripts, identifying causal relationships among codes using Kumu software. Results: Interview findings (n = 12 interviews) identified 36 interconnected factors organized into five reinforcing feedback loops and one balancing loop, revealing three themes: school district landscape influence on student enrollment, federal and state policies' effects on school meal funding, and school-level meal operations impacted by school meal policies. Implications for School Health Policy, Practice, and Equity: Schools can increase meal participation through DC-M. Conclusions: This study uses a systems approach to pinpoint barriers and facilitators that can inform strategies for improving FARM eligibility and supporting CEP programs.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1492034
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1492034
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/josh.70096
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
    Subjects:
      – SubjectFull: Health Services
        Type: general
      – SubjectFull: Federal Programs
        Type: general
      – SubjectFull: State Federal Aid
        Type: general
      – SubjectFull: Eligibility
        Type: general
      – SubjectFull: Disabilities
        Type: general
      – SubjectFull: Economically Disadvantaged
        Type: general
      – SubjectFull: Lunch Programs
        Type: general
      – SubjectFull: Disadvantaged Youth
        Type: general
      – SubjectFull: Poverty
        Type: general
      – SubjectFull: Low Income Students
        Type: general
      – SubjectFull: Disadvantaged Schools
        Type: general
      – SubjectFull: Nutrition
        Type: general
      – SubjectFull: Public Schools
        Type: general
      – SubjectFull: School Districts
        Type: general
      – SubjectFull: Maryland
        Type: general
    Titles:
      – TitleFull: System-Level, Decision-Making, and Program Operations during the Implementation of the Medicaid Direct Certificate (DC-M) Pilot on Maryland Community School Meals
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Samantha G. Alarcon Basurto
      – PersonEntity:
          Name:
            NameFull: Rishitha Reddy Chintala
      – PersonEntity:
          Name:
            NameFull: Dorbor Tarley
      – PersonEntity:
          Name:
            NameFull: Julia Gross
      – PersonEntity:
          Name:
            NameFull: Erin R. Hager
      – PersonEntity:
          Name:
            NameFull: Susan M. Gross
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 0022-4391
            – Type: issn-electronic
              Value: 1746-1561
          Numbering:
            – Type: volume
              Value: 96
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Journal of School Health
              Type: main
ResultId 1