News: New CMS toolkit supporting behavioral health for children and adolescents published
CMS recently published a behavioral health toolkit in an effort to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies ensuring children and youth get the care they need. This fits into CMS’ stated priority of improving access to high quality behavioral health treatment.
Medicaid and CHIP are the largest single source of funding for behavioral health treatment and support services in the United States. They provide critical coverage for behavioral health conditions for the 36 million children enrolled in these programs. Behavioral health conditions among children and adolescents are a known and prevalent issue in the U.S., with approximately 30% of children with public health coverage reporting a mental, emotional, developmental, or behavioral problem.
“Behavioral health” is not a specifically identified service that children and youth under the age of 21 and enrolled in Medicaid are entitled to under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements of the Social Security Act. However, states are obligated to cover an array of medically necessary mental health and substance use disorder services. EPSDT provisions require states to include an assessment of both physical and mental development in screenings, along with diagnostic or treatment services to correct illnesses and conditions that the screening identifies.
The toolkit is organized into four main sections, each with actionable strategies and sub-strategies. They include:
- Developing and supporting a behavioral health care delivery system that can meet a range of children’s needs
- Promoting early intervention for children’s behavioral health conditions
- Improving children’s access to behavioral health care through service coordination and integration
- Increasing the workforce capacity for children’s behavioral health services
Three appendices are also included in the toolkit to provide supplemental information about expanding states’ behavioral health coverage for children. The toolkit offers best practices and encourages states to ensure Medicaid managed care plans have sufficient payment structures and are able to provide access to EPSDT-required and medically necessary care.
Editor’s note: To read the full toolkit, click here. To read additional coverage of this study from MedPage Today, click here.