On Thursday May 17, the Congressional Children’s Health Care Caucus helped to host the third in a four-part series of briefings addressing why Medicaid is essential to children’s health care. The briefing focused on improving mental health services for children enrolled in Medicaid. In addition to providing a background on the issues most important in pediatric mental health, panelists discussed various initiatives that work to increase access to mental health care and that improve quality of care for special populations, such as children in foster care. The briefing was sponsored by the Children’s Hospital Association (formerly the National Association of Children’s Hospitals), the American Academy of Pediatrics, Family Voices, First Focus, March of Dimes, and the Georgetown Center for Children and Families.
Panelists included:
- Jane Meschan Foy, MD, FAAP, Chair, Task Force on Mental Health, American Academy of Pediatrics
- Robert Hilt, MD, Child Psychiatrist , Director of Partnership Access Line Consult Services, Seattle Children’s Hospital
- Steve Tuck, CEO, Children’s Home Society of West Virginia
- Beth Morrow, Director, Health IT Initiatives, The Children’s Partnership
Congresswoman Kathy Castor (D-FL), a co-chair of the Congressional Children’s Health Care Caucus, gave opening remarks at the briefing which mentioned her work on the section 1202 primary care payment “bump-up,” which was recently included in a rule by the Center for Medicare and Medicaid services that includes pediatric subspecialists as eligible providers for the section 1202 Medicaid payment increase to the Medicare level. This “bump-up” is a major policy change and the first time Medicaid payments have been tied to Medicare rates in the program’s history, an important victory for children’s health advocates.
Jane Meschan Foy, MD, of the American Academy of Pediatrics, spoke to the basics of mental health services and the Medicaid population. Currently, one out of every three children in the United States depends on Medicaid, and Medicaid is the single largest payer of mental health services in the country. Foy also spoke to the importance of early intervention and the need to recognize pediatric mental health disorders, as 21% of children and adolescents in the U.S. meet diagnostic criteria for Mental Health disorders. She additionally spoke to problems with access as only 20-25 percent of these children receive treatment, and 40-50 percent terminate services prematurely.
The Children’s Hospital Association was represented on the panel by Robert Hilt, MD, of Seattle Children’s Hospital, who spoke to ways to improve quality and contain costs through the Medicaid program. Specifically he spoke about a program organized and run by Seattle Children’s Hospital in coordination with Medicaid in Washington State that provide antipsychotic medication reviews, through the Partnership Access Line (PAL). PAL has seen average savings in expenditures of about $300,000 a month in the first two years and has reduced the number of anti-psychotic medications prescribed to children in the program. He additionally spoke to the need for encouraging increased access to mental health services through programs provided by PAL through education to primary care doctors in Washington and Wyoming.
The third presenter, Steve Tuck, spoke to personal experiences of children in foster care in West Virginia who rely on Medicaid. He shared the story of a child named Josh who was placed in foster care at age three, separated from his siblings and suffered from multiple mental health issues. However, thanks to mental health interventions that were paid for by Medicaid, Josh has since been adopted, his behavior has significantly improved, and he is a happy, healthy six year old. Josh’s story is important as it showcases how early interventions can reduce the likelihood that a child will require lifetime mental health services, a common problem for children in the foster care system.
The final presenter, Beth Morrow of The Children’s Partnership, discussed the big picture problems involved with mental health Medicaid coverage for children in foster care. Morrow spoke to the fact that Medicaid is the health provider of first and last resort for this population, as over 70 percent of children entering foster care already receive Medicaid. In addition, the average cost of Medicaid per child in foster care is over three times the average cost for nondisabled children. This difference is explained mostly by the fact that nearly 70% of children in foster care exhibit moderate to severe mental health problems. Morrow ended her presentation by discussing successful Health IT programs across the nation which are working to create “medical passports,” for children in foster care to increase both quality and access to mental health services for this population, bringing home the point that Congress must protect Medicaid in order to protect the health of vulnerable populations like these children.
The next briefing, scheduled for Friday July 13 at 3 PM EDT in HVC-200, will focus on reducing red tape in the Medicaid program. For more information visit our website.
For More Information Contact: Gillian Ray, Director of Public Relations,
Children’s Hospital Association, 703-797-6027, [email protected]
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