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California PACEs Action

New Brief: Securing the promise of the Medi-Cal entitlement for our children’s mental health [cachildrenstrust.org]

 

We are thrilled to announce a new and important national policy brief: Coverage of Services to Promote Children’s Mental Health, developed in partnership with Mental Health America and the Well Being Trust. The paper expertly lays out an analysis of how current state Medicaid and commercial health insurance payment policies fail to adequately reimburse for effective interventions to promote positive child and family mental health. It underscores that this failure violates current law and most significantly, that our children and youth are paying the price.

Read the Brief

The issue, as detailed in this policy brief, is that vital federal protections are being  overlooked or altogether violated.  Medicaid (Medi-Cal in California) set the standard for children’s mental healthcare by ensuring coverage for early and periodic screening, diagnostic, and treatment services (EPSDT). By law, plans must cover comprehensive screening services and health education, in addition to diagnostic services, treatment, and other measures necessary to address issues identified during screening for all children up to the age of 21.

The need to access these resources and services is critical, now more than ever, when we are seeing dramatic increases in suicide and other indicators of a mental health crisis. In a June CDC study, 1 in 4 youth ages 18 to 24 said they had "seriously considered" suicide in the past 30 days— more than twice as many as in any other age group. And nationally, during the pandemic from April through October 2020, mental health-related emergency department visits for youth under the age of 18 rose by 31% compared to a similar time frame in 2019.

Centering race and class is essential to any response at scale. Eighty-one percent of children on Medicaid are black or brown, and the suicide rate for black children, aged 5-12 is twice that of their white peers. Addressing disproportionality and ensuring that public mental health systems fulfill their promise to children and youth is essential to redressing racialized - and racist - structures and outcomes. 

California Children’s Trust is committed to putting a spotlight on the unfulfilled promise of Medi-Cal funding and leveraging these underutilized resources to address the striking acuity of the children’s mental health crisis, which has been exacerbated by the pandemic.

We remain committed to high leverage actions:

  • Maximize Medicaid dollars by claiming against what we are already spending, including EPSDT.
  • Remove diagnosis as a requirement for treatment so every child who needs and deserves mental and emotional support has immediate and ongoing access.
  • Ensure compliance by Medi-Cal Managed Care Organizations (MCO) to deliver required preventive mental health services to all youth.
  • Center schools and child serving systems in culturally relevant models of care that increase access and agency, including peer to peer and social models.

To support the advocacy necessary to fulfill this promise, CCT will release a companion brief in January 2021, along with our partners National Center for Youth Law and National Health Law Program. That brief will focus on the specific changes needed in California to meet Medi-Cal’s obligation to fulfill its entitlement to children’s mental health services. Additionally, it will be an essential resource during the Medi-Cal managed care re-procurement process, the first opportunity in 20 years to ensure MCOs are accountable for providing children and youth with mental health prevention and treatment services.

CCT also recently partnered with The California Alliance for Children and Family Services on a foundational seminar with nearly 175 behavioral health providers to underscore the role and largely untapped scope of Medi-Cal managed care. Visit our blog for a link to the video.

Stay tuned and stay engaged with us as we work to reimagine children’s mental health systems, centering them on equity and justice.

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