Mental Health and EPSDT: Title V - EPSDT Partnerships
State Title V agencies that have taken on important roles in EPSDT can increase attention paid to children’s mental health needs. Title V agencies that have been delegated tasks designed to ensure access and receipt of the full range of screening, diagnostic and treatment services can take steps to ensure that mental health is included in screening, diagnosis and treatment. A few States have included children’s mental health among their Title V Needs Assessment Priorities (e.g., Oregon).
Examples below describe some specific activities undertaken by Title V agencies:
Family Support Activities
- Assist with eligibility and enrollment for Medicaid, and in navigating access to pediatric mental health services.
- Assist with applications for services from IDEA Parts B and C, and the State mental health authority.
- Employ case managers with expertise in children’s mental health and make them available to coordinate service delivery for children whose special health care needs include behavioral health problems.
- Ensure Children with Special Health Care Needs (CSHCN) gain access to mental health services and family counseling.
- Assist in the design and implementation of family support services capable of meeting the needs of families with a child who has a serious emotional disturbance. In particular, understand and promote wraparound services.
- Work collaboratively with family support organizations to reach families with children who have or are at risk for social-emotional and mental health problems.
Provider Related Activities
- Offer training about children’s mental health to Medicaid primary care providers and their office staff.
- Promote screening and surveillance to identify social-emotional and mental health conditions among children and youth.
- Work with Medicaid to encourage use of Bright Futures guidelines and periodicity schedules that include mental health screening for children and youth birth to 21.
- Work with pediatric provider organizations (e.g., Academy of Pediatrics) to sponsor training and ongoing technical assistance in use of validated screening tools in primary care offices.
- Disseminate recommendations and guidance regarding when to treat children’s behavioral health problems in primary care, and when to refer to specialty care. These may come from pediatric, mental health, or child welfare professionals.
- Develop guidance and tools for providers based on Bright Futures and EPSDT rules.
- Support quality improvement projects designed to increase developmental and mental health screening, referrals, and follow-up.
- Encourage use of early childhood mental health consultants in child care, Head Start, and other early care and education settings.
Activities Related to Managed Care
- Assist in developing Medicaid managed care contract provisions that address mental health as an integral part of total health care, and recognize the heightened risk for mental health problems experienced by certain groups disproportionately served in Medicaid, including foster children, children with disabilities, and poor children. (See sample contract purchasing specifications )
- Monitor the adequacy of managed care plan provider networks to meet the heightened needs and more severe problems experienced by some children within the Medicaid service population.
- Review medical necessity decisions using skilled medical personnel with expertise in maternity, pediatric, and mental health care.