One of the most successful innovations in pediatric behavioral health access has been co-located primary care services.
Under this model, a social worker co-locates at the primary care office and can see patients as referred directly from the pediatrician. Through this innovation children and adolescents get prompt and qualified help, as soon as concerns are noted.
The co-located clinician can then refer the patient to more appropriate long-term support, if appropriate. This process works, and my own family has benefited directly from this model.
Access to mental health care remains one of the most systematic and harmful gaps within the health care system of the United States.
More heartbreaking, current Medicaid rules exclude some patients from this co-located model because providers cannot bill Medicaid twice on the same day. This means that a child enrolled in Medicaid who sees their pediatrician and learns of a mental health need, has to come back on a different day in order to see the co-located provider. While all families have enormous stressors of their time, families on Medicaid could have even more unforgiving schedules and less flexible jobs. The prohibition on same-day billing further creates a gap in care by making mental health care for children less accessible in this manner.
Recently Congressional Representatives Dunn (FL-02) and Craig (MN-02) have taken steps to fix this gap, in introducing the Improving CARE for Youth Act into the House of Representatives in Washington, which allows for same day billing mental health Medicaid providers. This important step, if passed, will remove a pointless barrier to children’s mental health and lead to more kids getting the prompt care that they need for behavioral health conditions.
We are excited about this potential change to help bridge the gap to quality care for children and provide better immediate access to care for the behavioral health needs of children on Medicaid.
To learn more about the mental health care access issues facing the 40 million children under 18 on Medicaid & CHIP, refer to our ebook: Expanding Access to Pediatric Mental Health Care
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