Many families of children and youth with special health care needs (CYSHCN) depend on public benefit programs like Medicaid and the Children's Health Insurance Program (CHIP) to pay for their child's health-related services. Medicaid and CHIP both provide coverage with little or no cost-sharing for families. Medicaid is particularly important to CYSHCN because enrollees under the age of 21 are entitled to Early Periodic Screening, Diagnosis and Treatment (EPSDT), which is designed to assure preventive treatment and to promote early diagnosis and treatment of identified health needs.  In addition to EPSDT, Medicaid offers a wide array of services to CYSHCN, such as Home- and Community-Based Service (HCBS) waivers which allow CYSHCN who meet an institutional level of care to live at home with the right supports.

As our nation slowly recovers from the worst recession since the 1930s, many families continue to face financial challenges after becoming unemployed. In October of 2010, the national unemployment rate was 9.6 percent - up from 6.6 percent in 2008.[1] Many adults who lose their jobs also lose access to their family's employer-sponsored health insurance, putting families at risk for uninsurance at a time when they are less able to afford out-of-pocket health care costs. Fortunately, need-based public benefit programs such as Medicaid were created as a vital safety net to help pay for health care in the wake of economic challenge. This safety net appears to be working for children in general and CYSHCN in particular.  While the percentage of people under the age of 65 without health insurance increased from 17.3 percent in 2008 to 18.8 percent in 2009, uninsurance rates for children under 18 remained stable[2]  - with much of the credit going to public benefit programs like Medicaid and CHIP.[3]  Thanks to these programs, the risk to would-be uninsured families that their child's health status would worsen because of delayed or missed care was lowered.

COMING SOON

A New Catalyst Center White Paper:

Financing the Mental Health Care of

Children with Serious Mental Health Treatment Needs

Children with serious mental health treatment needs comprise a special population of CYSHCN.[1]  Like other CYSHCN, they often face significant barriers to accessing affordable health care but coverage for treatment and services related to mental health can be particularly scarce. As a result, the mental health care they need to play, learn and grow to their fullest potential frequently goes unmet or unreimbursed, putting their families at risk for significant financial hardship.

In an upcoming white paper, the Catalyst Center will examine the barriers faced by children with serious mental health treatment needs and their families in accessing affordable mental health care, and the resultant negative consequences these barriers have on the health and well-being of these children and on the financial stability of their families. The paper will map out the various public options states can offer to expand coverage of mental health services, and discuss the advantages and drawbacks of each. In addition, the white paper will include a section on the potential impact of the Patient Protection and Affordable Care Act (ACA), also known as federal health reform, on children with mental health treatment needs and their families. 

While important legislation like the Mental Health Parity and Addiction Equity Act of 2008 has worked to make a difference, historically children with serious mental health treatment needs have been underrepresented in efforts to expand and improve both private and public health insurance options. It is critical that the unique needs of this population of CYSHCN not be forgotten as our nation moves forward with a revamped health insurance system. We hope the Catalyst Center's upcoming white paper will shed some light on these issues and serve as a conversation starter for both policymakers and advocates in their work to improve coverage and financing of care for CYSHCN. Look for the announcement of this paper's publication in an upcoming issue of the E-newsletter and on our website!

 Call for perspectives "from the field" 

Have you encountered policy issues related to coverage and financing of care for children and youth with serious mental health treatment needs that you think should be addressed in our white paper?

Do you know of successful best practices in coverage and financing for children's mental health services that we should be aware of?

If so, we want to hear from you!  Please e-mail your comments and suggestions to Emily Winter, Catalyst Center Research Assistant at ewinter@bu.edu by December 15. Thank you!