Jessica Keim-Malpass PhD, RN, Leeza Constantoulakis PhD, RN, Emily K. Shaw MSN, CPNP-BC, Lisa C. Letzkus PhD, RN, CPNP-AC
{"title":"通过家庭和社区医疗补助豁免,儿童和青少年的心理健康服务覆盖面滞后","authors":"Jessica Keim-Malpass PhD, RN, Leeza Constantoulakis PhD, RN, Emily K. Shaw MSN, CPNP-BC, Lisa C. Letzkus PhD, RN, CPNP-AC","doi":"10.1111/jcap.12392","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Problem</h3>\n \n <p>Many states cover mental health home and community-based services (HCBS) for youth through 1915(c) Medicaid HCBS waivers that allow states to waive certain Medicaid eligibility criteria and define high-risk populations based on age, medical condition(s), and disability status. We sought to evaluate how States are covering children and adolescents with mental health needs through 1915(c) waivers compared to other youth waiver populations.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Data elements were extracted from Medicaid 1915(c) approved waivers applications for all included waivers targeting any pediatric age range through October 31, 2018. Normalization criteria were developed and an aggregate overall coverage score and level of funding per person per waiver were calculated for each waiver.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>One hundred and forty-two waivers across 45 states were included in this analysis. Even though there was uniformity in the Medicaid applications, there was great heterogeneity in how waiver eligibility, transition plans, services covered, and wait lists were defined across group classifications. Those with mental health needs (termed serious emotional disturbance) represented 5% of waivers with the least annual funding per person per waiver.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>We recommend greater links between public policy, infrastructure, health care providers, and a family-centered approach to extend coverage and scope of services for children and adolescents with mental health needs.</p>\n </section>\n </div>","PeriodicalId":46587,"journal":{"name":"Journal of Child and Adolescent Psychiatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/99/JCAP-36-21.PMC10087945.pdf","citationCount":"1","resultStr":"{\"title\":\"Lagging coverage for mental health services among children and adolescents through home and community-based Medicaid waivers\",\"authors\":\"Jessica Keim-Malpass PhD, RN, Leeza Constantoulakis PhD, RN, Emily K. Shaw MSN, CPNP-BC, Lisa C. Letzkus PhD, RN, CPNP-AC\",\"doi\":\"10.1111/jcap.12392\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Problem</h3>\\n \\n <p>Many states cover mental health home and community-based services (HCBS) for youth through 1915(c) Medicaid HCBS waivers that allow states to waive certain Medicaid eligibility criteria and define high-risk populations based on age, medical condition(s), and disability status. We sought to evaluate how States are covering children and adolescents with mental health needs through 1915(c) waivers compared to other youth waiver populations.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Data elements were extracted from Medicaid 1915(c) approved waivers applications for all included waivers targeting any pediatric age range through October 31, 2018. Normalization criteria were developed and an aggregate overall coverage score and level of funding per person per waiver were calculated for each waiver.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>One hundred and forty-two waivers across 45 states were included in this analysis. Even though there was uniformity in the Medicaid applications, there was great heterogeneity in how waiver eligibility, transition plans, services covered, and wait lists were defined across group classifications. Those with mental health needs (termed serious emotional disturbance) represented 5% of waivers with the least annual funding per person per waiver.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>We recommend greater links between public policy, infrastructure, health care providers, and a family-centered approach to extend coverage and scope of services for children and adolescents with mental health needs.</p>\\n </section>\\n </div>\",\"PeriodicalId\":46587,\"journal\":{\"name\":\"Journal of Child and Adolescent Psychiatric Nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2022-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/99/JCAP-36-21.PMC10087945.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Child and Adolescent Psychiatric Nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jcap.12392\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child and Adolescent Psychiatric Nursing","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jcap.12392","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Lagging coverage for mental health services among children and adolescents through home and community-based Medicaid waivers
Problem
Many states cover mental health home and community-based services (HCBS) for youth through 1915(c) Medicaid HCBS waivers that allow states to waive certain Medicaid eligibility criteria and define high-risk populations based on age, medical condition(s), and disability status. We sought to evaluate how States are covering children and adolescents with mental health needs through 1915(c) waivers compared to other youth waiver populations.
Methods
Data elements were extracted from Medicaid 1915(c) approved waivers applications for all included waivers targeting any pediatric age range through October 31, 2018. Normalization criteria were developed and an aggregate overall coverage score and level of funding per person per waiver were calculated for each waiver.
Findings
One hundred and forty-two waivers across 45 states were included in this analysis. Even though there was uniformity in the Medicaid applications, there was great heterogeneity in how waiver eligibility, transition plans, services covered, and wait lists were defined across group classifications. Those with mental health needs (termed serious emotional disturbance) represented 5% of waivers with the least annual funding per person per waiver.
Conclusions
We recommend greater links between public policy, infrastructure, health care providers, and a family-centered approach to extend coverage and scope of services for children and adolescents with mental health needs.
期刊介绍:
Journal of Child and Adolescent Psychiatric Nursing (JCAPN) is the only nursing journal to focus exclusively on issues of child and adolescent mental health around the world. As a primary resource for nurses and other healthcare professionals in clinical practice, educator roles, and those conducting research in mental health and psychiatric care, the journal includes peer-reviewed, original articles from a wide range of contributors in a broad variety of settings.