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

IF 1.6 Q2 NURSING
Jessica Keim-Malpass PhD, RN, Leeza Constantoulakis PhD, RN, Emily K. Shaw MSN, CPNP-BC, Lisa C. Letzkus PhD, RN, CPNP-AC
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引用次数: 1

摘要

到1915年,许多州为青少年提供心理健康家庭和社区服务(HCBS) (c)医疗补助HCBS豁免,允许各州放弃某些医疗补助资格标准,并根据年龄、医疗状况和残疾状况定义高风险人群。我们试图评估与其他青少年豁免人群相比,各国在1915年(c)豁免期间是如何覆盖有心理健康需求的儿童和青少年的。方法从Medicaid 1915(c)批准的豁免申请中提取数据元素,包括截至2018年10月31日的所有儿童年龄段的豁免申请。制定了标准化标准,并计算了每次豁免的总覆盖范围得分和每个人每次豁免的供资水平。这项分析包括了45个州的142个豁免。尽管在医疗补助申请中存在一致性,但在豁免资格、过渡计划、服务覆盖范围和等待名单的定义上存在很大的差异。有精神健康需要(称为严重情绪障碍)的人占豁免人数的5%,每人每年获得的资助最少。我们建议加强公共政策、基础设施、卫生保健提供者和以家庭为中心的方法之间的联系,以扩大有心理健康需求的儿童和青少年的服务覆盖范围和范围。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Lagging coverage for mental health services among children and adolescents through home and community-based Medicaid waivers

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.

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来源期刊
CiteScore
2.90
自引率
6.70%
发文量
41
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.
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