The ECFC Early Relational Health (ERH)Workgroup explored opportunities for supporting early relational health through Medicaid and EPSDT with with Elisabeth Wright Burak, Senior Fellow, Center for Children and Families (CCF) Georgetown University McCourt School of Public Policy, Health Policy Institute. Among the challenges and opportunities we explored:
- Strategies for using doulas to improve maternal health.
- Assessment/diagnostic strategies for supporting dyadic treatments
- Billing/coding challenges for ERH related diagnosis and treatment
Several opportunities for supporting ERH through American Rescue Plan funds. Read: Implementing Medicaid’s new 12 month postpartum option (CCF blog); American Rescue Plan health coverage provision that will strengthen public and private health insurance (CCF blog). Child Health Transformation and a Relational Health Workforce by InCK Marks also outlines unprecedented opportunities in the American Rescue Plan Act to advance children’s, and particularly young children’s, healthy development.
Related Resources on Strategies to Support ERH in Medicaid:
- Using Medicaid to Ensure the Healthy Social and Emotional Development of Infants and Toddlers (2018)
- How States Use Medicaid to Cover Key Infant and Early Childhood Mental Health Services: Results of a 50-State Survey (2018 Update)
- Supporting Social-Emotional and Mental Health Needs of Young Children Through Part C Early Intervention: results of 50 state survey of Part C Directors, CCF and National Center for Children in Poverty (2020)
- National Academy for State Health Policy, Four State Strategies to Employ Doulas to Improve Maternal Health and Birth Outcomes in Medicaid (2020) includes examples from Indiana, Minnesota, Oregon, Nebraska.
- Babies Don’t Go to the Doctor By Themselves: Innovating a Dyadic Behavioral Health Payment Model to Serve the Youngest Primary Care Patients and Their Families, May 2020, California Children’s Trust (includes: page 14 – billing codes used by CA Healthy Steps related to dyadic behavioral health services; page 21 –Potential Healthy Steps Billing Opportunities for State Medicaid Agencies’ Consideration (and examples from other states)
- Pediatrics Supporting Parents (PSP) is addressing key structural barriers affecting young children’s health with concrete tools and guidance while also making the case for system-wide transformation of the well-child visit. During the first three years, PSP and partners extracted a set of 14 common practices for promoting social and emotional development from evidence-based programs. In addition, the initiative’s policy work prioritized reimbursement and public financing by unlocking the funding potential of Medicaid and the Children’s Health Insurance Program (CHIP) through the creation of a Blueprint and multi-state National Medicaid Workgroup. A complementary Guide to leveraging opportunities between Title V and Medicaid was developed to support state-level planning, action, and innovation to promote social and emotional development. PSP is working in nine states to provide TA, but hearing that tools like the Blueprint are being used in other states to change policy.
- ZERO TO THREE launched the Infant and Early Childhood Mental Health Financing Policy Project (IECMH-FPP) in 2016 with support from the Irving Harris Foundation, Robert Wood Johnson Foundation, Alliance for Early Success, and University of Minnesota to support states’ advancement of IECMH policies that will contribute to the healthy development of young children.
- National Center for Children in Poverty PRiSM project (Promoting Research-informed State IECMH Policies and Scaled Initiatives) highlights state policies, and profiles exemplary IECMH strategies used in state policies and scaled initiatives. For example, state profiles that include opportunities we discussed: Dyadic Treatment: Arkansas, Colorado, Connecticut, Florida, New Mexico, Oregon; Maternal Depression Screening and Response: Louisiana, Massachusetts, Michigan, New York, North Carolina.
- Aligning Early Childhood and Medicaid is a a national initiative made possible by the Robert Wood Johnson Foundation and led by CHCS, in partnership with ZERO TO THREE, the National Association of Medicaid Directors, Social Determinants of Health Consulting, and the Public Leadership Group.