California officials act to ensure Medicaid entitlement to children’s mental health care
In a call yesterday with Young Minds Advocacy Project’s Patrick Gardner and provider representatives Carroll Schroeder and Rusty Selix, California health care officials confirmed that counties that “overspend” on children’s mental health will be reimbursed from Realignment growth funds beginning with repayments of FY 2011-12 expenditures. California Health and Human Services Agency and Department of Health Care Services leaders confirmed that $8 million is expected to be paid to eight counties that overspent their allocation for EPSDT and drug Medi-cal programs. EPSDT, or Early Periodic Screening Diagnosis and Treatment, is the children’s Medicaid program (called Medi-Cal in California) that requires counties to provide medically necessary mental health services to all eligible youth. Counties will also receive about $20 million in additional growth funds for their behavioral health programs.
The state’s Realignment funding decision signals an important victory for young people and families in California with mental health needs. According to Mr. Gardner, “reimbursing counties for all of their EPSDT expenditures will increase investment in children’s mental health, and improve access to care for hundreds of young people and families with unmet mental health needs.” In addition to making a commitment to reimburse EPSDT spending with growth funds, the state reaffirmed that Realignment legislation did not limit or “cap” the EPSDT entitlement. Also, county “Maintenance of Effort” spending, which amounts to $50 million or more annually, continues to be required as matching funds for children’s mental health services. State officials also are committing to improve program equity and accountability by linking future funding to performance standards. Agency officials plan to release the growth fund allocation formula and future funding guidelines early next week in two All County Information Notices.
The commitments announced yesterday are also a victory for children’s mental health stakeholders who spent more than two years advocating to preserve the EPSDT entitlement and to increase investment in mental health services for children and youth.
This positive result is not the end of the road, however. Indeed, we hope it is just the beginning of a long-term collaborative partnership by advocates, mental health care providers, families and young people to:
- Increase access to individualized care
- Improve quality and effectiveness of care
- Heighten accountability
- Ensure collaboration among agencies and providers
- Promote family and youth engagement, and
- Secure better outcomes for families and young people with mental health needs.
For more information about this issue read our past posts about advocacy efforts around preserving EPSDT for youth.