State Approaches to Funding Home and Community-Based Mental Health Care for Non-Medicaid Youth: Alternatives to Medicaid Waivers

Graaf, Genevieve; Snowden, Lonnie R.

doi:10.1007/s10488-019-00933-2

Cited by 16 publications

(6 citation statements)

References 44 publications

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“…Services include screening, diagnosis, and treatment (including individual counseling and group therapy) for both adults and children. Another example of health care systems and community collaborations meeting this need can be seen through Home and Community Based Services (HCBS) Medicaid waivers, 33 which extends the reach of Medicaid (public health care insurance for low-income residents) to provide mental health services for youth whose family incomes exceed the Medicaid limit.…”

Section: Discussionmentioning

confidence: 99%

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

Chambers

Heller

Fiori

et al. 2020

Global Pediatric Health

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This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Youth (ages 2-17 years) in a large urban health system were identified and categorized into two housing types—public housing (n = 10 770) and not in public housing (n = 84 883) by age (young childhood, middle childhood, young adolescence). The prevalence of some pediatric conditions was higher in public housing but varied by age. Disparities in health conditions among youth in public housing were more common in early adolescence: asthma (26.4 vs 18.6; P < .001); obesity (28.5 vs 24.6; P < .001); depression/anxiety (19.2 vs 17.3; P = .008); behavioral disorders (8.1 vs 5.3; P < .001). These results show that chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing. However, this pattern is not consistent across all chronic conditions.

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Section: Discussionmentioning

confidence: 99%

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

Chambers

Heller

Fiori

et al. 2020

Global Pediatric Health

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“…Threshold aspects of assessment include understanding the guidelines and policies that shape the gatekeeping functions dictating eligibility, intake, and discharge practices and how these operate across each level of a social service system (e.g., outpatient, inpatient, long-term care) (Miles & Goetz, 1999). Relational assessment of macro-level relations include how organizational or professional guidelines, policies, and practices interact with each other and with key referral systems in the community, including the health, behavioral health, disability, housing, education, child and elder welfare, and carceral sectors (Bell et al, 2019; Graaf & Snowden, 2019, 2020). Further, attention should be paid to how the social service workforce reflects the communities being served.…”

Section: Application Of Place-based Principles In Social Work Practicementioning

confidence: 99%

“…For example, states or counties may mandate that intake appointments take place within 7 days of a service request, or that referrals to a service result in a first contact within 24 hours of referral (National Academies of Sciences et al, 2018). Funding allocations with timed boundaries affects service capacity (and as a result, accessibility), as many local communities expend their annual block grant or state general fund allocation for services six months into their fiscal year (Graaf & Snowden, 2019). Related mandates, and their enforcement through documentation and reporting requirements, set the criteria for threshold features of service including service eligibility, intake processes, assessment requirements, and expectations for discharge (Graaf & Snowden, 2020).…”

Section: Application Of Place-based Principles In Social Work Practicementioning

confidence: 99%

“…Relational aspects of social work, such as considering the extent to which the workforce reflects the identities of those being served, characteristics of interorganizational collaboration, or centering of participant voice in the design and delivery of services, are shaped at the macro-level through the formal and informal state or county policies and licensing regulations. Funding structures and governmental mandates incent or discourage workforce demographics and social service interorganizational collaboration (Barth et al, 2019; Graaf & Snowden, 2019; Johnson-Kwochka et al, 2020) or formally engaging and incorporating participant voice into service planning and continuous quality improvement efforts (Maglić et al, 2021).…”

Section: Application Of Place-based Principles In Social Work Practicementioning

confidence: 99%

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Orienting social work to incorporate place-based principles: A practical guide to the use of place in social work practice

Ratliff

Graaf

Choy-Brown

2023

Journal of Social Work

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Social work has long history with practice in diverse places. Indigenous social work traditions have long been grounded in place and land. There has been little attention to the role of place in Western and Northern social work practices. Place-based theories attend to the fundamental role of place in social work practice and provide principles that social workers can use to recognize place in their practice. There has been little practical guidance on how social workers can apply these principles to identify and modify place-based levers for improving practice and outcomes within Western contexts. To address these gaps and advance the use of place in practice, principles of place-based power dynamics are described here in relation to the micro, mezzo, and macro levels of the key areas of social work practice: assessment, intervention, and evaluation. Place-based principles of form, function, location, time, threshold, and relations, provide a framework that social workers can incorporate into social work practices at all levels and throughout social work practice phases. Social workers can use these principles to examine how social work practice can better assess, intervene, and evaluate the role of place in the social environment and in the daily lives of the participants and populations they serve. Incorporating place-based principles can illuminate malleable place-based levers to fit the needs of service users. Attending to place in social work practice can also heighten practitioners’ awareness of power and decision-making to identify and intervene at the root causes of social problems.

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“…Among children and youth with co‐existing medical complexity or multimorbidity, the prevalence of children and adolescents with concurrent SED is estimated to be between 30% and 50% (Einfeld et al, 2011 ). Children and adolescents with severe impairments either from SED alone or SED along with medical complexity need access to intensive services to be able to remain in home and community‐based settings (Graaf & Snowden, 2019 ; Graaf et al, 2021 ). Care delivered in the home and community‐based setting is a critical place of treatment for many SED, children with medical complexity (CMC), and other developmental disabilities (Barnert et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

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

Keim‐Malpass

Constantoulakis

Shaw³

et al. 2022

Child Adoles Psych Nursing

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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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State Approaches to Funding Home and Community-Based Mental Health Care for Non-Medicaid Youth: Alternatives to Medicaid Waivers

Cited by 16 publications

References 44 publications

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

Orienting social work to incorporate place-based principles: A practical guide to the use of place in social work practice

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

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