Compiled by Michelle Cassell
The North Carolina Department of Health and Human Services announced its plans for improving youth behavioral health in North Carolina and is leveraging the historic investment from the NC General Assembly to ensure everyone receives the care they need when and where they need it. One of the key initiatives is the Children and Families Specialty Plan — a first-of-its-kind statewide health plan to ensure access to comprehensive physical and behavioral health services for Medicaid-enrolled children, youth and families served by the child welfare system. NCDHHS released an updated policy paper about the plan on Wednesday, as NCDHHS prepares to launch the plan later this year.
“Too many children are struggling to access the mental health care and support they need to thrive — stuck in cycles of conflict at school, in emergency rooms without access to necessary care and sleeping in child welfare offices,” said Health and Human Services Secretary Kody H. Kinsley. “The Children and Family Specialty Plan is a first-of-its-kind innovation and part of our broader strategy to improve youth behavioral health and secure a healthy future for generations of North Carolinians.”
Based on recent data, one in five high school students in North Carolina has seriously considered suicide. This percentage has been increasing over the last decade. During the pandemic, the rate of children discharged from an emergency department with a behavioral health condition increased by as much as 70%. Nationally, children and youth in foster care use both inpatient and outpatient mental health services at a rate 15 to 20 times greater than that of the general pediatric population and approximately 60% have a chronic medical condition. Without adequate support, these conditions can persist and negatively impact short- and long-term health outcomes into adulthood.
“Only by investing in the comprehensive needs of children and families can we realize our vision that all children have the opportunity to develop to their full potential and thrive,” said Susan Osborne, NCDHHS Deputy Secretary for Opportunity and Well-Being. “This Children and Family Specialty Plan will ensure the key services that children and families with complex needs receive are better coordinated and consistently delivered no matter where they are in the state. From the child welfare system, to schools, to health care settings, the plan’s design will help children and families receive the right services at the right time.”
With the recent approval from the NC General Assembly to move forward, the expected launch date of the Children and Families Specialty Plan is later this year. A request for proposal will be issued in the coming weeks to hire the organization that will help manage the Children and Families Specialty Plan. On the first day the new health plan launches, it is expected that tens of thousands of children will be automatically enrolled in services. Those who will be automatically enrolled include children in foster care, children receiving adoption assistance, and former foster care youth under the age of 26.
The plan will cover an array of Medicaid-covered physical and behavioral health benefits regardless of the geographic location or situation the beneficiary is experiencing. This includes all services provided by the Standard Plan in addition to most Tailored Plan services. It also includes a broad range of behavioral health services such as outpatient therapy, inpatient treatment, and crisis and therapeutic residential options for children. Additionally, the Children and Families Specialty Plan will be responsible for addressing unmet health-related resource needs, including housing, food, transportation, and interpersonal violence.
In addition to the Children and Families Specialty Plan, $208.9 million from the 2023-2025 budget is targeted towards child and family well-being and includes a package of services that will prevent children from remaining in inappropriate settings like emergency departments and DSS offices while providing additional support for them and their families. This also includes the expansion of the NC Psychiatric Access Line that provides children and staff in K-12 schools with direct access to psychiatric experts to address mental and behavioral health concerns that students and staff are experiencing.
A separate $80 million is allocated towards other behavioral health service improvements for children and their families. These include specialty treatment programs for children with complex behavioral health needs and intensive support for children and families in the community.
Key outcomes for these investments in children’s behavioral health in 2024 and beyond are:
Fewer children will experience behavioral health crises because there will be more early intervention and prevention services to meet them where they are in communities and schools.
When children do experience a crisis, there will be faster, better ways to get them help.
Inpatient psychiatric hospitals’ capacity will better meet the demand thanks to a stronger and better-compensated workforce and more step-down options to less intensive care.
Fewer children will be “living” in emergency departments and DSS offices because more prevention services and more appropriate placements will be available.
NCDHHS continues its collaboration with county partners and providers to achieve the right care at the right time for children, youth and families across North Carolina.
Michelle Cassell is a seasoned reporter who has covered everything from crime to hurricanes and local politics to human interest over the course of 35 years. As managing editor, she hopes to encourage writers of a wide range of backgrounds and interests in TLR’s coverage of Southern Orange County news.