More State Medicaid Programs Covering Infant and Early Childhood Mental Health Services

Good news: More state Medicaid programs covered infant and early childhood mental health screenings, diagnoses and treatments in 2018 than in 2017.

The results from the 2018 update of the National Center for Children in Poverty’s 50-state survey, “How States Use Medicaid to Cover Key Infant and Early Childhood Mental Health Services,” illustrate the growing recognition that investing in healthy emotional and social development in the early years sets the stage for the lifetime of development that follows.  Medicaid, as the insurer of four out of every five young children in poverty, has a key role to play in making sure these children start life with a strong social and emotional foundation.

The survey looks at Medicaid coverage and policies around several services for children age birth to 6, including screening for social-emotional problems, maternal depression screening in pediatric and family medicine settings, diagnosis codes specific to young children, mental health services in multiple settings, parent-child treatment, and parenting programs to address child mental health needs.

The comparison between 2017 and 2018 is encouraging. For almost every indicator, more states are adding services, and in some cases the increase is dramatic. For instance, the number of states covering maternal depression screenings during a child’s well visit with coverage under the child’s Medicaid jumped from 11 states in 2017 to 32 in 2018. Dyadic treatment, which incorporates parents and children in therapy together, is available in three more states and several states now allow the therapy to happen in more settings in 2018 than in 2017.

Still, there’s much room for improvement. Only 13 states allow providers to use diagnosis codes that specifically reflect symptoms of social or emotional delays in young children, known as the DC:0-5. Only one state, Nevada, requires it. Embedding the use of DC: 0-5 in state policy, especially for Medicaid, is a practical way for states to signal that they take the social and emotional development of young children seriously, and that providers should prioritize the emotional development of infants and toddlers equally to their physical health.

Similarly, only nine state Medicaid agencies pay for health navigators to help families connect with follow-up treatment needed as the result of a positive social or emotional health screening. This dot-connecting is critical to ensuring that once a screening happens, children and families can get the services they need to stay on a healthy development trajectory.

For anyone interested in furthering Medicaid’s support of health social and emotional development in young children, this survey offers the perfect starting place to find out what your state offers, how you compare to others and where to start the conversation in your state about how to improve.

Maggie Clark is a Program Director at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.