Position:
Children and youth with complex social, emotional and substance
abuse diagnoses have a right to timely, appropriate treatment
and intervention. The circumstances of these children and youth
who are at risk, or who are adjudicated as dependent or delinquent,
are compounded by additional challenges in assessing their needs
and accessing services. In Pennsylvania, there is a rich array
of programs and services to address these needs with the majority
of such supports provided by private agencies. Costs continue
to escalate due to increasingly complex service needs, regulatory
and accreditation mandates, multiple and often duplicative documentation
and outcome requirements, and application of CASSP Principals
and best practice standards. Public funds appropriated for purchase
of services must be adequate to support provision of quality
services at financially sustainable levels.
Behavioral Health
Care Services:
The current primary source of funding for behavioral health
care services for children and youth who are also receiving
services through the child welfare and juvenile justice systems
remains medical assistance. Variations in process and practice
between managed care and fee for service systems present challenges
and barriers for providers.
Current categorical classifications, approval processes and
rate adjustment procedures hinder providers' efforts to meet
the unique needs of these children.
Core Principles:
Interventions and treatment for the behavioral health care
needs of children at risk or who have experienced abuse or
neglect are public mandates. Adequate funding and responsible
rate negotiation practices must follow.
The public funding
mechanisms for such services must address actual costs related
to:
· compliance with federal and state regulations
· standards for most appropriate/medically necessary
levels of care/interventions
· individualized treatment plans, and
· coordination with child welfare and juvenile justice
system goals and outcomes
While consideration
must be given to the least restrictive, least intrusive, and
most cost effective alternatives, service plans must address
what is most appropriate and realistic given the individualized
needs and strengths of children and families as well as community
resources.
The practice of
creating unfunded mandates must be eliminated. Punitive and/or
undisclosed practices related specifically to initial rate
determination and subsequent rate adjustments are not acceptable.
Private agencies, which actually provide the majority of services,
must be included as partners in the planning and funding discussions
with the public funders to insure quality outcomes and a responsive
service array.
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