Financing

The Administrator’s section on Assessing Financial Readiness refers to a report on Public Financing of Home and Community Services for Children and Youth with Serious Emotional Disturbance: Selected State Strategies (Ireys et al., 2006).This monograph provides information about sources of federal funding for child mental health services and profiles state approaches to financing home and community based services, which could include evidence-based practices. States are profiled by type of reform being implemented (broad statewide financing reforms or incremental reform), policy context and program characteristics, financing issues, and lessons learned. This is a valuable resource describing strategies and advantages and disadvantages of particular strategies, which could be considered by other states. Some of the financing strategies include:

• Pooling or braiding funds from mental health and other state agencies for the state’s Medicaid match to expand federal dollars
• Use of the Medicaid rehabilitation services option to expand coverage for mobile response and stabilization, in home services, and intensive case management
• Behavioral health care administered by a single purchasing collaborative
• Medicaid home and community-based waiver for specific target populations
• Combined Medicaid home and community based waiver and rehabilitation service option

Much has also been published on the approaches used to finance the local Milwaukee Wraparound Program, which uses managed care and blended funds from mental health, child welfare, and juvenile justice; and has diverted large numbers of children from institutional care.

Another helpful resource on financing was developed by the Bazelon Center for Mental Health Law (2003). It is called Teaming Up: Using the IDEA and Medicaid to Secure Comprehensive Mental Health Services for Children and Youth. For mental health administrators that may not know how IDEA can support therapeutic services and support, this report is very informative in describing the benefits and limitations of IDEA as a school-based entitlement and in providing examples of litigation involving IDEA and Medicaid.