Abstract
Integrating early childhood mental health services into primary care settings holds promise for increasing access to high quality healthcare services. Such services have the potential to prevent the development of later difficulties, promote health and well-being, identify early difficulties and address them when they first emerge, and treat disruptions and disorders in early childhood, including family-level factors that impact development. Establishing sustainable integrated early childhood behavioral health services requires leveraging resources and braiding and blending funding streams to create a comprehensive model of care that will meet the needs of young children and their families. Long-term sustainability depends upon advancing the “Four Ps”: procedures, practice, payment, and policy. This chapter details procedures for service delivery and billing that comply with healthcare regulations and allow continued growth and program innovation and characterizes the unique elements within the practice of integrated early childhood mental health services including a focus on prevention, health promotion, and universal access to high-quality care. In the current landscape of rapid healthcare reform and transformation, payment and compensation for services rendered and future innovations in service delivery are integrally linked to policy changes that are designed to secure integrated early childhood services. Beyond fee-for-service options, truly sustainable integrated early childhood behavioral health will likely rely on bundled payment models where early childhood mental health services are packaged within high-quality primary care for children, and capitated/per member per month (PMPM) rates reflect investments in prevention, health promotion, psychosocial screening processes, and interventions.
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Acknowledgements
Rose Community Foundation, The Colorado Health Foundation, Caring for Colorado Foundation, Walton Family Foundation, Denver Post Season to Share, Roots and Branches of the Rose Community Foundation, and the Irving Harris Foundation generously provided funding for efforts described in this chapter. Healthy Steps for Young Children is supported with funding from the Health Resources and Services Administration and from the Departments of Psychiatry and Pediatrics, University of Colorado School of Medicine. Thank you to our colleagues Lee Savio Beers, M.D., Leandra Godoy, Ph.D., and Sarah Barclay Hoffman at the DC Collaborative for Mental Health in Pediatric Primary Care and New York’s Children’s Health Home Program for contributing On the Ground examples. We are grateful to the Irving Harris Program in Child Development and Infant Mental Health, the University of Colorado School of Medicine Departments of Pediatrics and Psychiatry, Children’s Hospital Colorado, and the Pediatric Mental Health Institute. Finally, we are grateful to the providers, staff, and families in the Child Health Clinic at Children’s Hospital Colorado and our Project CLIMB team members for their contributions and ongoing support.
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Talmi, A., Buchholz, M., Muther, E.F. (2016). Funding, Financing, and Investing in Integrated Early Childhood Mental Health Services in Primary Care Settings. In: Briggs, R. (eds) Integrated Early Childhood Behavioral Health in Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-31815-8_9
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