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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Behavioral Health Programs

Approach. Support state agencies to identify eligibility and connect children to appropriate behavioral health services

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Overview. Title V agencies in several states have developed ties to other agencies (e.g., Administrative Service Organizations, Intensive Care Management programs) and strategies, such as Medicaid waivers to provide services and supports that address the mental, behavioral, emotional, and substance use needs of children and youth with special health care needs. (CYSHCN).

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Boston University's Catalyst Center Financing Strategies Database

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Mental Health. This strategy promotes emotional, psychological, and social well-being of individuals and communities.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Referral and Follow-Up (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of partnerships established between Title V and behavioral health agencies. (Measures efforts to build cross-sector collaboration)
  • Number of Medicaid waivers for other strategies implemented to expand behavioral health services. (Quantifies policy and program changes to increase access)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of Title V staff demonstrating competence in behavioral health needs and resources. (Evaluates workforce knowledge and readiness)
  • Percent of behavioral health services that adhere to evidence-based practices and guidelines. (Assesses quality of care delivered)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of pediatric primary care providers trained to screen and refer for behavioral health issues. (Builds capacity for early intervention)
  • Number of children assisted by Title V to appeal denials for behavioral health services. (Measures support for coverage and access)

OUTCOME MEASURES:

  • Number of children diverted from higher levels of care (e.g. inpatient) due to timely receipt of outpatient behavioral health services. (Demonstrates prevention of crisis and costly care)
  • Number of families referred to support groups for other resources to help them care for a child with behavioral health needs. (Assesses linkages to family supports)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of children and youth with special health care needs in the state screened for behavioral health needs. (Measures reach of identification efforts among the focus population)
  • Percent of behavioral health referrals that include care coordination and provider communication. (Assesses service integration and family-centeredness)

OUTCOME MEASURES:

  • Percent decrease in children and youth with special health care needs with unmet need for behavioral health care. (Demonstrates progress in closing service gaps for the focus population)
  • Percent of children with severe behavioral health issues who are able to live in their communities with appropriate supports. (Reflects least restrictive care)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.