Tag Archive: Medicaid expansion

  1. Improving Medicaid Reimbursement for Children’s Mental Health Services

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    Nearly half of Virginia’s children are enrolled in Medicaid for their health insurance coverage. To ensure that these young people have access to mental health providers, and for those providers to adequately compensate staff, reimbursement rates for behavioral health must be increased this year.

    Medicaid-funded services for children’s behavioral health has declined by $100 million since the beginning of the pandemic, largely due to the phase-out of Therapeutic Day Treatment Services in schools. While the dollar amount of funding has decreased, more children and youth have sought mental health services since the pandemic, meaning that services have not adequately kept pace with needs. Furthermore, only 14% of children on Medicaid are receiving behavioral health services, a significant gap below the need expressed in the general population of children and youth where 30% or more of young people express mental health concerns. Black and Latino children are disproportionately enrolled in Medicaid and report more barriers to accessing mental health care.

    Medicaid reimbursement for children’s mental health services has declined by $100 million since the pandemic, despite an increase in children seeking services. (Bar on the far right does not represent a full year.)

    The members of the General Assembly will consider several proposals to improve Medicaid reimbursement for behavioral health services. The options below can put Virginia on a path forward to bringing more behavioral health resources into schools and reaching more students who need mental health support.

    The Solutions:

    Medicaid rates must keep pace with inflation and ensure adequate staff compensation.

    Short-term solution: increase community behavioral health services rates in FY24

    • Support 304 #9s (Deeds)/304 #23h (Farriss): Medicaid Reimbursement Rates for Community-Based Behavioral Health Services

    This proposal would provide:

    • 25% rate increase for:
      • Intensive In-Home, Mental Health Skill Building, Psychosocial Rehabilitation, Therapeutic Day Treatment, Outpatient Psychotherapy, Peer Recovery Support Services — Mental Health.
    • 10% rate increase for BRAVO services:
      • Comprehensive Crisis Services (which include 23-hour Crisis Stabilization, Community Stabilization, Crisis Intervention, Mobile Crisis Response, and Residential Crisis Stabilization), Assertive Community Treatment, Mental Health – Intensive Outpatient, Mental Health – Partial Hospitalization, Family Functional Therapy and Multisystemic Therapy.

    And a long-term solution: conduct a rate study to determine inputs to delivering care and suggest a process for annual rate increases based on inflation.

    Modernize reimbursement rates for school-based mental health.

    Long-term solution: conduct a rate study on school-based mental health services to replace the currently offered service—therapeutic day treatment “TDT”. The future of behavioral health redesign planned to look at this service and develop new school-based services connected to multi-tiered systems of support in school. 

    • Support Medicaid Rate Studies for Behavioral Health 308#7s (McClellan)/ 308#11s (Brewer)

    This proposal provides a long-term solution to modernizing school-based mental health services and empowers young people to help design those services.

    • Youth voice/choice: this amendment specifies that students and school-based stakeholders must be involved in the design of school-based services.

    Provide TA to School Divisions to Implement Medicaid Reimbursement

    In a follow-up to the 2021 legislation proposed by Sen. Dunnavant to implement the “Free Care Rule” in Virginia, our state Medicaid agency has an application pending approval at the federal level to allow school divisions to bill Medicaid directly for school-based health and mental health services outside of a students’ IEP. This would enable school divisions to pull down a dollar-for-dollar match for the health services provided or initiated by schools. There is a catch though. School divisions will have to take on extra administrative tasks in order to seek reimbursement. This proposal allows DMAS to provide resources to DOE and school divisions to provide technical assistance and professional development to seek reimbursement.

    • Support Technical Assistance to School Divisions to Implement Medicaid Reimbursement Item 308#13s (McClellan)

  2. Recap- 10th Senate District Candidate Forum

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    On Tuesday, August 18th, Voices for Virginia’s Children sponsored the 10th Senate District Candidate Forum hosted by WCVE. The event was a great success, with approximately 140 people attending to hear all four candidates speak. This race is one of the most competitive races in the Commonwealth, as Republicans and Democrats vie for control of the state Senate. The district is currently represented by retiring Republican John Watkins.

    For the first half of the forum, candidates answered questions centered on public policy issues for children in Virginia – children living in poverty, teens who age out of foster care, mental health services, and early childhood education. In the second half of the forum, WCVE News Director Craig Carper asked the candidates questions about the state budget, education funding, Medicaid expansion, and the issue of partisanship in picking judges and redistricting.

    WCVE will air the event this coming Sunday night, August 23, at 6 p.m. on 88.9 FM in Richmond. It is also available here on their website.

    Read more about the event in this Richmond Times-Dispatch article by Michael Martz.

  3. Why Medicaid Expansion Matters for Kids

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    As a member of the Healthcare for All Virginians (HAV) Coalition, we were disappointed that the General Assembly once again failed to close the health insurance coverage gap for low-income adults during the special session last week. We think it’s important for policymakers and child advocates to understand the great extent to which this decision affects kids. We’ve prepared a Fact Sheet to explain this, and here are a few of the major points:

    100,000 parents in Virginia fall in the coverage gap.
    400,000 low-income adults fall in the coverage gap in Virginia, meaning they make too much to qualify for Medicaid but not enough to afford health insurance on the federal exchange. Fully one-quarter of those adults are parents of kids younger than 18.

    Insured parents get health insurance and health care for their kids.
    When parents have health insurance, they are more likely to obtain health insurance for their kids AND take them to the doctor for preventive care and treatment when they’re sick.

    When parents have access to health care, they are better able to care for their children.
    Parents are better able to care for their children when their own health needs are being met — for example, untreated maternal depression has a negative effect on the emotional development of young kids. Also, parents with health insurance are less vulnerable to the potentially exorbitant costs and heavy emotional toll of unexpected medical bills.

    For these reasons, Voices for Virginia’s Children will continue to advocate that Virginia close the coverage gap for low-income adults. Contact Voices’ policy analyst Ashley Everette at ashley@vakids.org for more info.

    For more facts about the importance of closing the coverage gap to improve the health and well-being of Virginia’s kids, see our Fact Sheet.

  4. Press Conference: Mental Health and Medicaid Expansion

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    Are you UNINSURED and unable to access mental health services as a result of being uninsured? Would having insurance coverage help you or a family member to access medication, therapy appointments, and other behavioral health services needed?

    In coordination with NAMI VA, VOCAL, MHAV and Virginia Coalition to End Homelessness, the Campaign for Children’s Mental Health will participate in a press conference regarding Medicaid expansion and mental health.

    We are currently looking for one or two people  to share their stories about being uninsured and unable to obtain mental health care coverage at a press conference this week.  Stories must be specifically  about being uninsured and the resulting difficulty this has caused you or a loved one in in obtaining the mental health services.

    To share your story, please email ashley@vakids.org as soon as possible.

    More information about the event will be posted as the details of the event are determined.