Many young children have developmental or behavioral problems that could be addressed or prevented with the right early response but that are not identified or treated, compromising children’s ability to perform up to their potential in school and leading to more costly interventions later. Because the quality of parenting is so critical to children’s development, parental or family difficulties—including maternal depression—can endanger children’s development. Yet, parents often do not receive needed medical or mental health care. This brief discusses state Medicaid and CHIP choices that can enhance delivery of medical, mental health, and related services to parents.
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Many young children have developmental or
behavioral problems that could be addressed or even
prevented with the right early response but that are
not identified or treated before entering kindergarten,
compromising children’s ability to perform up to their
potential in school and leading to more costly health
and special education interventions later. Because the
quality of parenting is so critical to young children’s
development, parental or family difficulties—
including maternal depression and other parental
mental health and medical problems—can endanger
children’s development. In these situations, treating
parents may be crucial to getting children’s
development back on track. Yet, for many reasons,
parents often do not receive needed medical or
mental health care or other supportive services.
This brief discusses state Medicaid and CHIP
choices that can enhance delivery to parents and
families of the medical, mental health, and related
services needed to support young children’s
development. A range of physical and mental health
problems affects parenting (for example, parents’
chronic pain and general health), but the evidence for
the role of two-generational services is greatest for
parental mental health problems. Among these
problems, research attention has focused especially on
maternal depression, which is widespread among lowincome
mothers, particularly damaging to young
children’s development if left untreated, yet very
treatable (NRC and IOM 2009). Therefore, after
initially identifying possible two-generational issues a
state could consider, we focus largely on barriers and
solutions to helping parents receive treatment for
Other briefs in this series address children’s
screening for developmental delays, referral and
follow-up treatment, and case management/care
coordination for young children (Hanlon 2010;
Kenney and Pelletier 2010; Pelletier and Kenney
2010). This brief is more exploratory and less
definitive than the other three because a more
challenging policy environment has meant less
program experience on which to base firm
recommendations. Policy and service approaches that consider parents and children together cut against the
grain of most federal and state funding streams and
service systems; while there are important exceptions,
many health, human services, and early childhood
programs are organized to support either services to
the child or services to the parent but not both. For
Medicaid, the central focus of these briefs, the key
distinction is that Medicaid eligibility and benefits are
more restrictive for parents than children. However,
even with these constraints, there are important policy
opportunities for states to explore, and health reform
will considerably expand those opportunities.
After addressing the reasons that two-generational
services matter, the Medicaid policy framework, and
the changes that health reform will bring, the brief
focuses on three policy opportunities for states:
increasing Medicaid coverage among eligible parents
of young children, increasing service receipt among
parents, and increasing receipt of family-based
services when children are Medicaid-eligible but their
parents are not.
End of excerpt. The entire brief is available in PDF format.
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