Report: ‘Waiting game’ hurts Philly kids with behavioral health issues

behavioral health pccy report
Credit: PCCY

Low-income children in Philadelphia who suffer from behavioral health issues face long wait times when it comes to receiving medical intervention, averaging nearly a month from the initial call for help to starting treatment, according to a report released Wednesday by advocacy organization Public Citizens for Children and Youth.

The report, which authors said they hope will serve as a “wake-up call for behavioral health providers in Philadelphia,” found city children with behavioral health issues who are enrolled in Medical Assistance wait an average of 15 days before providers are able to see them for an intake appointment.

That’s despite the fact that behavioral health agencies are, as a part of their contract with reimbursement entity Community Behavioral Health, required to see children for first appointments no later than seven days after they receive the initial call.

“Every day a child in Philadelphia goes without care, that child and his family is at risk,” PCCY executive director Donna Cooper said in a statement.

“CBH and the agencies need to get on the same page to implement changes so that our kids can have faster access to the services they need.”

In addition to the 15-day delay, the report found families face another 12-day wait, on average, until their children actually begin therapy, totaling nearly a month from the time help is requested for behavioral health problems to the time those problems are actually addressed.

PCCY asserts the delays, which leave kids with untreated behavioral health issues, can cause them to fall behind academically, fail to make friends and act out toward their siblings, outcomes that are particularly harmful in the face of widespread poverty and mass school closings in Philadelphia.

“The current processes used by many provider agencies for treating kids with behavioral health issues are unacceptable,” PCCY health director Colleen McCauley said in a statement.

“Not only are they failing our most vulnerable children who are struggling at school and at home when they should be receiving therapy, but they are also breaking their contract with CBH.”

The average 15-day wait figure for an intake appointment, which is based on data from children seeking treatment between 2010 and 2013, represents just a one-day improvement from the average wait for behavioral health services in 2008, which was 16 days.

The report also found the number of behavioral health agencies that couldn’t be reached after three separate tried more than doubled from 2008 to the period between 2010 to 2013, growing from an average of three agencies to an average of seven agencies.

“While we are pleased to see modest improvements in wait times, we will continue to invest in building our capacity for improved access to children’s behavioral health services,” Philadelphia Department of Behavioral Health and Intellectual Disability Services Commissioner of Philadelphia’s Department of Behavioral Health and Intellectual disAbility Services Dr. Arthur Evans said in a statement.

Advocates with PCCY are also calling on Philadelphia City Council members to investigate the city’s average wait times surrounding juvenile behavioral health treatment.

Councilman Marian Tasco, who heads up Council’s Committee on Public Health and Human Services, told the organization her office is considering holding hearings not just on provider wait times, but reviewing Philadelphia’s child behavioral health system as a whole.

“As Chair of City Council’s Committee on Public Health and Human Services, I commend PCCY for providing insight on how children receive behavioral health services in our city,” Tasco said in a statement.

“Working with public and private stakeholders, I hope that this report will spark a renewed effort toward improving the health of the children of Philadelphia.”

By the numbers

250,343 Philadelphia children were enrolled in Medical Assistance as of May 2013.

24,035, or about 10%, of Philadelphia children enrolled in Medical Assistance received outpatient behavioral health services in 2012.

Philadelphia children between 2010 and 2013 faced an average 27 day wait from the time they initially called for behavioral health help to the time they began treatment.

15 of those days, on average, were spent waiting for an initial intake appointment.

12 of those days, on average, were spent waiting for behavioral health therapy to actually begin.

Recommendations

PCCY made several commendations the organization believes could shorten wait times, including:

CBH should take measures to ensure children are seen for intake appointments within a week, such as requiring agencies to refer customers directly to CBH if they can’t accommodate an appointment within seven days so CBH can schedule an appointment with another agency that can see the child in a timely manner.

CBH, in addition to having a maximum wait time for children to receive initial appointments, should also adopt a maximum wait time for when every child should start therapy following the intake visit.

CBH should raise its Pay for Performance benchmark, which currently offers financial incentives to outpatient mental health agencies that schedule 45 percent of their child intake appointments within the seven day time frame.

CBH should aggregate and report on outcome data from the Pay for Performance program and share best practices with the provider community.


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