NCJ Number
242393
Date Published
December 2011
Length
5 pages
Annotation
This examination of funding for mental health services for youth in the juvenile justice system focuses on funding sources, the specific services funded, and who makes funding decisions, with attention to features of recent Federal health care reform.
Abstract
Generally, financing for mental health services for justice-involved youth has been shifting from targeted, specialized mental health funding to broad-based insurance. The largest Federal grant program that directly supports mental health services for youths is the Comprehensive Community Mental Health Services for Children and Families. This program supports project grants that involve the development of community-based care systems. The largest increase in funding for youth mental health services, however, has come from increased insurance coverage, primarily through the expansion of Medicaid and the introduction of the Children's Health Insurance Program (CHIP) in 1997. Many youths with mental health conditions still pay for significant portions of care through private insurance, which covers health expenditures for 58 percent of all children. For children with fair or poor mental health, however, private insurance plays a smaller role than Medicaid. The Medicaid agency in each State makes key decisions about coverage, reimbursement, and contracting; these decisions in turn drive mental health care delivery for justice-involved youths, poor children, foster care youths, and SSI recipients. The Patient Protection and Affordable Care Act (ACA) of 2010 will not significantly change the insurance coverage of children in the near term. States are responsible for organizing and operating the new health information exchanges, implementing the Medicaid expansions, designing income eligibility systems that coordinate Medicaid and the exchanges, and implementing electronic health records. In the course of these decisions at the State level, juvenile justice agencies must find a seat at the table and present their priorities in relation to the distinctive needs of justice-involved youth. 4 figures