Rosie D.
Reforming the Mental Health System in Massachusetts

Mental Health

Most children with Serious Emotional Disturbance (SED), and many others who will receive services from the new children's mental health system have a mental health diagnosis, and have received mental health outpatient, inpatient, or crisis services.

In its 2004 report to the federal Substance Abuse and Mental Health Services Administration, the Department of Mental Health (DMH) estimated that there are over 120,000 children in Massachusetts who have SED, at least half of whom are eligible for Medicaid.  DMH further projected that at least 15,000 of the Medicaid-eligible children had a severe functional impairment.  The Court adopted this figure in estimating the minimum number of children in the Commonwealth who would need home-based services and recognized that the number was probably much higher, since all Medicaid children with SED (over 30,000) were eligible for remedial services.


Because of its strict eligibility requirements, DMH serves only a small fraction of these children.  It currently enrolls approximately 3,600 children, about two-thirds of whom (2,400) receive Medicaid.  DMH expects that the vast majority of these Medicaid-eligible children will benefit from Intensive Care Coordination (ICC) and other home-based services.  However, because DMH funds a number of other services that are not covered by Medicaid, such as respite and after-school programs, some Medicaid-eligible children may continue to receive DMH services.


DMH is committed to integrating its service plans and service providers with Medicaid-funded home-based services and the ICC wraparound planning process.  Because of recent budget cuts, DMH has dramatically reduced its case management program and cut other community services for adults and children.  As a result, DMH will not continue to provide case management to children enrolled in ICC.  


DMH has developed a protocol for participating in the new children's mental health system and the Local Systems of Care Committees, including referral of youth who seek help from DMH, membership of DMH staff on care planning teams, and integration of DMH service plans in the Individual Care Plan developed by the CSAs.  Click to view the DMH protocol.


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