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Behavioral Health Screening in Pediatric Preventive Care The HUSKY Health Approach. Robert W. Zavoski , MD, MPH Medical Director, CT Department of Social Services. Connecticut Medicaid - Overview. Enrollees: 668,000 (17% of total population)
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Behavioral Health Screening in Pediatric Preventive CareThe HUSKY Health Approach Robert W. Zavoski, MD, MPH Medical Director, CT Department of Social Services
Connecticut Medicaid - Overview • Enrollees: • 668,000 (17% of total population) • 449,000 in family coverage (1 in 4 Connecticut children, 40% of all CT births) • Model of care – “managed fee for service” via administrative service organizations (ASOs) • Behavioral Health Partnership - children (2007), adults (2011) • Dental Health Partnership – 2009 • Medical ASO - 2012
Screening in HUSKY Health • Early Periodic Screening Diagnostic Testing (EPSDT) • Developmental Screening (2008) • Person-Centered Medical Home (2012) • Intensive Care Management (2012)
Developmental and Behavioral Screening in Health Supervision • Recommended by the American Academy of Pediatrics and the National Clearing House with use of validated tools • AAP.org/Bright Futures site lists and describes recommended tools • AAP also recommends ‘surveillance’ – routine assessments of risks and progress, as well as promotion of resilience
Rationale for Screening • Developmental disabilities are common • Disabilities can be ameliorated or successfully treated • Screening and counseling can be easily included in a routine preventive health visit • Many tools are either parent or patient self-administered
Provisos to the Rationale for Screening • “Easy” isn’t that easy • Development and Behavior are used together • Research to support routine developmental screening in young children is strong • Research to support routine behavioral screening or surveillance at any age is sparse • U.S. Preventive Health Services Task Force: • routine developmental screening - I rating • routine autism screening – no recommendation • specific behavioral screening – variable recommendations
HUSKY Health – next steps • Medical/behavioral Health integration • Health homes with DMHAS for those with serious and persistent mental illness • Routine universal behavioral screening for all under EPSDT
Questions? • Robert Zavoski, MD, MPH • Medical Director • CT Department of Social Services • robert.zavoski@ct.gov