The Commission is continuing its examination of behavioral health services for Medicaid-enrolled children and youth with behavioral and co-occurring health needs. The first phase of work examined appropriate access to residential treatment services for children and youth who require this level of treatment and resulted in a chapter in MACPAC’s June 2025 report to Congress. This second phase of work focuses on access to intensive community-based behavioral health services that prevent the inappropriate use of residential treatment for children and youth who are at risk of needing this type of treatment. Given the broad scope of services, this work focuses on five specific services that have been shown to be particularly important for this population: intensive care coordination or targeted case management; high-fidelity wraparound, mobile crisis response; crisis stabilization; and respite.
MACPAC staff began by presenting background on this population, a summary of key federal requirements to ensure access to behavioral health services, and an overview of intensive community-based behavioral health services. Staff then reviewed key findings from our federal and state policy scans, describing relevant state plan and waiver authorities that states use to deliver the five selected services.