Encourage I-ECMH screening in Medicaid

The Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents provides primary care practices with key background information and theory-based, evidence-driven recommendations for themes critical to healthy child development to be used at all preventative care screenings and health supervision visits.[1][3] The Guidelines recommend behavioral, social, and emotional screenings begin at birth[4] to assess infant and early childhood mental health (I-ECMH). I-ECMH encompasses a child’s capacity in three areas – emotions, interpersonal relationships, and familial and cultural environments.[2] Children with adverse childhood experiences, including physical abuse, mental illness, substance use, or other trauma, are at greater risk of developing I-ECMH disorders.[2] Approximately one in six U.S. children aged 2-8 years have a diagnosed mental, behavioral, or developmental disorder.[5][6] For those living below 100 percent of the federal poverty level, more than 20 percent have a mental, behavioral, or developmental disorder.[6] These children are part of the 27 million children under age 18 in the United States covered by Medicaid.[7]

However, neither guidance for I-ECMH screening nor available I-ECMH-trained practitioners is consistently supported within the Medicaid program.[8] Mandating that Medicaid follow the Bright Futures guidelines to screen for and, if indicated, further evaluate a child for I-ECMH disorders would support prevention and treatment for children and their families[2] and ensure that treatment incorporates the unique developmental needs of young children.[9]