In January 2017, the Primary Care Coalition (PCC) launched the Caring for the Whole Child pilot program to provide uninsured children and teens enrolled in Care for Kids (CFK) with access to needed behavioral health services. CFK is a public-private partnership that provides health care to low-income children who are not eligible for Medicaid or CHIP.
The Healthcare Initiative Foundation (HIF), the Health Resources and Services Administration (HRSA) and an anonymous donor provided the initial funding for the pilot. Through this program, adolescents enrolled in CFK will receive regular screenings for behavioral health conditions and have access to integrated behavioral health treatment for common mental health disorders within the primary care setting.
The PCC is partnering with CCI Health & Wellness Services, Mary’s Center for Maternal and Child Health, Catholic Charities McCarrick Center Medical Clinic, Holy Cross Healt Center in Germantown, and EveryMind to provide behavioral health care for children enrolled in CFK.
Integrating behavioral health care programs into primary care settings is a priority of Healthy Montgomery – Montgomery County’s Local Health Improvement Coalition. Behavioral health was also identified as a top issue by the Montgomery County Children Fleeing Violence Workgroup, which was established in 2014 in response to the influx of unaccompanied immigrant minors.
Early identification and treatment for behavioral health conditions offers the possibility of better mental and physical health for children throughout their maturation and into their adult years. The American Academy of Pediatrics advocates integrating behavioral health care into the primary care setting to promote better outcomes and enhance the quality of care for children who need it. Through integration, behavioral health services can be provided in settings that are culturally competent and have lower stigma attached than services delivered in distinct behavioral health settings.
All CFK children are foreign born, and 88% are Hispanic. Coming from developing countries with often inadequate health care systems, many have lacked consistent access to health care their whole lives. CFK children face overwhelming stressors which include discrimination, exposure to violence (in their home country, on route to the U.S., and in the U.S.), economic deprivation, overcrowding, family separation, lack of family stability or social cohesion, trauma, and more. All of these factors put CFK children at high risk for physical and mental health conditions and poor health outcomes, as well as impaired educational and psychosocial development.
Program Manager for Care for Kids, Marisol Ortiz, expressed PCC’s gratitude for the funds that make this pilot program possible, “Behavioral health is not secondary to primary care. CFK children have seen and experienced terrible things that have lingering effects both mentally and physically. Comprehensive care that integrates primary care with behavioral health services ensures the children receive the health services needed to move forward with their lives.”
This pilot program aims to screen, at least 70% of CFK children and teens seen in primary care at partner clinics for depression and trauma exposure. Those with positive screening results will receive behavioral health services. The program expects to see improvement in behavioral health and a reduction in symptoms for children after they access services.
The Caring for the Whole Child pilot program is part of a community wide response to a growing need for behavioral health services and other supports for children fleeing violence and seeking refuge in our community. PCC will continue to make comprehensive health care a priority for the vulnerable children in Montgomery County.