Lonnie R. Snowden ^1*, Mary C. Masland ¹, Neal T. Wallace ², Allison Evans-Cuellar ³

¹ UC Berkeley Center for Mental Health Services Research
² Portland State University, School of Public Policy
³ Columbia University

^* To whom correspondence should be addressed. E-mail: snowden{at}berkeley.edu.

	Abstract

We investigated enforcement of mental health benefits provided by California Medicaid’s Early Periodic Screening, Diagnosis and Treatment (EPSDT) program. Enforcement, compelled by a consumer-driven lawsuit, resulted in an almost fourfold funding increase over a 5-year period. We evaluated the impact of enforcement on outpatient treatment intensity and rates of emergency care treatment. Using fixed-effects regression, we examined the number of outpatient mental health visits per client and the percentage of all clients using crisis care across 53 autonomous California county mental health plans over 32 3-month periods (quarters) (emergency services use) and 36 quarters (outpatient treatment intensity). Enforcement of EPSDT benefits in accordance with federal law produced favorable changes in patterns of mental health service use, consistent with policy aims.

Key Words: Health Financing, Health Policy, Access to Care, Health Service Delivery, Mental Health