Child and Adolescent Behavioral Health: CHA Presents on Hospitals’ Data Collection Effort

At the Wednesday, December 3, meeting of the Transforming Children’s Behavioral Health Policy and Planning Committee, the Connecticut Hospital Association delivered a presentation detailing hospitals’ ongoing statewide effort to collect and analyze data on child/adolescent psychiatric emergency department (ED) utilization and inpatient bed capacity.

In October 2021, a surge in child and adolescent visits to the ED prompted Connecticut hospitals to implement a data collection process designed to document ED behavioral health census, inpatient bed need, and available inpatient youth psychiatric beds.  Hospitals have reported these data to CHA every day over the last four years, revealing trends that illustrate deficiencies in access to acute care. 

Allison Matthews-Wilson, senior director of workforce and clinical policy at CHA, noted that the post-pandemic mental health crisis drove more kids to seek support in emergency departments.  She also highlighted that in response to the pandemic, pediatric providers established a daily incident command call to communicate capacity status, identify seasonal trends and population patterns, and examine throughput challenges.  

Marci Mitchell, senior director of ChimeData Solutions, CHA, walked through key takeaways from the last four years of data collection.  Mitchell explained the data show seasonality within youth behavioral health bed demand continues to be consistent and predictable year-over-year; most months, there aren’t enough beds for child or adolescent behavioral health patients requiring inpatient care, averaging approximately 14 beds short; and behavioral health patients spend substantially more time in the ED than any other service line or medical need.

Based on four years of data — as well as member feedback regarding system bottlenecks related to discharge planning, community- and school-based supports, and alternative crisis response programs, such as mobile crisis intervention units and urgent crisis centers (UCC) — CHA outlined several policy recommendations, including:

• Establish Medicaid rate structures for initiatives like children’s behavioral health urgent care centers
• Expand community-based and school-based services to all areas of the state
• Institute Medicaid reimbursement for care coordination initiatives, including collaborative care model (COCM) services and community care teams (CCT)
• Access to billing codes that support specialized ED observation efforts
• Improved access to specialized beds
• Streamlined coordination of care and post-acute discharge planning

CHA delivered a similar presentation to the Connecticut General Assembly’s Behavioral Health Partnership Oversight Council’s (BHPOC) Child/Adolescent Quality, Access & Policy Committee in October.