CHA Presents Analysis of Youth Behavioral Health Data

At this month’s meeting of the Connecticut General Assembly’s Behavioral Health Partnership Oversight Council’s (BHPOC) Child/Adolescent Quality, Access & Policy Committee, the Connecticut Hospital Association (CHA) delivered a presentation detailing statewide hospital emergency department (ED) utilization and inpatient bed capacity over the last four years.

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.  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.

According to 2024 data, there were 11,458 behavioral health-related ED visits for individuals under the age of 18, and 44% presented at  Connecticut Children’s or Yale New Haven Children’s Hospital, 68% were seen for mood and anxiety disorders, 66% were covered by Medicaid, and the average time spent in the ED was 26 hours, compared to the medical or surgical average of three hours.

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

Click here to watch CHA’s presentation to the Child/Adolescent Quality, Access & Policy Committee on Wednesday, October 15.