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Identifying Under- And Overutilization Patterns For Idaho Youth With Serious Emotional Disturbance.
Olga A Vsevolozhskaya1, Madison Merzke2, Wiley T Turner3
1Olga A. Vsevolozhskaya, University of Kentucky, Lexington, Kentucky.
Many youth with serious emotional disturbance underuse Medicaid behavioral health services. This study examined service use and needs in Idaho
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Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Public Health
Background:
- Serious emotional disturbance affects 7-12% of US youth.
- Idaho's Youth Empowerment Service (YES) program provides Medicaid-funded community-based treatment for eligible youth.
- The program targets youth under 18 with serious emotional disturbance and household incomes up to 300% of the federal poverty level.
Purpose of the Study:
- To assess the association between clinical needs complexity and Medicaid behavioral and mental health service utilization among youth in Idaho.
- To identify potential underuse or overuse of services within the YES program.
Main Methods:
- Utilized the Child and Adolescent Needs and Strengths (CANS) tool, a 97-indicator assessment, to measure clinical needs complexity.
- Analyzed administrative Medicaid claims data from Idaho for the years 2018-2022.
- Examined the relationship between CANS indicators and actual service use.
Main Results:
- A significant proportion of youth with serious emotional disturbance were found to be underusing Medicaid behavioral and mental health services.
- Instances of service overuse were minimal.
- The findings highlight a gap between assessed needs and service utilization.
Conclusions:
- There is substantial underutilization of Medicaid behavioral and mental health care among youth with serious emotional disturbance in Idaho.
- Results suggest a need to review utilization management practices in Medicaid behavioral health.
- Programmatic efforts are crucial to ensure families with youth experiencing serious emotional disturbance remain engaged with the YES program.

