Philadelphia children on Medical Assistance are waiting twice as long as they are supposed to for behavioral-health appointments, according to a report released Thursday by Общественные граждане для детей и молодежи (PCCY).

The youth-advocacy organization surveyed nearly 60 agencies that provide mental-health services to children on Medical Assistance, the state health insurance program for low-income people. It found that the average wait for an initial appointment was 15 days.

The report said the agencies’ contract with Community Behavioral Health, which administers mental-health services for the city, required agencies to make such appointments within seven days. As a pay-for-performance incentive, CBH rewards agencies that meet the seven-day goal 45 percent of the time.

Colleen McCauley, health-policy director for PCCY, said quick response to mental-health problems was especially important as many children are facing disruption from reorganization of the financially challenged city schools. She said that school performance could suffer while children awaited care and that parents could grow discouraged if they had to wait too long.

PCCY is seeking a hearing on the issue before City Council’s health committee. It recommends that agencies that cannot meet the deadline be required to refer parents to a central office that can suggest other providers.

Roxy Woloszyn, a health-policy associate for PCCY who was involved in the survey, said she did not know whether CBH did anything to punish agencies that failed to make timely appointments.

Joan Erney, chief executive officer of CBH, said the state had included the one-week rule in its program standards for Medical Assistance managed-care programs since 1997. It applies to behavioral-health patients of all ages. CBH has generally used an incentive strategy to improve compliance, she said, adding that longer waiting times are a problem across the state.

CBH is taking the issue very seriously, she said, and is considering PCCY’s recommendations. It will undertake a “really robust capacity analysis in the fall,” Erney said.

Patients with psychiatric emergencies can get same-day appointments at special centers.

Woloszyn said PCCY asked each agency how long it would take to get an intake appointment. Severity of symptoms was not described. PCCY made seven cycles of calls between April 2010 and February 2013.

A dozen agencies were able to see a patient within a week or less. The report said some agencies told PCCY that their intake processes had improved since the survey.

On average, it took an additional 12 days after the intake for the child to begin treatment, making the average waiting time for therapy to begin 27 days.

PCCY last did the survey in 2008, when the average wait for a first appointment was 16 days.

According to PCCY, about 10 percent of city children on Medical Assistance – 24,035 – received outpatient behavioral-health services in 2012.

The Philadelphia Inquirer – August 2, 2013 – Читать статью онлайн