Funding & Financing Flashcards

Medicaid's EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit is significant for CAASP because it:

Answer: Requires states to cover any medically necessary service for enrolled children, even if not in the state plan

EPSDT mandates that states cover any service determined medically necessary for a Medicaid-enrolled child, giving systems authority to cover a broad range of behavioral health interventions.

Which Medicaid waiver type gives states the most flexibility to test innovative children's mental health delivery models by waiving standard Medicaid requirements?

Answer: 1115 Demonstration Waivers

1115 Demonstration Waivers allow states to waive standard Medicaid rules to pilot new approaches, making them the most flexible tool for testing innovative children's behavioral health models.

Wraparound Milwaukee's financing model is frequently cited as a CAASP best practice because it:

Answer: Pools Medicaid, child welfare, and juvenile justice funds into a single capitated per-child budget

Wraparound Milwaukee pioneered pooling funds from multiple child-serving systems into a single per-child capitated budget managed by a care coordination entity, enabling flexible individualized services.

In a CAASP context, formal 'cost-sharing' agreements between child-serving agencies typically refer to:

Answer: Two or more agencies agreeing to share financial responsibility for serving mutually eligible youth

Inter-agency cost-sharing involves formal agreements where systems such as mental health, child welfare, and education share the financial responsibility for youth who are eligible across multiple systems.

The Children's Health Insurance Program (CHIP) extends behavioral health coverage to children who:

Answer: Exceed Medicaid income limits but whose families cannot afford private insurance

CHIP covers children in families with incomes too high for Medicaid but too low to afford private insurance, extending behavioral health coverage to a broader population of children.

Under a Medicaid managed care arrangement, a behavioral health 'carve-out' means that:

Answer: Behavioral health benefits are separated from physical health and managed by a specialized behavioral health organization

A behavioral health carve-out separates mental health and substance use services from the general managed care contract, placing them under a specialized behavioral health managed care organization.

Federal financial participation (FFP) in Medicaid is provided to states through:

Answer: A matching formula (FMAP) where the federal government pays a percentage of each eligible state expenditure

Medicaid uses the Federal Medical Assistance Percentage (FMAP) formula, under which the federal government matches a state-specific percentage of every eligible Medicaid expenditure.