Connecticut’s Systems Approach to Improving Children’s Behavioral Health
Improving the way we meet the behavioral health needs of young people.
Accountability and transparency are critical and necessary components of a system of care that hopes to provide the highest quality of services. The COVID-19 pandemic highlighted the need to seek new and innovative solutions to the many challenges facing children, adolescents and their families struggling with behavioral health issues. The historically under-resourced care delivery system in Connecticut raised significant questions about how our state can improve the way we meet the behavioral health needs of young people.
During the 2022 Legislative Session, a bi-partisan majority enacted a series of laws supporting and expanding children’s behavioral health. Three key pieces of legislation of the session enabled a wide range of programs and funding related to early childhood development, school-based mental health, and the behavioral health workforce. These were closely aligned with the goals of other statewide initiatives – like Connecticut’s Behavioral Health Plan for Children and Connecting to Care – which serve to build and enhance a connected, collaborative network of care infrastructure that prioritizes health equity, workforce development, family-centered care, integrative care models, and an accessible array of services.
There still exists an opportunity to improve the way we plan, fund and evaluate performance by creating a more transparent and accountable system of care. In their desire to advance this change, the CT General Assembly passed Public Act 23-90 in 2023 establishing the Transforming Children’s Behavioral Health Policy and Planning Committee (“TCB”).
The law charges the TC with two primary tasks. First, the Committee is to “evaluate the availability and efficacy of prevention, early intervention, and behavioral health treatment services” for children from ages birth to eighteen, including those for substance use disorders, and the general well-being of children.
Specifically, the TCB is directed to assess and identify:
Statutory and Budgetary changes needed to improve the behavioral health system.
Service Delivery Gaps and other missed opportunities to advance the State’s ability to offer families a set of streamlined, accessible, and responsive solutions.
Strengths and Barriers that either support or hinder children’s behavioral health care.
School-Based Efforts that collaboratively support efforts to improve behavioral health outcomes for children.
Disproportionate Behavioral Health Outcomes for children of color.
Disproportionate access and outcomes across the behavioral health care system for children with developmental disabilities.
Quality Assurance framework(s) to maintain timely data analytics to improve both private and publicly operated behavioral health services, facilities, and programs capacity to streamline and centralize processes operations with accountability and agility.
Governance Structure to align state public policy and healthcare goals to ensure that all children and families, in urban, rural, and all other areas of the state, can access high-quality behavioral health care.
Sustainable Workforce Needs to support the evolving behavioral health needs of children.
The second task charged to the TCB is to “make recommendations to the General Assembly and executive agencies regarding the governance and administration of the behavioral health care system for children.” Recommendations should be those necessary to improve: (1) developmental and behavioral health outcomes for children; (2) facilitate transparency and accountability across state agencies, community-based organizations, and institutional providers; and (3) promote policies to advance data sharing and reporting between state agencies and state-funded programs.
Pursuant to its enabling statute, the TCB has established five workgroups based on the most critical areas of children’s behavioral health: Prevention, Services, School-Based Initiatives, System Infrastructure, and Strategic Planning. These workgroups are pivotal in fulfilling the TCB’s mandate by providing leadership and direction on practical and policy matters to foster comprehensive community and state-level programming. Tasked with reviewing the needs and developing strategies to leverage opportunities, each workgroup may recommend changes that “align children's behavioral health programming with policy initiatives to optimize funding, decrease disparities, and improve outcomes for children with behavioral health needs and their families.” The workgroups are guided by the TCB’s overarching goal of transforming the children’s behavioral health system of care and use a collaborative approach that harnesses the expertise of existing committees and service providers to learn and build upon ongoing initiatives.
The authorizing statute establishes a diverse body of 45 members that brings in expertise from various sectors such as the legislature, state agencies, community advocates, and non-profits. The committee is led by Tri-Chairs including the Deputy Majority Leader of the House of Representatives, the Deputy President Pro Tempore of the Senate, and the Senior Policy Advisor for the Office of Policy and Management.
While other statewide oversight or policy committees report directly to the Department of Children and Families, Connecticut’s behavioral health authority for children, the TCB reports directly to the legislature.
The TCB is a new and bold effort to engage a broad representation of providers, advocates, policy makers and educators to proactively find solutions to the system-wide challeges we face in delivering quality behavioral health care to children and families. This is a model that we feel could be replicated in other states who, like Connecticut, are seeking ways of improving care.
There is renewed hope that substantive and actionable recommendations will be generated and presented to the Legislature by the end of 2024, and that these will soon impact the system of care for children and families..
