Washington State exhibits wide regional variation in proportion of Medicaid-eligible children who get needed mental health care.

In Washington State, mental health care for Medicaid-eligible children is delivered through thirteen regional support networks. The estimated statewide prevalence rate for serious emotional disturbances in children up to age seventeen is 7 percent; analysis found, however, that the proportion of Medicaid-eligible children who received mental health care ranged from 2.91 percent in the North Central network to 8.16 percent in the Southwest network. The variation was not linked to the racial or ethnic makeup of the local population or the rural or urban nature of the region. Instead, interviews with network administrators indicated a substantial contributor to this regional care variation was the state's Access to Care Standards, which restrict network mental health services to children with the most severe disorders. Other factors contributing to the regional variation included funding, the networks' geographic size, and availability of providers. With the Affordable Care Act expected to bring more children with mental health care needs into the Medicaid system, our findings and recommendations offer policy makers timely information on how to improve children's access to mental health care.