About MCPAP

MCPAP:

The Massachusetts Child Psychiatry Access Project (MCPAP) is a system of regional children's mental health consultation teams designed to help primary care providers (PCPs) meet the needs of children with psychiatric problems.

MCPAP Goals:

  • Improve access to treatment for children with psychiatric illness
  • Promote the inclusion of child psychiatry within the scope of the practice of primary care
  • Restore a functional primary care/specialist relationship between PCPs and child psychiatrists
  • Promote the rational utilization of scarce specialty resources for the most complex and high-risk children

MCPAP Vision:

  • Child psychiatry will be a part of the scope of practice of pediatric primary care.
  • Pediatricians will be familiar with the most common psychiatric diagnoses and have strategies for preliminary assessment
  • Pediatricians will be familiar with the wide spectrum of community based mental health services offered in private and public sectors and will know how to refer.
  • Pediatricians will have confidence in their expertise including the limits of their knowledge.
  • Pediatricians will help parents be effective advocates for their children
  • Pediatricians will collaborate with mental health providers and coordinate function when needed (with exception of highly complex patients, whose care is coordinated by a child psychiatrist).
  • Pediatricians will do systematic mental health screening in the context of well-child care

MCPAP History:

In 2002, a consortium of New England states under Centers for Medicare and Medicaid Services (CMS) leadership of Ron Preston (former health and human services secretary) met to discuss concerns around the number of children insured by Medicaid who were receiving psychotropic drugs at young ages and children of all ages who were receiving multiple psychotropic drugs.  In 2003, based on these concerns, CMS and MassHealth provided a grant to  Dr. Ron Steingard at UMass Medical School to develop a pilot program in Central Massachusetts (TCPS- Targeted Child Psychiatric Services) providing consultation to pediatricians around child psychiatry problems, including the prescribing of psychotropic medications.

In FY04, MBHP (Massachusetts Behavioral Health Partnership, with significant stakeholder input, adapted the UMass pilot into a program design that would allow statewide rollout and determined need for $2.5 million budget (now known to be closer to $3.0 million).  This was supported by the advocacy efforts of Massachusets Child Mental Health Task Force.  The project received legislative approval in June 2004 to be administered by the Massachusetts Behavioral Health Partnership (MBHP) as a contracted Performance Incentive project. The project included 6 Regional Teams with:

  • 1.0 FTE child psychiatrist
  • 1.5 FTE social worker/psychologist
  • 1.0 FTE care coordinator
      ◊The service would be available for all 1.5 million Massachusetts   children regardless of insurance.
      ◊Telephone consultation would be provided Monday - Friday, 9   a.m. to 5 p.m., within 30 minutes of request.
      ◊The team would provide ongoing education to PCPs based on   their need.

The rollout of the program occurred as follows:

Program Region Clinical Start    Date
Baystate West 10/1/04
UMass Central 11/1/04
North Shore Medical   Center Northeast 3/1/05
Mass General Hospital Boston A 6/1/05
Children's/Tufts Boston B 11/1/05
McLean-Brockton Southeast 12/1/05