Early assessments of SCHIP's effect on access to care for adolescents.
OBJECTIVE
To examine implementation issues and challenges affecting access to care for adolescents during the first year of SCHIP operation in five states (California, Connecticut, Maryland, Missouri, and Utah).


METHODS
Information was obtained through on-site interviews with senior SCHIP program staff members, medical directors, and other key staff members from managed care organizations; key staff members from behavioral health subcontractors or the state's behavioral health plans; a variety of physical and mental health providers; and families. Analysis of relevant SCHIP documents and available enrollment, capitation, and quality data was also conducted.


RESULTS
The five states generally have focused little attention in the start-up phase to the unique service needs of adolescents. Although primary care was readily available, concerns were raised about training and experience in serving this population and the availability of multidisciplinary practice arrangements. Access to family planning did not appear to be a problem. However, access to mental health services and dental services was seriously affected by limited provider participants.


CONCLUSIONS
Because adolescents constitute a sizeable proportion of the SCHIP population, states and managed care organizations need to consider ways to increase the participants of adolescent providers and to identify various financial and other incentives to address the serious shortages in mental health services and dental care.
Fox
Harriette B
HB
Maternal and Child Health Policy Research Center, 750 17th Street NW, Suite 1025, Washington, D.C. 20006, USA. hfox@foxhealth.com
McManus
Margaret A
MA
Limb
Stephanie J
SJ
D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics* / Q000458:organization & administration; D000385:Aid to Families with Dependent Children / Q000191:economics*; D002140:California; D003237:Connecticut; D003729:Dental Care / Q000458:organization & administration; D011307:Drug Prescriptions / Q000191:economics; D005193:Family Planning Services / Q000458:organization & administration; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007407:Interviews as Topic; D008396:Maryland; D008484:Medicaid / Q000191:economics*; D008605:Mental Health Services / Q000458:organization & administration; D008923:Missouri; D011320:Primary Health Care / Q000458:organization & administration; D015397:Program Evaluation; D013221:State Health Plans / Q000191:economics*; D014481:United States; D014589:Utah