CHARLESTON, W.V. – Aetna Better Health of West Virginia, a CVS Health company, and Community Care of West Virginia have joined efforts to combat the pressing issue of limited access to child and adolescent psychiatry services in the state. Together, they developed the “Critical Access to Pediatric Psychiatry Program (CAPP WV),” a pioneering initiative aimed at providing rapid access to specialized child psychiatry services for at-risk populations throughout West Virginia. Aetna Better Health of West Virginia provided $1.5 million to support the program.

The scarcity of child and adolescent psychiatrists in West Virginia has led to alarmingly high wait times for mental health assessments and subsequent treatments. This systematic problem disproportionately affects at-risk populations, such as those within the foster care system and adoptees, who have an urgent and heightened need for these essential services. CAPP WV will serve Aetna members enrolled in the state’s Mountain Health Promise (MHP) program, which includes children in foster care, kinship care, and adoptive care.

CAPP WV was thoughtfully crafted to bridge the gap in access to child psychiatry services for at-risk populations statewide. The program’s primary goal is to enhance access to care, limit foster transitions, and reduce out-of-state placements by establishing a dedicated crisis response unit.

Key features of the program include:

• Access for Aetna Members to Specialized Pediatric Psychiatry Services: CAPP WV will collaborate closely with pediatricians and primary care physicians to provide expert behavioral health recommendations for Aetna members, ensuring comprehensive mental health care for those in need.
• Timely Psychiatric Evaluations in Emergencies: In situations where on-site psychiatric care is unavailable, CAPP WV will expedite psychiatric evaluations within 24 hours, ensuring urgent interventions for children facing emergent mental health crises.
• Support for Small Rural ERs: CAPP WV will offer Emergency Room consultations and follow-ups for small rural healthcare facilities that lack access to their own behavioral health consultants, ensuring that critical expertise is available to those in remote areas.
• Bridging Appointments for Continuity of Care: For patients with medication needs who are placed on waitlists, CAPP WV will facilitate bridging appointments to long-term established behavioral health providers, ensuring seamless and continuous care during the waiting period.

“We are thrilled to partner with Aetna for this greatly needed behavioral health program,” expressed Trish Collett, Deputy CEO of Community Care of West Virginia. “Community Care has always been committed to providing comprehensive healthcare services to our communities and behavioral health is an important part of that. We believe CAPP WV will make a significant positive impact on the lives of West Virginia’s most vulnerable children and adolescents.”

In addition to addressing the urgent need for specialized pediatric psychiatry services, CAPP WV is committed to creating employment opportunities to meet this pressing demand. The program aims to establish a mobile mental health clinic to provide on-site crisis intervention and treatment in underserved areas, extending mental health support to those regions that have historically faced limited access to essential care.

“We’re always working to improve access to essential pediatric psychiatric assessments for children and families in West Virginia, regardless of their location,” said Kathy Szafran, Executive Director, Mountain Health Promise, Aetna Better Health of West Virginia. “Due to limited availability of adolescent psychiatrists, children experiencing a behavioral health crisis can spend significant time in the emergency room waiting to be evaluated. With the coordination between Community Care and Aetna, we can now offer a virtual pediatric psychiatric evaluation anywhere in West Virginia usually within 24 hours. In conjunction with the Aetna care coordination team and Critical Access to Pediatric Psychiatry, the needed assessment and care coordination for ongoing services can be available throughout the state for under-resourced children. The goal is to get children assessed, level of care identified, and appropriate services coordinated as soon as possible. Our current outcomes are promising, keeping children with family and with the services needed.”

By providing swift access to specialized care and creating a crisis response unit, CAPP WV aims to reduce the burden of extended wait times, limit foster care transitions, and minimize out-of-state placements, ultimately paving the way for healthier and more resilient communities.

Aetna Better Health of West Virginia is the sole managed care organization serving MHP beneficiaries statewide, through the Department of Health and Human Resources (DHHR), and began supporting MHP in 2020. MHP covers the physical and behavioral health care services for children and youth in the foster care system and individuals receiving adoption assistance, as well as those in the Children with Serious Emotional Disorder (CSED) waiver program in West Virginia.