Healthcare Program-Policy Evaluation Analysis
Healthcare Program/Policy Evaluation |
Pediatric Mental Health Care Access (PMHCA) Program |
Description |
The PMHCA Program is a grant program developed by the Health Resources and Services Administration (HRSA) to help meet the mental and behavioral needs of children in the United States. The PMHCA program provides support to pediatric health professionals with consultation, training, resources, and referrals, which allow them to provide effective behavioral health care to children and adolescents through routine checkups. The PMHCA program was designed in response to the fact that an estimated 17% of children aged below 18 years in the US have a mental health issue, and only about one-half of them successfully seek out and have access to mental healthcare (Bettencourt et al., 2022). Accordingly, the PMHCA is designed with the purpose of promoting behavioral health integration into pediatric primary care by using telehealth modalities and other evidence-based approaches to provide high-quality and timely mental and behavioral healthcare to children and adolescents, promoting the integration of behavioral health in pediatric primary care in new or existing telehealth access programs, providing training and education to pediatric primary care professionals on children’s mental health, and supporting telehealth consultations and referrals. The program also serves as a resource for pediatric primary care providers and mental health care professionals. The overall goal of the PMHCA Program is to help achieve mental health equity regardless of race, ethnicity, and geography, especially in rural and other underserved areas. |
| How was the success of the program or policy measured?
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The PMHCA Program’s main outcome has been the notable increase in access to mental health services for children and adolescents, especially in the rural areas of the US. This has been due to the program increasing the number of mental healthcare providers accessible in pediatric primary care settings. The program has also resulted in increased collaboration among primary pediatric care providers, mental health specialists, including child psychiatrists, and other mental health and program coordinators, leading to enhanced equity in access to mental health services in rural areas. The program has also enhanced access to coordinated quality behavioral health services to children, adolescents, and their families in various sites, including emergency departments and schools, with reduced wait times and better mental health outcomes among pediatric patients.
The measures for the outcomes of the program have been through the use of data that the program’s awardees share with HRSA during reporting, review of data from health care provider (HCP) surveys, and data from practice-level surveys. Outcomes and program impacts have also been evaluated through nonexperimental time series in which PCP surveys, practice-level surveys, and program implementation survey/semi-structured interviews (SSI) are conducted. More data is also collected and reviewed from the National Survey on Children’s Health, National Health Care Surveys, and American Community Surveys. |
| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?
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The PMHCA Program has provided $22.9 million in federal funds to mental health programs for children across 43 states, with an extra $80 million announced in 2022 for expansion from primary care settings to schools and emergency rooms over the next four years (Lee et al., 2023). So far, the program is available in 46 states. Based on data from the HRSA (2023), in 2022, over 8,880 PCPs in 50 states and territories had participated in a statewide or regional PMHCA Program, with over 10,000 PCPs successfully receiving training. An estimated 27,000 children and adolescents receive mental care under the program, and a further 6,800 children and adolescents in rural and underserved counties receive care via telehealth services (Health Resources and Services Administration (HRSA), 2023). |
| At what point in program implementation was the program or policy evaluation conducted? | The HRSA has designed the PMHCA Program to allow evaluation at various stages of the program implementation, with data collected and evaluated during the implementation period and after the program had been fully implemented across all target states, regions, and territories. Most evaluations are conducted annually with a focus on evaluating outcomes and impacts of the program. |
| What data was used to conduct the program or policy evaluation?
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The awardees and other participants were required to share data with the HRSA, including data on patient demographics, the rates of mental health services utilization after the program was implemented, accessibility data, changes in mental health and clinical outcomes among children accessing the mental health services after the program implementation, number of participants, and training data. The evaluation also utilized qualitative feedback data from PCPs and other participants.
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| What specific information on unintended consequences was identified?
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No significant unintended consequences have been reported or identified so far in relation to the implementation of the PMHCA Program. However, there are possible and potential disparities in access to mental health services due to the barriers associated with the use of telehealth, especially in rural settings, including low levels of digital literacy and access to necessary technologies (Chen et al., 2021). |
| What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. | The main stakeholders in the PMHCA Program include children and adolescents, their families, pediatric primary care providers, mental health specialists, healthcare administrators within the states and regions already under the program, policymakers, and mental health community organizations. The group that will benefit the most from the results of the PMHCA Program includes the pediatric primary care providers; for example, they will receive needed support and resources to address pediatric mental health needs at the local levels. Others are children and adolescents, especially those in rural and underserved regions, as they will have enhanced access to timely and effective mental health care. |
| Did the program or policy meet the original intent and objectives? Why or why not?
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The PMHCA Program has so far achieved its original intent and objectives, including improving access to mental health services for children and adolescents in rural regions, promoting collaboration and coordination of mental healthcare services, training pediatric PCPs, and promoting mental health equity. Based on data from FY 2020, 4,500 PCPs in 21 states enrolled in a statewide or regional PMHCA Program, 3,400 enrolled PCPs received training, 3,000 children were contacted, and 2,000 children in rural regions received care (Reddy, 2021), which rose to 8,880 PCPs in 50 states and territories participating in a statewide or regional PMHCA program, over 10,000 PCPs successfully trained, over 27,000 children and adolescents getting contacted, and further 6,800 children and adolescents in rural and underserved counties receiving care via telehealth services (Health Resources and Services Administration (HRSA), 2023). |
| Would you recommend implementing this program or policy in your place of work? Why or why not?
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I would recommend the implementation of the HRSA’s PMHCA Program within my current practice settings for a number of reasons. Firstly, the program aims to promote access to mental health services for pediatric patients. It also focuses on training and collaboration, as well as enhancing pediatric mental health services coordination, which is critical to achieving equitable mental health care. Finally, I would recommend this program because it promotes the adoption of telehealth services in mental healthcare service delivery. |
| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.
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I could become involved in evaluating the program by
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| General Notes/Comments | The PMHCA Program aims to improve equitable access to mental health services for children and adolescents, especially those in rural and underserved regions, by providing consultation, training, and support to pediatric primary care providers. It also utilizes technology and integrates telehealth services in care collaboration and coordination, which improves the capacity of PCPs in rural regions to provide pediatric mental health needs at a time when the US is experiencing an increase in the number of children and adolescents with mental health disorders with limited access to mental healthcare services. |
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Question 
Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Healthcare Program-Policy Evaluation Analysis
The Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
Describe the healthcare program or policy outcomes.
How was the success of the program or policy measured?
How many people were reached by the program or policy selected?
How much of an impact was realized with the program or policy selected?
At what point in program implementation was the program or policy evaluation conducted?
What data was used to conduct the program or policy evaluation?
What specific information on unintended consequences was identified?
What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
Did the program or policy meet the original intent and objectives? Why or why not?
Would you recommend implementing this program or policy in your place of work? Why or why not?
Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.