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Issue Brief 53 - 21st Century Cures Act


April 10, 2017

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The 21st Century Cures Act: Opportunities for Connecticut


Last year, the U.S. Congress enacted a historic and comprehensive effort towards mental health reform in America. The 21st Century Cures Act incorporates key provisions from various bills focused on mental health reform, including legislation championed by Connecticut’s Senator Chris Murphy. The 21st Century Cures Act amends language within existing law, such as the Public Health Services Act, to transform and improve our mental health care systems at the federal and state level, to promote the use of scientific and evidence-based practices, and to further integrate health and mental health care for children across the country. This reform provides validation of the historic work undertaken to improve mental health services in Connecticut and provides opportunities to expand these efforts moving forward. 

Selected provisions of the law are summarized below with examples of initiatives in Connecticut that are already making significant impacts in each area, with links to more information about these initiatives on CHDI’s website.



21st Century Cures Act Provisions

Related Initiatives in Connecticut

Improving state-level systems of care 

Requires states receiving mental health block grants to develop plans to promote the use of evidence-based practices that address the mental health needs of children across the state and to create a system of integrated care spanning social, educational, child welfare and judicial services.

Through the Connecticut Network of Care Transformation (CONNECT) initiative, funded by SAMHSA, Connecticut has created a partnership between families, state agencies, and service providers to support children and families in accessing the services they need in a timely and effective manner through an integrated network of care. Also, Connecticut is a national leader in using evidence-based practices to address the mental health needs of children. The Department of Children and Families (DCF) has worked with CHDI and other partners to disseminate or support an array of evidence-based treatments including seven designed to treat children’s trauma and mental health, with plans for adding more.  

Promoting children’s recovery from trauma

Reauthorizes the National Child Traumatic Stress Initiative (NCTSI) to support children recovering from trauma; authorizes grants that support the development of evidence-based practices and that identify and treat children’s mental and behavioral health conditions resulting from trauma; provides support for training initiatives that disseminate evidence-based and trauma-informed treatments to grantees, states, and service providers.

In Connecticut, CHDI has collaborated with state agencies, providers and others to build a comprehensive trauma-informed system of care, including workforce development, trauma screening, trauma services, access to evidence-based practices, and cross-system collaboration. The Early Childhood Trauma Collaborative (ECTC) was recently established in Connecticut to expand services to young children suffering from exposure to trauma. ECTC will disseminate four trauma focused evidence-based interventions for young children and will improve the capacity of Connecticut’s early childhood workforce to identify and treat trauma.  

Promoting infant & childhood intervention & treatment

Authorizes a new program to enhance infant and early childhood mental health promotion, intervention, and treatment programs; increases services for infants and children at significant risk or who have been diagnosed with a mental health condition; ensures that such programs and services are evidence-informed or evidence-based, and emphasizes maintaining supportive caregiver-child relationships. 

Connecticut policy makers, state agency officials, and providers have worked together to translate research on early childhood and infant attachment into effective policy solutions that improve skills and competencies among the mental health workforce and promote stable and nurturing relationships between children and caregivers. To promote early intervention, CHDI has worked to integrate mental health screening into early child care settings. CHDI’s Developmental Screening and Mid-Level Developmental Assessment initiatives help ensure social-emotional and other developmental concerns in young children are identified and addressed as early as possible.

Promoting screening & treatment for maternal depression 

Authorizes a new program to increase the percentage of mothers screened and treated for maternal depression within the first 12 months after giving birth, and to ensure that maternal screening takes place within pediatric primary care settings.

Pediatric primary care providers across Connecticut have significantly increased screening for maternal depression. CHDI has supported this increase by providing research, treatment information and screening tools for maternal depression to over 308 providers at 35 different child health practices.  

Improving the children’s health & mental health workforce

Prioritizes funds for educational programming and training that prepare students and professionals to work in integrated settings that include mental health, substance use, and primary care treatment, and to work in underserved settings; seeks to improve the skills and capacity of the mental health workforce to utilize evidence-based treatments and to integrate mental health services within primary care settings.

The Connecticut Office of Early Childhood (OEC) and the Connecticut Association for Infant Mental Health (CT-AIMH) have partnered with CHDI to develop Infant Mental Health Competencies for the early childhood workforce and to provide training to early care and education and health providers. The goal is to build competencies among the workforce and to actively promote infant and early childhood mental health in educational and healthcare settings.   

Integrating primary health & mental health care

Authorizes new grants that promote the integration of primary health and mental health care settings and increase coordination between the two systems. These “Integration Incentive” grants give special attention to the integration of primary care and behavioral health care for children and adolescents with serious mental illness and co-occurring physical health conditions. 

CHDI promotes the linking of behavioral health and primary care through the Educating Practices In the Community (EPIC) program, which provides free and comprehensive training spanning 17 topics to help pediatric practices across the state meet the health and mental health needs of children. ACCESS Mental Health CT is another statewide program that offers free consultative services to primary care practitioners seeking assistance in providing behavioral health care services to children and adolescence, regardless of insurance. These programs have led to a significant increase in the number of children screened, treated and/or  referred for mental health services by a primary care physician.

 While we wait to see if funds for the 21st Century Cures Act reforms are appropriated, the changes to existing mental health law ushered in by the reform reaffirm Connecticut’s work and provide opportunities to build upon existing initiatives that advance a comprehensive system of care for children and their families.

 For more information, visit or contact Kyle Barrette (, 860-679-4945)