Continued access to robust, community-based services covered by Medicaid in childhood directly reduces costs on other state and community resources. Without this access, the Commonwealth will experience increased costs of incarceration, hospitalization, in-patient services, low graduation rates, teen pregnancy rates, etc.—which are all negative outcomes associated with not receiving intervention for childhood trauma or early onset mental illness. Please keep access as open as it is now for children to receive outpatient mental health services. Even with license-eligible counselors and social workers able to serve Medicaid clients while under supervision, there is a greater demand for services to children than providers are able to meet. Further constraining access is tantamount to creating a community health crisis for families in the Commonwealth. DO NOT approve the proposed changes to provider qualifications for psychiatric services as outlined in Chapter II, pages 15-16 to eliminate the ability of residents in counseling and supervisees in social work to see clients in outpatient counseling settings.