Infant-early childhood mental health services

Infant-Early Childhood Mental Health (IECMH), sometimes referred to as social and emotional health, is the developing capacity of the child from birth to 5 years of age to form close and secure adult and peer relationships; experience, manage, and express a full range of emotions; and explore the environment and learn—all in the context of family, community, and culture (Cohen & Andujar, 2022).

This page helps providers, billers, and partners stay informed about how to provide infant-early childhood mental health treatment services to children enrolled in Apple Health (Medicaid).

Want to connect with HCA's IECMH team? Visit our IECMH Statewide Tour webpage to find out when HCA is coming to visit you! 

Stay informed! Want to stay updated on work related to infant-early childhood mental health?


Approximately 1 in 5 young children has a diagnosed mental, behavioral, or developmental disorder (Vasileva et al., 2021). These disorders, if properly identified, can be treated with infant-early childhood mental health (IECMH) services, which are designed to alleviate the distress and suffering of a young child’s mental health problem and support the return to healthy development and behavior, by enhancing the quality of the caregiver-child relationship. IECMH treatment services are highly effective and offer a strong return on investment; every dollar spent on IECMH treatment services can yield $8.00-$15.00 in savings per child (Oppenheim & Bartlett, 2022). Mental health providers contracted with Apple Health (Medicaid) can provide mental health treatment services to children birth through age five and their families.

Medicaid contracting and billing is a complex process in general, and services for infant-early childhood mental health (IECMH) treatment, a newer concept for care, can feel even more complex. To support providers in this work, HCA and their partners currently offer multiple resources, tools, and opportunities for connection.

IECMH office hours

The Health Care Authority (HCA) IECMH team offers quarterly virtual office hours to support providers and agencies on topics related to IECMH and Apple Health (Medicaid). This is a time for providers to build connections, ask questions, and discuss additional IECMH needs.

Join the next IECMH Office Hour: Thursday, January 25, 10-11am.

Slides from past IECMH office hours

Mental Health Assessment for Young Children (MHAYC)

When providing mental health treatment services, mental health professionals first conduct a mental health assessment (i.e., Psychiatric Diagnostic Evaluation or Intake Evaluation) to identify needs and establish whether a child meets medical necessity criteria. For children birth through age five, the DC:0-5™ is the developmentally appropriate tool for assessment and diagnosis. To find resources about billing for mental health assessment for young children and using the DC:0-5™, please visit the Mental Health Assessment for Young Children webpage for providers.

Other IECMH resources

Additional resources to support providers in aligning with Apple Health (Medicaid) policies and procedures for infant-early childhood mental health treatment services.

IECMH toolkit

In response to questions and feedback from the provider community, HCA's IECMH team has developed a toolkit on service models for providing IECMH services through Apple Health. The Apple Health Infant-Early Childhood Mental Health Service Models Toolkit covers:

  • Avenues to provide mental health services and bill Apple Health for these services
  • Requirements to become a licensed mental health provider or behavioral health agency (BHA) with Department of Health (DOH)
  • Additional resources and supports
Evidence-based practices

The use of high-quality psychotherapy services, or evidence-based practices (EBP), for children is reported using EBP codes submitted as part of routine Apple Health (Medicaid) billing data. The current EBP Reporting Guide outlines eligible training entities and documentation requirements for evidence based Infant Mental Health treatment.

WISe Birth through Five (B-5)

Mental health providers contracted with Apple Health (Medicaid) can provide intensive mental health treatment services, including WISe (or Wrap-around with Intensive Services) to children birth through age five and their families. Because intensive mental health services for young children is a newer concept for care, additional resources about this topic are available on the WISe webpage for providers.

Emotional Health of Babies and Toddlers flyers

This set of flyers is about the basics of emotional health for babies and toddlers, and how we all can play a role in supporting families of young children. These flyers are designed for either print or digital dissemination, with customized content for different audiences, including behavioral health, child welfare, early learning, and health care providers.

The flyers were codeveloped by the Barnard Center for Infant Mental Health, the Washington Association for Infant Mental Health, The Practice Northwest, the Department of Children, Youth, and Families, and the Health Care Authority, with support from Zero To Three.

Download or print the flyers

B-5 at BHAs presentation

In June 2023, the HCA IECMH team presented at the Washington Behavioral Health conference about infant-early childhood mental health best practices and opportunities for behavioral health agencies. These slides are a useful tool for anyone interested in providing mental health services to young children and families. 

IECMH reports and data

As outlined in HCA's data strategy, data is one of HCA's most valuable assets, helping us understand strengths and challenges, holding us accountable, and informing our efforts to champion health equity. The HCA IECMH team is committed to gathering, examining, and sharing information about our work in partnership with communities, providers, and families. The stories told in these reports from HCA help us move towards our vision of building a strong IECMH network in Washington state. 

HCA contracts with the Infant-Early Childhood Mental Health Workforce Collaborative (IECMH-WC) to coordinate DC:0-5™ training and other professional development supports for mental health assessment for young children. The IECMH-WC publishes reports about their work on a regular basis, including the number of trainings offered, the demographics of training participants, and the impact of trainings on knowledge and skills. These reports are available on the IECMH-WC Reports webpage.

HCA’s innovative work on infant-early childhood mental health has been featured in several national publications. These reports demonstrate how Washington state is leading the way when it comes to whole-person, high-quality, and community-centered care in the earliest years of life.

IECMH updates

HCA wants to make sure you’re informed about our infant-early childhood mental health work. Subscribe to the Prenatal through Age 25 behavioral health mailing list to get the latest bulletin updates. Starting May 2023, you can also subscribe to receive our monthly Prenatal – Five: Grow & Thrive newsletter.

Recent bulletins and newsletters are linked below; older items are available upon request.


Email: Christine Cole, LCSW, IMH-E®
Infant and early childhood mental health program manager

Email: Kimberly “Kiki” Fabian, M. Ed
Infant and early childhood mental health systems analyst