When children enter foster care, the state child welfare agency assumes responsibility for their safety, permanency, and well-being. In order to meet those needs, child welfare agencies rely on connections with other entities, like Medicaid, to fund and coordinate services. Studies have shown that children in foster care have higher rates of complex physical and behavioral health service use, establishing them as a high-cost, high-need population. As such, Medicaid and child welfare agencies have a shared responsibility to provide children, youth, and their families with quality health and health-related services in a way that is coordinated and strives to improve well-being, while paying particular attention to their unique needs.
The Family First Prevention Services Act (FFPSA), signed into law in 2018, creates an opportunity for cross-system coordination between state Medicaid and child welfare agencies. FFPSA provides historic reforms to federal child welfare financing by allowing states to redirect federal funding from high-cost out-of-home care to prevention-oriented services that preserve families and ensure children remain in a home setting whenever possible. Many of the prevention services outlined in FFPSA, as well as some of the therapeutic components of residential services, can be funded through Medicaid. Therefore, it is critical that state Medicaid and child welfare agencies work together to ensure the resulting service array fills gaps, increases timely access to services, and is not duplicative.
To facilitate cross-system coordination between state Medicaid and child welfare agencies and take advantage of new opportunities available under FFPSA, the Center for Health Care Strategies (CHCS), with support from Casey Family Programs, created a set of technical assistance briefs describing the role of Medicaid for children involved with the child welfare system. These foundational resources are designed to help staff within state child welfare agencies understand the Medicaid landscape and more effectively coordinate with their state Medicaid partners in providing timely and quality health-related services to children and youth involved in the child welfare system. The resources were developed under Advancing Child Welfare and Medicaid Alignment, a national CHCS initiative aimed at fostering cross-agency alignment and capacity building between state child welfare, Medicaid, and behavioral health agencies.
Technical Assistance Briefs
- How can Medicaid-funded services support children, youth, and families involved with child protection? This brief describes how states can leverage Medicaid to provide a broad array of services, including evidence-based practices, for children, youth, and families involved with child welfare systems.
- How can jurisdictions ensure consistent health care access for children and youth in foster care? This brief highlights how states can ensure better continuity of care for children in foster care by implementing continuous eligibility for Medicaid and Children’s Health Insurance Program coverage.
- What are promising practices for using Medicaid to address the needs of children and youth in foster care? This brief outlines how state Medicaid agencies can use state plan amendments and waivers to address the health needs of child welfare involved children and youth.
- How can Medicaid support the treatment costs for youth in residential programs? This brief details how Medicaid funds support residential treatment programs and outlines considerations to help jurisdictions plan for Family First Prevention Services Act implementation in their state.
Medicaid Webinar Series
Casey Family Programs developed a webinar series, including presenters from CHCS, to provide an overview of the Medicaid program and build an understanding of how Medicaid services and supports can address the needs of children and families involved in the child welfare system.