Primary care, especially pediatrics, is largely focused on prevention. By supporting child and family health and well-being, pediatric and family care providers can help prevent unnecessary child welfare system involvement and reduce unwarranted and often biased reporting to child protective services, which disproportionately impacts families of color.

With Medicaid covering more than 40 percent of children across the nation — including over half of Black, Latino, and Indigenous children — there is significant opportunity for state Medicaid agencies to support primary care practices in building capacity to advance child and family well-being. This critical assistance can promote health equity and prevent child welfare system involvement.

This report, developed through support from the Conrad N. Hilton Foundation, explores the role of primary care in preventing families’ involvement with the child welfare system and identifies practice-level approaches for implementing effective interventions. It provides recommendations for how Medicaid programs can support practices and enable delivery system reforms that mitigate child welfare involvement. The recommendations align with recently released Centers for Medicare & Medicaid Services guidance on best practices to ensure children’s access to Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits.