Virtually every child and youth in foster care is eligible for Medicaid and receives health care services through a Medicaid provider. Children in foster care are more likely to have both physical and behavioral health conditions requiring treatment. Given the shared responsibility that Medicaid and child welfare agencies have for this population, state agencies are increasingly looking to collaborate more effectively to improve health outcomes for children and youth involved in the child welfare system. Part of this process requires a shared understanding of the financing mechanisms available to fund services through Medicaid.

State Medicaid agencies have two primary vehicles for making changes to the services and benefits provided to beneficiaries: state plan amendments and waivers. This issue brief outlines how these vehicles are structured and how they may be used to address the health needs of children and youth involved in the child welfare system.