How Medicaid Can Help Child Welfare Systems Meet Kids’ Needs

Posted October 17, 2016, By the Annie E. Casey Foundation

A new primer on Medicaid offers hands-on advice for child welfare leaders, Medicaid agencies and service providers who want to do a better job of collaborating to meet kids’ behavioral health needs.

Funded by the Annie E. Casey Foundation, Partnering with Medicaid to Advance and Sustain the Goals of the Child Welfare System, “offers concrete guidelines to help,” says Tracey Feild, director of Casey’s Child Welfare Strategy Group. “State Medicaid authorities and their provider networks can be key resources for child welfare leaders. But only if they know how to work together.”

Feild adds, “Let’s say you have a teen who has an Individualized Education Plan at school for learning disabilities, sees a psychologist because of acting out in class, and then gets removed from home by child protection services. What is the best way to meet this teen’s multifaceted needs?”

In many instances, say the authors of Partnering with Medicaid, the answer is to use Medicaid-funded services and supports that allow the teen to thrive while living at home or in family foster care — without an unnecessary placement in a residential setting. Out-of-home placements, the report notes, are generally counter-indicated because they can “exacerbate [the teen’s] existing sensitivities and fears” and be ineffective and costly.

Instead, child welfare agencies and partners must collaborate to develop a flexible array of behavioral health services and supports to help children and teens while they live at home, with their parents or other caregivers. In most communities, Medicaid is the chief funder of such services.

Partnering with Medicaid offers brief case studies of states with successful Medicaid/child welfare partnerships, including Massachusetts, New Jersey and California. It also describes several models by which child welfare agencies and Medicaid can work together, noting that pathways to collaboration differ depending on a number of factors, including whether the child welfare agency is state- or county-run and whether the Medicaid agency is in the same or a different agency than the state’s behavioral health services.

“Currently, the small number of kids who access Medicaid-funded behavioral health services account for nearly a third of total Medicaid spending for children,” Feild says. “Better collaboration can provide more kids with earlier, more effective and less costly services. That’s a much better way to help kids and put our hard-earned tax dollars to work.”

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