How Medicaid Can Help Child Welfare Systems Meet Kids’ Needs

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

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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