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Children in Foster Care: Challenges in Meeting Their Health Care Needs Through Medicaid

NCJ Number
Margo Rosenbach
Date Published
March 2001
11 pages
This report provides data and information on Medicaid-funded services for foster care children in California, Florida, and Pennsylvania, and it offers recommendations for improving health services to this population.
The study period for California and Florida was 1994 and 1995; for Pennsylvania, it was 1993 and 1994, representing the most recent years of data available in each State. The study population was composed of children under age 19 with a foster-care placement during the year. The study encompassed only health care use and expenditures that were paid by Medicaid. The study found that children in foster care represented between 1 and 3 percent of Medicaid children, but between 4 and 8 percent of Medicaid expenditures. Most children were enrolled in Medicaid before they entered foster care, but between one-third and one-half lost their Medicaid coverage when they left foster care. Children in foster care were more likely than other groups of Medicaid children to have a mental health or substance abuse condition. Further, health care use varied considerably across the three States studied. Four main implications emerged for policy. First, discontinuities in health insurance coverage can have an adverse effect on access to care; policymakers should focus on ways to improve the continuity of health insurance coverage for children in foster care. Second, Medicaid may be underused as a funding source, since evidence of State variation in Medicaid expenditures suggests that States differ in the use of Medicaid to serve children in foster care. Third, a broad-based concept of care coordination is required; and fourth, the structure of managed care systems should recognize foster care children's needs. Study limitations are noted, and suggestions are offered for additional analyses. 4 figures