Special Considerations for Children and Families Involved with the Child Welfare System

■ The high prevalence of serious and complex behavioral health needs among the children and families served by the child welfare system. Children in the child welfare system tend to be extremely vulnerable and are at high risk for health, mental health, and d e v e l o p m e n t a l problems. For children placed in foster care, the trauma of separation from their families and the experience of multiple moves within the foster care system itself can increase their vulnerability and compound their mental health problems. Since the principal funding source for health and behavioral health services for children in the child welfare system is Medicaid, Medicaid managed care directly affects this population of children. In the managed care reforms surveyed by the HCRTP, there was a 22% increase from 1997/98 to 2000 in those reforms that include children involved with the child welfare system—from 60% to 82%. When children in the child welfare system are included in the managed care plan, it is important to consider the special needs of this relatively small group of children who will require higher than average levels of services and supports.