Behavioral Health Service Utilization and Cost for North Carolina's Foster Children: A Report for Partnering For Excellence.
Foosness, Susan Cohen.
Published: April 2014
This paper explores how county Departments of Social Services (DSS) and Local Management Entity-Managed Care Organizations (LME-MCOs) in North Carolina use existing data to better manage the foster care population and improve mental health outcomes. It begins by discussing the prevalence of mental health disorders among children and youth in foster care as well as their behavioral health utilization and costs to Medicaid, effective models of treatment, and barriers to accessing services. Findings are then provided from a study that used child protective services, services information system, child placement and payment system, and Medicaid behavioral health services data for Rowan County for 2004 through 2012. Results indicate foster children have significantly greater behavioral health issues, utilize more services, and account for a disproportionate amount of behavioral health expenditures. It found that there may be inadequate and inconsistent behavioral health assessments of high-risk children who have contact with child protective services, and particularly for children in DSS custody. Policy recommendations are made to address the systemic challenges to providing effective high quality behavioral health services to children in contact with child welfare. Recommendations include using trauma informed comprehensive clinical assessments, evidence-based practices, and care coordination, identifying high-cost and high utilization indicators and providing wraparound services, providing continuity of care with behavioral health providers and addressing barriers, and providing training to DSS workers. 9 figures, 12 tables, and 34 references.
foster children; North Carolina; mental health services; behavior problems; barriers; use studies; service integration; costs