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Mental Health Care for Child Welfare Clients During the last decade the Medicaid program has become an increasingly important element of the mental health treatment in Florida. Consistent with this growth, the Agency for Health Care Administration (AHCA) has introduced a number of initiatives that are designed to improve the efficiency and effectiveness of the Medicaid program. In order to implement these programs and to determine the degree to which they are effective in accomplishing their goals, AHCA has contracted with the Louis de la Parte Florida Mental Health Institute (FMHI) to engage in several evaluation projects. The AHCA Child Welfare Study specifically assesses the mental health care provided to child welfare clients within the state of Florida. This research is in its third year. We are presenting on the results of the second year of study, FY 2000-01; however this handout provides an overview of each of the three years of the AHCA Mental Health Care for Child Welfare Clients Project. Year 1 (FY 1999-2000): Child welfare and Medicaid historical administrative data were analyzed for FY 1997-1998 in AHCA Areas 4 and 6. Descriptive information on the demographics of the children served, penetration rates for mental health services, and service utilization patterns were compared among the various health plans. Services provided to children varied based on the health plan in which they were enrolled, although high percentages of children accessed physician services related to mental health issues. Children in the Medipass Area 4 and Medipass/PMHP health plans accessed mental health services at a level consistent with conservative estimates of need for mental health intervention. Overall, the HMOs had provided mental health services to significantly fewer children with similar involvement in the child protective system. Further study was suggested to assist in understanding the concomitant mental health needs of children in the child welfare system. http://www.fmhi.usf.edu/institute/pubs/pdf/ahca/2000-berson-armstrong-historical.pdf Year 2 (FY 2000-01): Clinical case record reviews were designed to assess: (a) access to and level of care provided to child welfare clients by fee for service and managed care plans/providers; (b) the appropriateness of provider networks for this population; and (c) whether the mental health needs of the children receiving protective services are being met. It was found that the children who have accessed Medicaid-funded mental health services have more extensive and pervasive mental health problems than non-service users. The children who did not access Medicaid-funded mental health services displayed much higher levels of resiliency overall. Barriers to treatment included client noncompliance, lack of proper financial or emotional support, mobility of children and families, and family history of disturbance. http://www.fmhi.usf.edu/institute/pubs/pdf/ahca/2001-berson-etal.pdf Year 3 (FY 2001-02): Thirty clinical case studies were conducted, sampling from two counties in AHCA Area 6. The case studies included a child in foster care who receives Medicaid-funded mental health services, the caregiver, and a primary behavioral or mental health service provider. Semi-structured interviews and clinical assessments (Child Behavior Checklist, Youth Self Report, and Trauma Symptom Checklist for Children) assessed: (a) how demographic, behavioral, attitudinal, family and service system factors are related to service use patterns; (b) how foster care outcomes (child safety, permanence, child well being and family stability) are supported through the mental health services received; and (c) whether interventions have been designed to include multiple systems (the child, foster parents, peers, school staff, behavioral and mental health professionals, and the broader community). Go to top of page

The Consortium for Child Welfare Studies is sponsored by the Department of Child and Family Studies at the Louis de la Parte Florida Mental Health Institute, a college of the University of South Florida.

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