Overview Medi-Cal and Child Welfare
Purpose
Provide information to Child Welfare Agencies (CWAs) about Medi-Cal plans and the services they provide. Assist CWAs and the families they serve to gain a better understanding of Fee-For-Service (FFF) and Managed Care Plans (MCPs), and foster youth Medi-Cal mental health services so an educated choice can be made when picking a health care plan for foster youth.
Additionally, the purpose is to provide MCPs a high-level overview of the Child Welfare System in order to best serve foster youth who choose a MCP as their Medi-Cal provider.
Background of Medi-Cal:
Medi-Cal is the Medicaid program in California that allows low-income individuals and families access to medical providers and services. The California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS) oversee the program.
Background of Child Welfare:
Child Welfare Services (CWS), also referred to as child protective services (CPS), are the major system of intervention of child abuse and neglect in California. Existing law provides for services to abused and neglected children and their families. CWS goal is to keep the child in their home when it is safe, and when the child is at risk, to develop an alternate plan as quickly as possible. Resource Parents or Kinship Providers or Non-Relative Extended Family Members provide a supportive and stable family for children who cannot live with their parents due to challenges such as parental neglect, abuse, or exploitation that has led to an unsafe environment for the youth.
Background of Foster Youth and Mental Health:
Children and families involved in child welfare must navigate complex systems such as medical care, behavioral health, social services, intellectual and developmental services, education, and the justice system. Mental health challenges are a major concern among children and youth in the foster care system. Up to 80% of children in foster care have significant mental health challenges, compared to approximately 18-22% of the general population. Half of children and youth receiving foster care do not receive any specialty mental health services (SMHS) which could help address trauma and prevent the development of later health conditions.
The American Academy of Pediatrics identified mental and behavioral health as the greatest unmet health need for children and youth in foster care. Factors contributing to the mental and behavioral health of children and youth in foster care includes the history of complex trauma, frequent transitions of placement and situations, complex family relationships, inconsistent and inadequate access to mental health services and the over-prescription of psychotropic medications.
Call your MHP toll-free phone number to request an initial assessment.
You may also be referred to your MHP for SMHS by another person or organization, including your doctor, school, a family member, guardian, your Medi-Cal managed care health plan, or other county agencies. Usually your doctor or the Medi-Cal managed care health plan will need your permission, or the permission of the parent or caregiver of a child, to make the referral directly to the MHP, unless there is an emergency. Your MHP may not deny a request for an initial assessment to determine whether you or your child meet the criteria to receive services from the MHP.