By Laura W. Boyd, Ph.D., Public Policy and Government Relations Consultant, Foster Family-based Treatment Association
Finally, a state has responded to a need that afflicts adoptive families in all states!
Ask any child welfare advocate/professional whether in the public or private sector and you will hear of struggle after struggle by adopted parents to gain access to needed mental health services for children whom they adopted from state care.
The need for mental health services for children who have experienced traumatic events is of no surprise any more thanks to advances in research, clinical practice, and policy. Clearly, many adopted youth experienced trauma prior to entering the state system, while in the state system, or after adoption, which if not adequately addressed, continue to interfere with their current functioning, well-being, and ability to form and maintain relationships.
We do not know how many adopted youth are struggling with unresolved trauma. But we do hear frequently about adoptive families who feel forced to relinquish a child in order for that child to be able to access needed mental and behavioral health services. These situations are the most desperate; however, there are many other instances in which adoptive families struggle to find the behavioral health providers and services they need. Just ask any professional in the fields of foster care or adoption.
The North Carolina Medicaid office, at the urging of advocates and providers, has created a new policy that makes it easier for adoptive parents to get mental health services for their children. North Carolina has made it clear that wherever an adoptive family lives within the state, that family’s residence should be used for access to Medicaid treatment and provider payment of services.
For North Carolina families, this is important in two specific ways: 1- it restates that children who were on Medicaid at the time of their adoption continue to qualify for Medicaid services and reimbursement after adoption, and 2- for a state with a strong county administered services system, wherever that family lives is not relevant to being eligible for services.
All states should look to this example and adapt relevant practices for their adoptive families. Public agencies and private providers need to be reminded that federal law provides clear options for adopted youth. If the family chooses to seek services through their own insurance coverage, they may. However, federal law also states that the state Medicaid office “must allow an individual who would be eligible under more than one category to have his eligibility determined for the category he selects.” This means that adoptive parents are entitled to seek mental and behavioral health services for their child through Medicaid if that is their desire.
No child should be relinquished because of denied access to services or inability of parents to pay providers.
Sadly, many public child welfare agencies and certainly adoptive families do not know of the right of these families to access services if their child was eligible for Medicaid at the time of adoption. (Keep in mind that all foster youth are categorically eligible for Medicaid once in state care.)
As leaders in the child welfare and children’s advocacy communities, we may need educate and remind other public and private systems within the states where we live and work of this protection. Better yet, let’s not wait until the next incident arises whether in the press or through a phone call. There is nothing to prevent us from contacting public child welfare agencies and Medicaid administrators to be sure they are aware of the federal protection….and the example of North Carolina in providing clarity for the families in that state.