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Ensuring Health Care Access for Youth in the Child Welfare System

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Mathematica and UConn’s Innovations Institute partner to advance policymakers’ understanding of how Medicaid and child welfare agencies ensure youth in the child welfare system receive access to health care

The Medicaid and CHIP Payment and Access Commission (MACPAC) has awarded a 10-month contract to Mathematica to help the commission better understand the role and responsibilities of state Medicaid and child welfare agencies in meeting the health care needs of children and youth served by the child welfare system. Mathematica has partnered with the University of Connecticut School of Social Work’s Innovations Institute to shed light on the current state-specific child welfare landscape.

This report will inform MACPAC’s deliberations on policies and strategies for ensuring that Medicaid- and CHIP-eligible children in the child welfare system have timely access to quality care. Partnerships between state Medicaid agencies and state child welfare agencies are key to achieving access to health care for children and youth in child welfare systems. However, coordination is challenging and financing is complex, with systematic, historical, and structural issues contributing to the complexity of this coordination.

Mathematica and Innovations Institute bring extensive expertise to the intersection of Medicaid and child welfare services at the federal, state, and local levels across the country. Through this project, Mathematica and Innovations Institute will identify current federal rules that require state Medicaid and child welfare agencies to ensure health care access for Medicaid-enrolled children and youth in foster care. They will select, profile, and interview Medicaid and child welfare agencies in seven states that are diverse in demographics, Medicaid systems and structures, child welfare systems and structures, and levels of innovation and system-reform initiatives. They will provide MACPAC with information on how states implement federal requirements around health care access and the issues they face in ensuring the delivery of all necessary health services. They will also identify opportunities to address gaps in access and care through changes in federal policy.

MACPAC is a nonpartisan federal legislative branch agency responsible for policy and data analysis and recommendations to Congress, the secretary of the U.S. Department of Health and Human Services, and the states on issues affecting Medicaid and CHIP. The agency, comprising 17 commissioners from diverse regions across the U.S., is an independent source of information on Medicaid and CHIP. MACPAC publishes issue briefs and data reports throughout the year to support policy analysis and program accountability and to make recommendations to Congress on access to and quality of care, among other issues.

 

 

 

 

Supporting the Mental Health Crisis Workforce to Address the Needs of LGBTQ+

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The UConn School of Social Work’s Innovations Institute has launched a new training program for crisis counselors and first responders.

A Pride flag in the foreground, with a mental health professional seated in the distance.

As the nation works to build the systems and services necessary to respond to the U.S. mental health crisis, the workforce within those systems require support and specialized training to effectively address the needs of vulnerable populations and to meet the growing demands for care.

The UConn School of Social Work’s Innovations Institute leads a Center of Excellence for LGBTQ+ Behavioral Health Equity (COE), funded by U.S. Substance Abuse and Mental Health Services Administration, to provide behavioral health practitioners with vital information to support LGBTQ+ people.

Innovations—experts in instructional design and in behavioral health—has launched a new COE training designed to provide crisis counselors and first responders with in-depth knowledge to address the specific needs of and improve outcomes for LGBTQ+ populations.

In October of 2020, Congress passed the National Suicide Hotline Act, designating 988 as the new nationwide number for suicide prevention and mental health crisis. And in Spring of 2022, the U.S. Department of Health and Human Services announced $35 million in funding opportunities to strengthen and expand community mental health services and suicide prevention efforts.

These groundbreaking efforts paved the way for expanded services and support 24/7—important for LGBTQ+ people—a community that has been markedly impacted by negative mental health outcomes due to stigma, prejudice, and inequitable access to care.

“The current data on LGBTQ+ communities highlight the need for tailored and culturally responsive mental health services, particularly at times of mental health crises. Through trainings like this one we are implementing change strategies to directly address behavioral health disparities in the LGBTQ+ community and improve outcomes,” says COE Principal Investigator Marlene Matarese.

The Trevor Project’s 2023 National Survey on the Mental Health of LGBTQ+ Young People found that 41% of LGBTQ+ young people between the ages of 13 and 24 seriously considered attempting suicide in the 12 months preceding the survey. Their findings also highlighted that 56% of respondents were not able to access mental health care when they needed it in the preceding months.

Research also found that LGBTQ+  adults are at higher risk to suicide when compared to their straight and cisgender peers, and that older LGBTQ+ adults report high levels of isolation and loneliness, contributing to negative health and life outcomes. Disparate mental health outcomes are compounded for LGBTQ+ people of color who face multiple forms of discrimination.

Designed to improve mental health outcomes for LGBTQ+ people, the new self-paced online training was developed by the COE in partnership with Vibrant Health—administrators of the 988 Suicide and Crisis Lifeline. Titled Introduction to LGBTQ+ Populations with Special Considerations for the 988 Suicide & Crisis Lifeline the training addresses disparities; introduces accurate and respectful terminology, mental health considerations, the coming out process; and outlines the ways that 988 crisis counselors can support LGBTQ+ people over call, chat, and text.

Crisis counselors responding to those reaching out through 988 can build their knowledge and skills to address the needs of LGBTQ+ populations, thereby ensuring everyone who reaches out through crisis lifelines feel supported. The course takes approximately 60 minutes to complete and provides 1.0 CECs or a certificate of attendance.