Making a Truly Healthy Transition to Adulthood Relies on a Strong Medicaid Program and Our Commitment to Enhance Access to Quality Care

Jennifer Pokempner, Child Welfare Policy Director, Juvenile Law Center,
Three youth standing together talking.

Unlocking Potential: The Strength of Our Stories as the Key to Child Welfare Reform was released in July 2017. It is the Congressional Coalition on Adoption Institute 2017 Foster Youth Internship Program Report and contains 12 recommendations for reforming the child welfare system. The Chronicle of Social Change has been spotlighting each of the 12 recommendations and providing commentary. The 12 recommendations are excellent and present policy responses that reflect the insight and experiences of youth who have been in foster care. Because of the continued activity around the federal health care law—and its importance to the health and well-being of current and former youth in foster carewe wanted to provide a special highlight on Justin Abbasi’s recommendation related to access to behavioral health services and the Chronicle’s commentary.

Meeting a young person’s health and behavioral health needs is foundational to a successful transition to adulthood. If these needs are not met, it is hard to meet other goals like working, going to school, and taking care of family. Making sure these needs are adequately addressed is a significant foster care and aging out issue because of the large numbers of youth in foster care who do have behavioral health challenges and have been exposed to trauma. For example, research shows that more than half of youth in foster care have significant behavioral health needs or developmental delays.

Abbasi’s proposal would help ensure that youth and young adults actually get the treatment they need as they age out by reducing barriers to access and improving quality. The recommendation is to do this by enhancing the transition planning requirement so that there is more detailed focus on informing youth about their insurance coverage and resources for treatment in the community; providing support services to reduce barriers to accessing treatment, like transportation; and providing funds for the development of trauma informed services targeted at transition aged youth.

The Chronicle raises some excellent points that are crucial in our current times. Behavioral health services currently should be available to youth aging out of foster care since they are eligible for Medicaid unto age 26. This access depends on the existence of a strong Medicaid program that includes the requirement of essential services such as behavioral health services. Abbasi’s excellent recommendations build on the base we have in Medicaid and leverages the Chafee Act and case planning/transition planning to improve access and quality. We should follow Abassi’s recommendations and do more to make sure barriers are reduced to make sure youth actually access what they are entitled to and develop the capacity and expertise to serve transition aged youth. This work does depend on continued advocacy to make sure the Medicaid program remains intact with such crucial component as the EPSDT requirement for youth under age 21 and the Essential Health Benefit requirement for adults.

Abbasi’s recommendations point out that there is more work to be done to ensure that youth making the transition to adulthood actually get the treatment and care they need and deserve to have a foundation for a successful and healthy life. They also remind us that protection of a strong Medicaid program is a vital child welfare and transition to adulthood issue.