Mental health care utilization and expenditures by children in foster care

Area of Science:

• Child Health Services
• Mental Health Services Research
• Health Services Administration

Background:

• Children in foster care often face complex health and behavioral challenges.
• Understanding their mental health service needs is crucial for effective care.
• Comparison with other vulnerable populations, like children with disabilities, provides valuable context.

Purpose of the Study:

• To determine the prevalence of mental health diagnoses in children in foster care.
• To compare mental health service utilization and expenditures for children in foster care versus other Medicaid-eligible children.
• To assess if these patterns differ for children with disabilities.

Main Methods:

• Analysis of Medicaid claims and eligibility data from southwestern Pennsylvania (FY 1995).
• Inclusion of 39,500 children aged 5-17 continuously eligible for Medicaid.
• Categorization of outcomes by foster care status and Medicaid eligibility.

Main Results:

• Children in foster care were 3-10 times more likely to have mental health diagnoses.
• They had 6.5 times more mental health claims and 7.5 times higher hospitalization rates for mental health conditions.
• Mental health expenditures were 11.5 times greater ($2082 vs $181) than for children in the Aid to Families With Dependent Children (AFDC) program.

Conclusions:

• Children in foster care have substantially higher rates of mental health conditions and service use than AFDC children.
• Service utilization and expenditures for foster care children mirror those of children with disabilities.
• Reimbursement rates and care management strategies for children in foster care require reevaluation.