About this poster

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Panel information
Panel 6. Risk, Intervention, Prevention, and Action

Abstract

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A large proportion of children who receive child welfare services are eligible for Medicaid. Linking Medicaid data to child welfare system data can identify key areas of impact to promote more equitable outcomes for children and families, and locate opportunities to improve coordination between these two programs and improve the effectiveness of their services. As a result of identifying the importance and utility of linked child welfare and Medicaid data the Child and Caregiver Outcomes Using Linked Data project, a multi-state initiative, was implemented to link child welfare and Medicaid data systems. This poster demonstrates the capacity of linked child welfare and Medicaid data to advance equity research, using data from this project.

The goal of this project was to provide technical assistance to states in linking the Medicaid administrative claims of children and their caregivers with case-level data from the child welfare system and to combine the state-specific datasets into a multi-state, deidentified dataset for secondary data analysis by researchers. The linked dataset contains information from both child welfare and Medicaid information systems on case demographics, medical diagnoses, services, outcomes, and other information pertinent to identifying inequities within these systems. These data facilitate research on the relationships between receipt of child and caregiver Medicaid and child welfare services, health care outcomes, and child welfare outcomes.

Children engaged with child welfare systems in Kentucky and Florida from 2016 to 2021, and their caregivers were included in the dataset. Further, children and caregivers can be linked across child welfare and Medicaid data, which allows for research concerning inequities for both children and their caregivers to be identified. These data include information on: child welfare system engagement (including allegations and substantiated allegations of child maltreatment) on over 1,000,000 children, child welfare services supported in part by federal funds through Social Security Title IV-E, Medicaid enrollment, diagnoses, inpatient and outpatient claims, and prescription data on over 850,000 children with any child welfare involvement, and Medicaid data on over 85,000 caregivers with children engaged with child welfare services. Additionally, as part of this project, a randomly selected comparison sample of non-child welfare engaged caregivers and children were included in corresponding Medicaid data that can be used for analyses. Demographic data (race, ethnicity, and gender) available for linked children and caregivers, as well as comparison samples which is key for understanding areas of inequities in child welfare and Medicaid systems.

This project and data demonstrates the importance of research at the nexus of child welfare engagement and Medicaid usage. Linked data on services from child welfare and Medicaid are valuable for understanding a range of questions and topics that address critical challenges faced by families at risk of child welfare system involvement. Such research includes identifying indicators of risk for abuse and neglect to better target equitable prevention efforts, improving the implementation and effectiveness of interventions designed to treat substance use disorders and other behavioral health challenges, as well as promoting positive child development and family well-being. This poster discusses a range of potential research topics that could be explored using the dataset resulting from this project, and will present select exploratory analyses. The goal of this poster is to inform and inspire researchers to engage critically with this innovative and robust dataset to improve the lives of children and families. This poster will also provide guidance to researchers on the capacity of the data to address essential equity related research questions, and discuss limitations to aid researchers in their use of these data. The presentation of this poster will offer development scientists a new resource to examine and address inequity.

Author information

Author	Role
Brett Greenfield, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation	Presenting author

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