A shared mission: On the indispensable partnership between Medicaid and child welfare in state governments, and the promise of research using linked data

Children whose parents experience mental health and substance use disorders are at greater risk of child welfare system involvement, especially in low-income families. Researchers have investigated whether the provision of established psychiatric services can effectively prevent child maltreatment and contact with state child welfare authorities. Their results have contributed to a promising body of knowledge which suggests that psychiatric treatments can be an important means of preventing child maltreatment and preserving families. However, the practical reality that Medicaid and the child welfare system are administered by two very distinct functions of state governments poses a set of serious obstacles to coordination of care and hinders the efforts of practitioners to deliver services in a way that meet families’ needs. This is particularly important in light of the implementation of the Family First Prevention Services Act, which requires states to provide a suite of evidence-based practices in an attempt to prevent removing children from their homes. This article discusses the creation of a new data asset called the Child and Caregiver Outcomes Using Linked Data (CCOULD), which provides researchers with a new way to test hypotheses about how the practices of Medicaid and child welfare agencies impact one another. CCOULD contains linked data of Medicaid claims with records from the National Child Abuse and Neglect Data System (NCANDS) and Adoption and Foster Care Analysis and Reporting System (AFCARS) for a set of over 1.5 million cases in Florida and Kentucky and is now available for request.