Does the state provide financial assistance to address health and mental health care needs for children in foster care?
The main resource for health and mental health services for any child served by the child welfare system is the child’s Medicaid health plan (MHP). This is why it is critical for children to get enrolled in Medicaid and assigned to an MHP as soon as possible after entry into foster care. The health plan covers the initial comprehensive medical examination and ongoing periodic medical examinations, dental care and mental health care for children with mild-moderate mental health needs. When children have Serious Emotional Disturbance, they are served through the Community Mental Health Service Provider (CMHSP). Children might start services in an MHP but if their mental health needs increase to a Serious Emotional Disturbance, they would shift to the CMHSP for treatment. Similarly, children receiving services through CMHSP might shift to a Medicaid health plan if they no longer meet criteria as Serious Emotional Disturbance. Care coordination during these transitions is critical.
The programs and/or services listed below are also available to children served by child welfare.
Children with Special Health Care Needs – Children's Special Health Care Services is a Michigan program within the Michigan Department of Health and Human Services that provides certain approved medical service coverage to some children and adults with special health care needs. Children must have a qualifying medical condition and be under 21 years of age. Persons 21 and older with cystic fibrosis or certain blood coagulating disorders may also qualify for services. For more information, click here.
Michigan Department of Health and Human Services (MDHHS) Incentive Payment – When community mental health providers provide Wraparound or Home-Based services to children in foster care or CPS Category 1 or 2, MDHHS provides an incentive payment to the Pre-Paid Inpatient Health Plan (PIHP), the administrative structure for the Community Mental Health service providers (CMHSP), in addition to the Medicaid capitation payment for the services provided. The incentive payment supports the CMHSP in building capacity for Wraparound or Home-Based services. Incentive payments are also provided to a CMHSP when a child in this population receives Wraparound or home-based services AND is new to the CMHSP or has not received services from the CMHSP for the last six months. This payment process is available to all the PIHPs/CMHSPs across the state.
Serious Emotional Disturbance (SED) Waiver – Children with a very high level of need (likely to be hospitalized without intensive community supports) may be eligible for the SED Waiver. Even children with private insurance can be made Medicaid eligible as a family of one if they meet the criteria for SED Waiver services. The SED Waiver providers services that are enhancements or additions to Medicaid State Plan coverage for children through age 20 with SED. Wraparound is a required service for children in the SED Waiver. The SED Waiver is not yet available in all counties. Click here for a map of the counties that participate in the SED Waiver.
Adoption Medical Subsidy – This is a program that can reimburse adoptive parents for costs to treat medical or emotional problems. The problems must have been there before the adoption. Parents must apply for this subsidy before the child’s 18th birthday. The subsidy is used only when all other medical coverage has been used fully. For more on adoption subsidy, see the Michigan Department of Health and Human Services (MDHHS) Adoption Assistance Manual (AAM 400).
In the uncommon event that a child needs assessment or treatment that is not able to be covered by Medicaid, MDHHS contracts with providers who perform these services. These services need to be approved by the MDHHS Adoption Assistance caseworker.
Health Liaison Officers - The Health Liaison Officers are based in Michigan Department of Health and Human Services offices. Their chief task is to provide support to protective services and foster care workers so that children’s health and mental health needs are met. This includes assisting with enrollment in Medicaid and scheduling comprehensive health examinations and building relationships between the foster care and health systems. If you do not know the Health Liaison Officer in your area, click here for a current listing.
Family Support Subsidy Program - Families may be eligible for this program if they have a child under age 18 who has been identified by Michigan’s public school system as having a special education eligibility category of:
- Cognitive impairment
- Severe multiple impairment
- Autism spectrum disorder
The local Community Metnal Health determines eligibility for this program. Families are paid a little over $200 per month. The family’s taxable income may not exceed $60,000. Families can be headed by birth parents, adoptive parents, or legal guardians. Foster parents are not eligible. In addition, the family cannot receive reimbursement from the medical Subsidy Program for Adoptive Children.
Mental Health Services for Children in Residential Settings – Mental health care including therapy and psychotropic medication treatment is arranged by a residential treatment provider. Community Mental Health service providers (CMHSP) cannot provide services to a child in a residential setting. However, 60 days prior to planned discharge, CMHSP can provide case management or Wraparound services to facilitate discharge and transition planning. Contact the Permanency Resource Manager in your area for assistance with transition planning from residential services to the CMHSP.