Health Conditions, Utilization, and Expenditures of Children in Foster Care. Selection of Study States


We used the following hierarchical criteria to aid in the selection process:

  1. Availability of Medicaid claims and enrollment data in the SMRF files
  2. Ability to identify foster care children in the SMRF files
  3. Identifiable foster care population of at least 10,000 children, to detect significant health conditions that are relatively rare events
  4. Degree to which children are enrolled in Medicaid managed care
  5. Variation in features of state foster care systems

As of August 1998, 34 states were participating in SMRF in 1995; 27 of these states were able to identify children who qualify for Medicaid because they are in some form of foster care or receive adoption assistance (Table II.1).(1)

Table II.1: States with State Medicaid Research Files (SMRF) that Identify Children in Foster Care, by Size of Foster Care Population.

Seven of the 27 states  California, Pennsylvania,(2) Florida, New Jersey, Washington, Wisconsin, and Georgia(3)  had foster care populations of more than 10,000 children, and Indiana had a population of nearly 10,000 children. Four additional states  Missouri, Colorado, Kansas, and Minnesota  each had populations between 6,000 and 8,000 children. The remaining states all had foster care populations of less than 5,000 children.

After we narrowed the list of states to the seven with at least 10,000 children in foster care, we considered two additional factors, namely the extent of Medicaid managed care enrollment and variations in state program characteristics. We now turn to a discussion of each factor.