June 2024Vol. 25, No. 5Considerations for Linking Child Welfare and Medicaid Data

Historically, states have not linked their child welfare and Medicaid data, despite many children involved with child welfare being eligible for Medicaid. A recent project from the Office of the Assistant Secretary for Planning and Evaluation; the Office of Planning, Research, and Evaluation; and RTI International explores the benefits of connecting this data.

The Child and Caregiver Outcomes Using Linked Data (CCOULD) project began in October 2019. Its goal was to provide technical assistance to states in linking child welfare case-level data and Medicaid administrative claims of children and their caregivers. A recent research brief provides lessons learned from the project based on the experiences of two states, Kentucky and Florida. Both states created linked datasets covering 2016 through 2021, with Florida's including 80 percent of children who had been in contact with child welfare and Kentucky's including 81 percent.

The brief highlights lessons learned in four categories:

• State recruitment and short- and long-term sustainability of the linkage project: Florida and Kentucky joined the project following a robust recruitment effort, which took longer than anticipated, according to the report. In the future, linkage efforts could focus on highlighting the value of linking data to states.
• Data availability, consistency, and quality: Agencies may not have data dictionaries or user guides for their data and infrastructure. There was also a lack of data on caregivers and title IV-E prevention services.
• State and federal regulations related to data linkage and sharing: States may benefit from clarifying regulations, improving data sharing, and following federal guidance.
• Linkage methodology: The CCOULD project used a common data model and was able to link most children and caregivers using Social Security numbers. However, the linkage of parents to children was challenging because of a lack of family identifiers in Medicaid claims.

To explore the lessons learned in more detail, read the full research brief, Linking Child Welfare and Medicaid Data: Lessons Learned From Two States.