Reducing the number of children in foster care requires actionable policy and practical solutions. By identifying subpopulations of children and youth who use intensive or frequent services, we might shed light on those who lack the right types of support at critical junctures, live in overly restrictive environments, receive too many ineffective services, or require better and different ways of meeting their needs.

This cross-sector project linked and analyzed administrative data from two sites—the state of Tennessee and a three-county region in Florida including Hillsborough, Pinellas, and Pasco Counties—to identify children and youth who are frequent users of child welfare, Medicaid, and other services; to understand their characteristics and service use; and to find predictive factors of frequent service use.

Project goals

1. Help child welfare, Medicaid, and other service agencies achieve better outcomes for youth and families by providing more tailored and effective services
2. Use findings to demonstrate the need for service coordination across systems to identify better strategies to serve children in foster care
3. Demonstrate how savings could be realized if more effective services are provided earlier and coordinated across systems
4. Demonstrate the value of conducting cross-sector research using existing data

Research questions

1. What is superutilization of child welfare and other services? What are the distinguishing characteristics of children who experience superutilization of child welfare and other services?
2. Are there different types of superutilization? Specifically, are there types of superutilization based on frequency, duration, intensity, or cost of services?
3. What characteristics of children at the time of child welfare involvement—specifically at the time of entry into out-of-home care—predict superutilization?

Mathematica Policy Research conducted the study in partnership with Casey Family Programs and our site partners, including the Tennessee Department of Children’s Services, TennCare, the Florida Department of Children and Families, the Florida Agency for Healthcare Administration, and Eckerd Kids.