{"id":31764,"date":"2020-08-10T17:27:02","date_gmt":"2020-08-10T17:27:02","guid":{"rendered":"https:\/\/caseyfamilyv2.wpengine.com\/medicaid-waiver-authorities-2\/"},"modified":"2026-07-13T16:25:23","modified_gmt":"2026-07-13T16:25:23","slug":"medicaid-waiver-authorities","status":"publish","type":"post","link":"https:\/\/www.casey.org\/es\/medicaid-waiver-authorities\/","title":{"rendered":"\u00bfCu\u00e1les son las pr\u00e1cticas prometedoras para utilizar las Enmiendas al Plan Estatal de Medicaid y las exenciones para abordar las necesidades de los ni\u00f1os y j\u00f3venes en hogares de acogida?"},"content":{"rendered":"
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Summary<\/h3>\n

This brief explains how specific healthcare funding and delivery models are organized to better provide medical and mental health services to children in foster care.<\/em><\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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By the Center for Health Care Strategies<\/a><\/p>\n\n\n

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Virtually every child and youth in foster care is eligible for Medicaid and receives health care services through a Medicaid provider. Children in foster care are more likely<\/a> to have both physical and behavioral health conditions requiring treatment. Given the shared responsibility that Medicaid and child welfare agencies have for this population, state agencies are increasingly looking to collaborate more effectively to improve health outcomes for children and youth involved in the child welfare system. Part of this process requires a shared understanding of the financing mechanisms available to fund services through Medicaid.<\/p>\n

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State Medicaid agencies have two primary vehicles for making changes to the services and benefits provided to beneficiaries: state plan amendments (SPAs) and waivers. This issue brief outlines how these vehicles are structured and how they may be used to address the health needs of children and youth involved in the child welfare system.<\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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State Plans<\/h2>\n \n \n \n

A Medicaid state plan is an agreement between a state and the federal government describing how that state will administer its Medicaid program. Through the state plan, the state provides assurance of how it will abide by federal rules. It also defines the parameters for how and when the state will be able to claim federal matching funds. The state plan describes the groups of individuals to be covered, services to be provided, methodologies to reimburse providers, and administrative activities in the state. Given that state plans address programmatic areas that comply with federal rules, no waivers are required for services addressed within the state plan. Further, the federal government negotiates the state plan through one part of state government (referred to as the “single state entity”) even if the administration of certain Medicaid services and financing are delegated to other entities within state government. For example, the state Medicaid agency may be the “single state entity” and negotiate certain services that are delivered by and with the match funding provided by the Department of Mental Health.<\/p>\n

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State Plan Amendments <\/b><\/h3>\n

A state’s Medicaid state plan does not have to be updated unless a change is made. When updates are needed, agreement between the state and federal government is facilitated through the state’s submission of a State Plan Amendment (SPA). Given that state plans address programmatic options allowed under existing federal rules, SPAs are only used to make changes to a state’s plan that also comply with existing federal rules. Any changes proposed in a SPA must:<\/p>\n