Linked Child Welfare and Medicaid Data in Kentucky and Florida Highlights Racial Disparities in Access to Care.

Parents with serious mental health (MH) and substance use disorders (SUD) can face profound challenges caring for their children. MH/SUD treatment can improve outcomes for both parents and their children. This study evaluated whether parents with Medicaid with MH/SUD conditions whose children had child protective services (CPS) involvement were receiving MH/SUD treatment and whether receipt differed by race. We analyzed the 2020 Child and Caregiver Outcomes Using Linked Data (CCOULD) which contains Medicaid and child welfare records from Kentucky and Florida on 58,551 CPS-involved caregivers. Among caregivers with an MH diagnosis, White individuals were more likely than Black individuals to have received counseling (42% vs. 20%) or an MH medication (69% vs. 52%). Among caregivers with an SUD, White individuals were more likely than Black individuals to have received counseling (43% vs. 20%) or an SUD medication (43% vs. 11%). More effort is needed to connect parents with CPS involvement to MH/SUD treatment, particularly Black parents.