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HHS Releases Guidance on Addressing Trauma & Improving the Social-Emotional Health among Children Known to Child Welfare

Administration for Children & Families – June 26, 2013 | Bryan Samuels

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Today, I’m pleased to announce the release of a letter to state child welfare, Medicaid, and mental health directors on the importance of focusing on identifying and treating trauma among children and youth known to the child welfare system. The letter includes useful and actionable information for policymakers on the effects of trauma and cross-system strategies for addressing it to include important information about federal funding streams and flexibilities.

Across disciplines, researchers recognize that childhood trauma, particularly when it is interpersonal in nature, has a profound effect on development and well-being. Its effects damage children’s functioning in the short term and reverberate across the lifespan.

Photo of a young scared child hugging an adult.

Children and youth in foster care are a diverse group; however, they share a history marked by exposure to trauma – from abuse, neglect, or witnessing violence. Child welfare systems, charged with ensuring safety, permanency, and well-being for those they serve, have a responsibility to support healing and recovery from trauma to improve outcomes for this particularly vulnerable population. Medicaid and mental health systems are essential partners in this work.

The letter, signed by Acting Assistant Secretary for Children and Families George Sheldon, CMS Administrator Marilyn Tavenner, and SAMHSA Administrator Pam Hyde, encourages state leaders of these three systems to develop integrated approaches to address trauma for children and youth in child welfare. It also outlines ways in which system leaders can take advantage of existing opportunities to strengthen trauma-focused efforts. Some of these include:

  • In child welfare: Using IV-E dollars to support training on the nature and consequences of child trauma, the use of screening and assessment tools and practices, and the array of evidence-based interventions to address trauma
  • In Medicaid: Designing Early Periodic Screening, Diagnosis, and Treatment benefits to better meet the needs of children with behavioral health issues
  • In mental health: Using Mental Health Block Grant funds to develop and identify strategies that build state and provider capacity to deliver evidence-based, trauma-specific interventions in the context of a trauma-informed delivery system

The letter is intended to help further that work to implement effective approaches to address the specific needs of this vulnerable group of children and their families. We hope the information is both helpful in current efforts and spurs new thinking, new partnerships and increased capacity to deliver the screening, assessment and evidence-based practices that can help children and youth get back on track developmentally.

Bryan Samuels is the Commissioner of the Administration on Children, Youth and Families(ACYF). Samuels has spent his career formulating service delivery innovations and streamlining operations in large government organizations on behalf of children, youth, and families.

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