Child and Caregiver Outcomes Using Linked Data

This project is a partnership between the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Office of Planning, Research, and Evaluation (OPRE). It is funded by the Patient Centered Outcomes Trust Fund. A contract to support this work has been awarded to RTI International.

HHS is working with states to enhance capacity to examine outcomes for children and parents who are involved in state child welfare systems and who may have behavioral health issues. Of particular interest are outcomes for families that may have substance use disorders, like opioid use disorder. Specifically this project seeks to develop state data infrastructure and increase the available de-identified data for research in this area.

HHS is currently working with two state agencies and universities to:

• Develop state-level datasets that link the Medicaid records of parents with the records of their children from the child welfare system
• Create multi-state research datasets for secondary analysis. These research data sets will be de-identified and archived as restricted access files with a third party data archive
• Develop a resource to document lessons learned and assist other states in accomplishing the above goals. This public-facing document will provide lessons learned on sharing and linking data between state Medicaid and child welfare agencies. These lessons and tools may include sample data agreements and advice about designing data structures, conducting analysis, and overcoming organizational barriers.

The project supports HHS’s goal to become better informed using all of the data available and find better outcomes for our nation’s struggle with opioids and substance use disorders (SUDs). This work will develop new linked data infrastructure, leverage existing data to gain new insights, and promote the use of the data to the broader research community, with minimal burden to state agencies.

Among other research topics, the linked datasets will allow researchers to:

• Identify trends in uptake and receipt of Medicaid-funded SUD treatment by parents involved in child welfare systems
• Explore how receipt of/adherence to treatment by parents relates to family stability, child maltreatment, and foster care outcomes such as length of stay in care or foster care re-entry
• Explore the role of child welfare systems in treatment uptake and adherence and how services provided by the child welfare system can supplement treatment provided through Medicaid
• Compare trends across states or counties that approach child welfare or the opioid crisis in different ways
• Relate SUD diagnoses and treatment to medical services utilized by children in the child welfare system
• Identify gaps in the provision of SUD treatment and other supportive services
• Provide the data infrastructure for rigorous evaluations of interventions

CCOULD Project Overview (PDF) 

Child and Caregiver Outcomes Using Linked Data Report  (PDF)

The points of contact for this project are Valeria Butler (OPRE), Robin Ghertner (ASPE) and Emily Madden (ASPE).