By Nadia Ramlagan
Changes in federal law will permit West Virginia and other states to use Medicaid dollars to pay for health care services for incarcerated youths beginning Jan. 1.
In addition to helping kids get physical and dental health care, the new rules should give them needed resources to address mental and behavioral health challenges stemming from childhood trauma.
Elizabeth Crouch, associate professor of health services policy and management at the University of South Carolina, said mitigating adverse childhood experiences is a growing part of efforts to keep rural children out of the juvenile justice system and detention.
“A fifth of rural children are diagnosed with developmental behavioral mental health disorders,” Crouch pointed out. “Rural children are more likely to be diagnosed with developmental behavioral disorders, such as ADHD, than their urban counterparts.”
About 45% of West Virginia children experience adverse childhood experiences, a rate five points higher than the national average. The Medicaid coverage for youth in detention includes physical, dental and behavioral health screenings and case management services.
States are also taking into account neurocognitive research showing teen brains do not fully develop until the mid-20s. Crouch noted arrests of young people have dropped by more than 80% since the mid-1990s, as a greater understanding of childhood trauma has increased the number of alternatives to detention. Still, she acknowledged the challenges for rural kids are formidable.
“What we have found is that rural children have been disproportionately living in homes affected by current substance use or mental illness,” Crouch explained. “Rural children have experienced much higher rates of opioid use.”
Despite declining arrests and detention rates, young people of color are still far more likely than white youth to be held in juvenile facilities, according to The Sentencing Project.
