North Carolina’s Groundbreaking Health Plan for Children in Welfare System Launches
In a significant step towards enhancing healthcare accessibility for children associated with the child welfare system, the North Carolina Department of Health and Human Services has introduced the Children and Families Specialty Plan (CFSP). This initiative, which debuted on December 1, 2025, is the first comprehensive statewide health plan of its kind, developed in partnership with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and sanctioned by the North Carolina General Assembly. The plan is officially named Healthy Blue Care Together.
NC Health and Human Services Secretary Dev Sangvai highlighted the importance of this initiative, stating, “The Children and Families Specialty Plan is another example of NC Medicaid’s innovative efforts to provide seamless, integrated, and coordinated care to some of the state’s most at-risk people.” This underscores the plan’s goal to create a unified system for improving the wellbeing of children facing complex challenges.
Children and families within the child welfare framework often struggle with navigating a fragmented healthcare system. To address this, the CFSP aims to provide a holistic and coordinated array of services, including physical health, mental health, pharmacy, non-emergency medical transportation (NEMT), long-term services and supports (LTSS), and additional value-added benefits, ensuring coverage irrespective of geographic location.
Upon its rollout, around 32,000 children, youth, and young adults—both current and former participants in foster care, as well as their minor children—were automatically enrolled in the CFSP. The plan offers extensive coverage, encompassing all services under the Standard Plan and most services from the Tailored Plan. These include 1915(i) Home and Community-Based Services, enhanced behavioral health, and residential services. Mental health support extends to outpatient therapy, inpatient treatment, and crisis and therapeutic residential options for children. Additionally, the CFSP tackles unmet health-related needs such as housing, food, transportation, and interpersonal violence, alongside covering pharmacy, LTSS, and Intellectual/Developmental Disability (I/DD) services.
Despite the progressive strides, NC Medicaid has implemented provider rate cuts due to a budget shortfall from the North Carolina General Assembly for Medicaid rebase. These cuts, although detrimental to those relying on NC Medicaid, were unavoidable without further funding. The NCDHHS has committed to revisiting these cuts should the NCGA provide full Medicaid funding. The CFSP forms a part of the Session Law 2023-134 and is financed by the existing Medicaid budget.
The CFSP is among several efforts by the NCDHHS aimed at uplifting the health and welfare of North Carolina’s children and families. This includes a suite of services designed to prevent children from being placed in unsuitable environments like emergency departments and DSS offices, while offering additional support to them and their families. For a detailed overview of services for those involved in the child welfare system, view the white paper Transforming Child Welfare in North Carolina: A Unified Vision for Children and Families.
Further details about the CFSP can be found on the Children and Families Specialty Plan webpage.
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