The North Carolina Department of Health and Human Services (NCDHHS) announced the launch of a new health plan for children and young adults who are —or were— under the child welfare system.
The program is called the Children and Families Specialty Plan (CFSP) and began operating on December 1, 2025.
According to an official statement from the NCDHHS, this is the first plan of its kind statewide and seeks to address a persistent problem: many families involved in the child welfare system face serious difficulties navigating a fragmented health system, with multiple agencies and coverages that do not always coordinate with each other.
Who is covered by the new program?
With its launch, the state automatically enrolled approximately 32,000 people. Beneficiaries include children and youth currently in foster care, as well as young adults under 26 who were previously in the child welfare system.
And minor children of those young people and young adults.
This is a population that has historically required a more complex level of support, both in physical and mental health. This demographic has frequently had difficulty maintaining continuity of treatment when they change homes, counties, or providers.
The following are eligible: Medicaid beneficiaries from North Carolina who are in foster care, receive adoption assistance, and are enrolled in the above foster care eligibility program.
This includes:
- Children and young people who are currently in foster care
- Children and young people currently receiving adoption assistance
- Young adults under 26 years of age who were in foster care at age 18
- Former foster children in North Carolina who turned 18 on or before December 31, 2022
- Former foster children in any state who turned 18 on or after January 1, 2023
- Children under 18 from these populations
- Children and youth who are currently in EBCI's Family Safety Program, or who meet the above criteria, are not automatically enrolled in the Specialized Plan for Children and Families, but have the option to enroll.
What does the Children and Families Specialty Plan offer?
The CFSP brings together, in a single state plan, medical services, mental healthlong-term support and additional benefits. According to the statement, this includes:
- Physical and mental health care.
- Outpatient therapy, hospital treatment, and residential therapeutic options for children.
- Crisis services.
- Pharmacy services.
- Non-emergency medical transport (NEMT).
- Long-term services and support (LTSS).
- Services for people with intellectual and/or developmental disabilities (I/DD).
- Standard Plan services and most Medicaid Personalized Plan services, including 1915(i) services.
In addition, the plan has the responsibility to identify and address non-medical needs that affect health, such as lack of housing, food, transportation, or experiences of interpersonal violence.
“This plan ensures a unified system of care and accountability when it comes to improving the well-being of children living with the most complex challenges,” said Dev Sangvai, North Carolina Secretary of Health and Human Services.
Why is this plan important?
The lives of children and young people involved in the child welfare system are often marked by constant transitions: changes of home, school, medical providers, and support services. Each change can affect their physical and emotional health.
El CFSP It seeks to reduce that instability by ensuring that, no matter where they live or which county they move to, they maintain continuous and coordinated access to all their medical and mental health care.
Concern over Medicaid cuts
The statement also warns that, due to a funding shortfall in the state Medicaid budget, the program had to implement trimmings in the fees paid to health care providers. The NCDHHS describes these cuts as “devastating” and notes that they could be reconsidered if the General Assembly decides to fully fund the Medicaid base.
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