Arizona seeks to amend 1115 waiver to improve care for former foster care youth


Hannah Saunders


The Arizona Health Care Cost Containment System (AHCCCS) is working with the CMS to amend the Medicaid Section 1115 Research and Demonstration Waiver, which would waive the requirement for foster youth between ages 18 and 26 to apply for other cash benefits in order to be eligible for Medicaid. The goal of the five-year waiver amendment is to promote the continuity of care and to improve health outcomes for the former foster youth population.

“Foster youth and former foster youth have a higher risk of experiencing multiple chronic health conditions and health related social needs (HRSN), beyond what is associated with socioeconomic instability,” AHCCCS’s Notice of Public Information documents said regarding the waiver.


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Foster youth often have adverse childhood experiences, such as abuse, neglect, domestic violence, and parental substance abuse, which increases the risk of health issues later in life, such as diabetes, heart disease, cancer, stroke, chronic obstructive pulmonary disease, and broken bones, according to AHCCCS. The agency also states:

  • Former foster youth are twice as likely to experience PTSD compared to Iraq combat veterans.
    Former foster youth are twice as likely to experience depression compared to the general population.
    Former foster youth are more likely to suffer from anxiety or attempt suicide.

In addition to greater rates of mental health distress, former foster youth experience higher rates of homelessness when transitioning into adulthood. According to AHCCCS, about 20% of former foster youth report being unhoused between the ages of 17 and 19, and 29% report being homeless from the ages of 19 to 21. Native populations are more likely to experience homelessness, with 43% reporting being unhoused between the ages of 19 to 21.

AHCCCS currently offers transitional medical care for children leaving foster care between the ages of 18 and 26, through its Young Adults Transitional Insurance (YATI) program. Under YATI, former foster care youth who are Arizona residents, who age out of foster care, and who are within the age category are eligible.

Changes to the YATI program include automatic renewal for eligible individuals without requiring additional information until that person reaches 26 years. Under the proposed waiver amendments, no changes will be made to the Medicaid benefit package design. There will also not be any new cost sharing, copayments, or coinsurance, and the delivery system for AHCCCS’s current program will remain the same.

Coverage may end if the individual reaches 26 years; ceases to be an Arizona resident; AHCCCS determines incorrect eligibility because of agency error or fraud, abuse, or perjury attributed to the individual; or if the individual dies.

AHCCCS held an initial public hearing on Jan. 23rd. On Feb. 9th, AHCCCS will meet for a Tribal Consultation, and the second public forum will be held on Feb. 22nd.