Medicaid Supports Former and Current Foster Youth

Samantha, a lifelong Tennessean and resident of Hickman County, Tennessee, knows the foster care system intimately—first as a child who spent most of her youth in state custody, and now as a mother determined to break that cycle for her own children.

After aging out of foster care at 18, Samantha earned an associate’s degree in medical office administration, later completed a second degree, fell in love and got married, and became a proud mother to two daughters: sixteen-year-old Kaycee and ten-year-old Bethany.

Like Samantha, Bethany began life in the foster system. Samantha and her husband welcomed her into their home when she was just six months old and adopted her at age five. Bethany lives with a complex set of behavioral and developmental health conditions, including Level 2 autism, ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, psychosis, and developmental delays, many of which are believed to stem from prenatal trauma and substance exposure.

“She has an amazing heart,” Samantha says. “But she experiences feelings and emotions outside of her control.” Samantha goes on to share that if Bethany had the capacity to manage her emotions, she would.

Despite her challenges, Bethany is a joyful and loving child who lights up when singing and dancing. Keeping her safe and supported requires around-the-clock care, intensive therapy, and specialized instruction—needs that would be completely out of reach without TennCare, Tennessee’s Medicaid program.

Bethany is enrolled in TennCare’s Employment and Community First (ECF) CHOICES program, which provides critical services to individuals with intellectual and developmental disabilities. Through ECF CHOICES, Bethany receives support from Omni’s Family Intervention Treatment Team (FITT), which helps families like Samantha’s avoid out-of-home placement by offering 24/7 crisis support, in-home care, and coordinated behavioral health services. At school, she benefits from more than 22 hours a week of tailored instruction, including speech, behavioral, and comprehension therapies.

For children with significant behavioral or developmental challenges, Medicaid-funded services like crisis response teams, in-home therapy, and wraparound care can help families manage safely at home—and prevent disruption or re-entry into the foster system.