Skip to main content

Foster Care Initiative

Blue Cross NC foster care initiative

Supporting the well-being of children in foster care and families means providing the whole-person health care they deserve statewide.

North Carolina’s children in foster care and their families have been subject to a regionally-managed, fragmented system of care, contributing to poor outcomes, placement instability and delays in achieving the security and permanency these families need. That is why it is time for our state to transition to a single source statewide plan, investing in more evidence-based treatments for youth and families, and leveraging resources from across North Carolina to alleviate lapses in care. We support the state’s effort to move away from the current regional approach (PDF), building out a robust program to support both youth in foster care and their families across the state.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC)’s Healthy Blue Medicaid plan already provides our families with integrated health care options that treat patients holistically, through a broad array of services and supports that meet their specific needs. We’ll bring this proven, collaborative, family-focused approach to youth in foster care, leading to better outcomes and reducing the burden on the child welfare system – all so families, no matter where they live in North Carolina, can get the care they need to stay healthy and stay together.

Our vision

From Fragmented to Integrated – Improving North Carolina’s child welfare system through intensive, local coordination supported by a single statewide plan

Statewide care

Family-centered care

Whole-person care

Foster care team

Mark Washington

Executive Director, Healthy Blue North Carolina

Kristy Kent

Manager, County Engagement and Healthy Blue DSS Liaison, Healthy Blue North Carolina

Keith Cradle, Ph.D.

Juvenile Services Liaison, Healthy Blue North Carolina

Jamilah McClain, LCSW

Program Manager, Healthy Blue North Carolina

John Thacker, LCMHC, LCAS

Program Manager, Healthy Blue North Carolina

The latest

January 1, 2024

Healthy Blue Spotlight: Benchmarks' Center for Quality Integration (NC)

Benchmarks’ Center for Quality Integration (CQi) is highlighting our work with Blue Cross and Blue Shield of North Carolina’s Healthy Blue Medicaid plan. Healthy Blue is one of the five health plans selected to provide Standard Plan services to NC Medicaid recipients. Standard Plans offer physical and mental/behavioral health coverage to individuals experiencing mild to moderate behavioral health concerns.

September 28, 2023

North Carolinians Talk Childhood Well-being on Blue Cross NC’s State Tour

It’s one thing to read the data. It’s quite another to see it firsthand – or to hear stories from families and communities that have been affected. For nearly two years now, Blue Cross NC leadership have been on a statewide listening tour to do just that.

September 26, 2023

Blue Cross NC, LIFE Skills Support Youth Transitioning Out of Foster Care

LIFE Skills provides safe, stable housing and comprehensive services to support the journey to independence. Blue Cross NC has been honored to partner with LIFE Skills to expand its footprint at properties in Orange and Wake counties. 

August 30, 2023

Angela Boykin Named CEO of Blue Cross NC’s Medicaid Plan

Boykin has more than 30 years of health care experience in commercial and government operations. She is deeply committed to the people and communities of North Carolina.

August 16, 2023

Opportunity to Thrive - NC’s Child Welfare System

An important and insightful conversation with Jan Elliot, the former director of Pitt County Social Services and recipient of North Carolina’s 2021 “State Director of the Year” award.

July 19, 2023

Blue Cross NC Invests $4.3M to Support Children and Families

Building on its commitment to North Carolina’s long-term health and well-being, Blue Cross NC has invested in partnerships, programs and initiatives to support children, youth and families involved with the child welfare system.

June 29, 2023

First Lady Kristin Cooper Presents Family Champion Awards

Cooper presented the awards at the Children's Home Society's reTHINK Permanency Conference, recognizing social workers across North Carolina who work to strengthen, build and advocate for families.

June 26, 2023

A Special Post from Angela Boykin, CEO of Healthy Blue

On last week’s Extra Miles Tour stop in Hyde County, the Blue Cross NC leadership team heard powerful evidence of why North Carolina urgently needs a statewide approach to health care for children and families impacted by foster care.

June 22, 2023

Mentorship and Job Stability: Challenges When Aging Out of Foster Care

Daniel Dunning shares his experience of aging out of the foster care system and the challenges he, along with many other young adults leaving the foster care system, faced.

June 4, 2023

Girl Scouts Organization Launches Mental Health Program

Girl Scouts Carolinas Peaks to Piedmont (GSCP2P) and Crossnore Communities for Children partnered to launch a program called Healthy View, Healthy YOU! The program equips girls to care for their mental health and well-being.

March 31, 2023

Only 1 in 5 Youth in Foster Care Pursue Their College Dreams

Young adults leaving foster care can face difficult barriers to college enrollment and success. Working with community partners to close gaps in educational attainment helps North Carolinians get on track toward a life of prosperity and good health.

May 9, 2023

Blue Cross NC Volunteers Pack "Comfort Cases" for North Carolina Children in Foster Care

As part of National Foster Care Month, Blue Cross NC's Healthy Blue Medicaid plan and Comfort Cases, an international non-profit dedicated to providing hope and dignity youth in foster care, teamed up to host a packing party.

May 9, 2023

Blue Cross NC Launches Apprenticeship Program for Youth Exiting Foster Care

Innovative program provides career opportunities, wraparound support for young adults transitioning out of North Carolina’s foster care system.

April 27, 2023

Nonprofit Launches New Website to Help Fill Gaps for Kinship Caregivers in North Carolina

The website helps kinship caregivers explore their legal options, whether working with child welfare or caring for children outside the child welfare system

April 17, 2023

Forsyth County Foster Youth Receive Boost on Path to College

Crosby Scholars Program Receives $500,500 for Foster Care Pilot Program

December 8, 2022

Blue Cross NC awards CSCP $500,000 to Pilot a Foster Care Youth Initiative

Blue Cross and Blue Shield of North Carolina has awarded the Crosby Scholars Community Partnership $500,000 to pilot a five-year Foster Care Youth Initiative

November 15, 2022

Triangle Non-Profit Provides Homes for Teens Transitioning from Foster Care to Adulthood

LIFE Skills offers a variety of services including independent living skills classes, transitional and independent housing and mental health support.

June 30, 2022

Streamlining Mental Health Services for Children in Foster Care

Foster care advocates in North Carolina are working towards coordinated statewide care for children in need of mental health resources.

June 15, 2022

First Lady Kristin Cooper Supports Local Foster Care Community

The Children's Home Society’s Raleigh Family Picnic celebrated the Triangle's local foster care community and included a donation of 60 pre-packed backpacks for children entering the foster care system.

June 7, 2022

$2 Million Effort to Address NC Behavioral Health Crisis

Eleven organizations awarded to improve access to behavioral health care services in North Carolina’s rural and marginalized communities. 

May 20, 2022

Over 700 “Comfort Cases” Packed for Children in Foster Care

Volunteers gathered for a “Packing Party” event, putting together over 700 packages to be donated to organizations that work with our foster youth.

May 19, 2022

New Alexander Youth Network Program to Support LGBTQ Youth

Blue Cross NC and the Guilford Green Foundation & LGBTQ Center are funding a pilot program to help recruit and train foster families to serve LGBTQ youth in foster care.

April 26, 2022

Children of Color Face an Invisible Threat. Here’s How We Can Support Them

Here in North Carolina, 69 of our 100 counties have no child psychiatrists; 27 have no psychiatrist at all. Failure to address this challenge now will have long-term consequences.

December 7, 2021

Dr. McKnight on NC Foster Care

Dr. Jacqueline McKnight shares her thoughts on the pressing issues facing youth in foster care.

November 30, 2021

Tackling Substance Use & Protecting Families

Investing in prevention and treatment is crucial in building stable communities and protecting children of those dealing with substance abuse.  

November 12, 2021

Post-placement Depression & Supporting Adoptive Parents

Psychological and social changes during parenthood are not unique to biological parents. Supporting parents through post-placement depression is crucial in protecting children.

From fragmented to integrated: a locally-focused statewide plan

From working through complex trauma to skill-based programs for parents, youth in foster care and their families have a broad range of individualized needs. A single statewide health care plan can best manage the full range of benefits and services meant to address them, including crisis intervention, treatment and placement coordination.

Through our Healthy Blue plan, we support the state’s vision to transform the existing fragmented health care delivery model for youth and families involved with local Departments of Social Services (DSS) into one that offers seamless, integrated, and coordinated physical and behavioral health care – including care management and placement coordination for children and youth in foster care.

Ultimately, a single statewide plan will provide consistent, streamlined services that:

  • Offer care coordination in collaboration with county DSS caseworkers.
  • Ensure timely and seamless authorizations for treatment and placement.
  • Improve placement stability and crisis response, mitigating the risk of re-traumatization for vulnerable youth.
  • Create connections and build relationships throughout North Carolina.
  • Eliminate the need to screen services and assessments from other plans.
  • Reduce the excessive administrative burden on local DSS.
  • Integrate and centralize information with consistent standards.
  • Coordinate care effectively across providers to ensure continuity and ease transitions for youth and families.
  • Measure outcomes for every youth and family who receives care.

Across all 100 counties

Blue Cross NC has an established statewide network of integrated services and programs that has served generations of North Carolinians, strengthening families and communities across the state for more than 80 years.

We know our state’s communities because we’re in them, providing localized solutions that meet their needs. Our extensive network of resources, programs and expertise allow us to deliver coordinated, evidence-based treatment to families across every region of the stat – and makes us uniquely qualified to reach more of them.

In partnership with DHHS, DSS and local providers, our Healthy Blue program will reach out to future generations of children and families before they enter the child welfare system, focusing on:

  • Quality and outcomes
  • Responsiveness
  • Simplicity and reduced administrative burden
Map showing NC counties that keep families together, have behavioral health, whole-person care and counties with investments targeting multiple focus areas.

Keeping families together

Foster Family Alliance of North Carolina

The Foster Family Alliance is spearheading a three-part effort to support foster parents across NC, which includes regional support groups for foster parents, resources, services and training for foster families, and "The Love Fund" to support foster parents with sudden practical needs, like childcare or food.

Statewide

Focus Area: Keeping Families Together

Youth Villages

The Intercept program by Youth Villages is an integrated, intensive in-home parenting skills program used to safely prevent children from entering out of-home care or to reunify them with their families. Family Intervention Specialists work with both the children and their families to address issues impacting the stability of the home.

New Hanover County, Pitt County, Craven County, Martin County, and Nash County

Focus Area: Keeping Families Together

Parenting Path

Parenting Path provides a home visiting program that delivers information, referrals, parental coaching, and case management services to families that have been screened out of DSS intervention in Forsyth County.

Forsyth County

Focus Area: Keeping Families Together

Thompson Child & Family Focus Services

This endeavor by Thompson embeds a team of clinicians specializing in Family Centered Treatment (FCT) into the healthcare system of Cumberland County, NC. FCT's home-based treatment reduces the need for costly and often ineffective out-of-home placement for families and youth in the foster care system.

Cumberland County

Focus Area: Keeping Families Together, Behavioral Health

Behavioral health

Alexander Youth Network

Alexander Youth Network’s Therapeutic Foster Care Program for LGBTQ youth aims to recruit and train foster parents in Guilford County to provide LGBTQ youth in foster care with housing stability and resources to better cope with trauma and manage their mental health challenges.

Guilford County

Focus Area: Accessible Care

Lumbee Tribe

The Lumbee Tribe is increasing its recovery services for American Indians within the tribal territory, providing peer support, post-overdose emergency response, and a non-emergency hotline for information and resources.

Robeson County, Scotland Country, Hoke County

Focus Area: Behavioral Health, Accessible Care

Center for Child and Family Health

The trauma-informed training program by the Center for Child and Family Health provides training to mental health and child welfare providers and allied professionals throughout North Carolina, prioritizing counties with high numbers of children in the foster care system.

Mecklenburg County, Guilford County, Wake County, Durham County

Focus Area: Behavioral Health

Duke University Health System

Symmetry is a mobile health tool and platform by the Duke University Health System that standardizes opioid screening, prescribing and monitoring. The mobile app engages patients and their caregivers and helps address the complexities surrounding opioid treatment and misuse processes.

Statewide

Focus Area: Behavioral Health

UNC School of Medicine

UNC School of Medicine's Medication Assisted Treatment (MAT) Group Visit project integrates primary care, behavioral health and group therapy into a combined program, enabling researchers to train more providers and launch additional MAT programs across North Carolina.

Statewide

Focus Area: Behavioral Health

Rowan Country Health Department

The Rowan County Health Department has developed a Post-Overdose Response Team to offer emergency medical care and coordinated support to address the opioid epidemic affecting high-risk communities.

Rowan County

Focus Area: Behavioral Health

National Center for the Advancement of Prevention

This partnership between the Pacific Institute for Research and Evaluation (PIRE) and Stanly County EMS will enable first responders to assist opioid overdose survivors in seeking Medication-Assisted Treatment beyond immediate resuscitation.

Stanly County

Focus Area: Behavioral Health

Together for Resilient Youth

Together for Resilient Youth's Forward Together initiative supports programs, systems, states, territories and tribes with effective recovery services for children, young adults, adults, seniors, families and other populations with mental or substance use disorders.

Durham County, Vance County, Granville County, Edgecombe County, Yadkin County, Craven County

Focus Area: Behavioral Health

Thompson Child & Family Focus Services

This endeavor by Thompson embeds a team of clinicians specializing in Family Centered Treatment (FCT) into the healthcare system of Cumberland County, NC. FCT's home-based treatment reduces the need for costly and often ineffective out-of-home placement for families and youth in the foster care system.

Cumberland County

Focus Area: Keeping Families Together, Behavioral Health

East Carolina University

ECU's NC-STeP program expansion aims to increase access to behavioral health care services for students at Elizabeth City State University. The project embeds psychiatric providers at ECSU's student health center in an effort to provide integrated care.

Northeastern NC

Focus Area: Behavioral Health

TROSA

TROSA is an innovative, multi-year residential program that empowers people struggling with substance use by providing comprehensive treatment, vocational training, education and continuing care. TROSA’s program expansion improves access to services in Western NC.

Forsyth County, Guilford County

Focus Area: Behavioral Health

Reintegration Support Network

Through specially trained paraprofessional mentors, Reintegration Support Network is lessening the gaps in continuum of care in behavioral health treatment of youth ages 13 to 20 with challenges related to mental health, substance abuse, and involvement with the juvenile justice system.

Orange County, Chatham County, Durham County, Alamance County

Focus Area: Behavioral Health, Accessible Care

North Carolina Central University

North Carolina Central University’s community counseling clinic, through its Counselor Education Program, will enhance access to counseling services for Durham and surrounding communities. The clinic will also serve as a training site for counselor education students and a research site for faculty, which will teach the principles of wellness, multicultural counseling, and social justice.

Granville County, Durham County, Person County, Vance County

Focus Area: Behavioral Health, Accessible Care

Whole-person health

Blue Cross NC Apprenticeship Program

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has launched an innovative employment solution designed to provide career opportunities (PDF) for youth aging out of the North Carolina foster care system. The selected young adults will have full-time employment in our Blue Cross NC Centers and receive a wide array of social, educational and financial support to help them successfully transition to adulthood.

Wake County

Focus Area: Whole-Person Care

Open Table

The Open Table provides youth who are aging out of the foster care system with a network of support through relationship building among "tables" of volunteers. The Open Table model ensures that youth in foster care are equipped with the skills, knowledge and resources they need to start an independent life when they age out of the child welfare system.

Statewide

Focus Area: Whole-Person Care

Wake Tech

Wake Tech's Fostering Bright Futures program assists young adults making the transition from foster care by eliminating barriers to their educational goals. The service has doubled in size and expanded its core services since 2019.

Wake County

Focus Area: Whole-Person Care


Youth Villages

The YVLifeSet program by Youth Villages serves roughly 80 NC counties, providing evidence-based transition services to youth who have been or are currently in foster care, juvenile justice or behavioral health programs. Trained LifeSet specialists meet with program participants weekly to assist with securing safe housing, getting a job, continuing education, coping with past abuse and neglect, building healthy support systems, and developing life skills.

New Hanover County, Brunswick County, Columbus County, Onslow County, Pender County

Focus Area: Behavioral Health, Whole-Person Care

SaySo - Children's Home Society

SaySo's Housing Flex Fund helps youth transitioning out of foster care avoid homelessness by addressing barriers to obtaining housing, including helping youth in need with deposits, short-term or partial rental assistance, rental and utility arrears, and acquiring essential furniture.

Statewide

Focus Area: Whole-Person Care

A text quote
A text quote

Blue Cross NC and Healthy Blue won’t stop until health care is better for all, including the most vulnerable among us. We want to help build a system of care and well-being for youth and families across our state that delivers accountable care through localized support and accredited treatment. We know the value that home, family and community have on health and well-being. We see it every day, and we are committed to creating opportunities for every child and family across each of our communities to thrive.

authors photo

Fran Gary

Senior Vice President, Government Markets

Related news

May 9, 2023

Blue Cross NC Volunteers Pack "Comfort Cases" for North Carolina Children in Foster Care

As part of National Foster Care Month, Blue Cross NC's Healthy Blue Medicaid plan and Comfort Cases, an international non-profit dedicated to providing hope and dignity youth in foster care, teamed up to host a packing party.

May 9, 2023

Blue Cross NC Launches Apprenticeship Program for Youth Exiting Foster Care

Innovative program provides career opportunities, wraparound support for young adults transitioning out of North Carolina’s foster care system.

April 27, 2023

Nonprofit Launches New Website to Help Fill Gaps for Kinship Caregivers in North Carolina

The website helps kinship caregivers explore their legal options, whether working with child welfare or caring for children outside the child welfare system

April 17, 2023

Forsyth County Foster Youth Receive Boost on Path to College

Crosby Scholars Program Receives $500,500 for Foster Care Pilot Program

December 8, 2022

Blue Cross NC awards CSCP $500,000 to Pilot a Foster Care Youth Initiative

Blue Cross and Blue Shield of North Carolina has awarded the Crosby Scholars Community Partnership $500,000 to pilot a five-year Foster Care Youth Initiative

November 15, 2022

Triangle Non-Profit Provides Homes for Teens Transitioning from Foster Care to Adulthood

LIFE Skills offers a variety of services including independent living skills classes, transitional and independent housing and mental health support.

June 30, 2022

Streamlining Mental Health Services for Children in Foster Care

Foster care advocates in North Carolina are working towards coordinated statewide care for children in need of mental health resources.

December 15, 2021

UNC Pembroke Tackles Student Homelessness

UNC Pembroke’s ASPIRE Program is providing homeless students mentorship, community, and support to keep them on the path to success.

December 7, 2021

Dr. McKnight on NC Foster Care

Dr. Jacqueline McKnight shares her thoughts on the pressing issues facing youth in foster care.

It starts with families

A new statewide plan for youth in foster care and their families must include the entire child welfare population. From providing support services to biological families to reduce the need for placement, to post-placement support services for young adults up to age 26, the plan should meet the needs of both foster and biological families at every stage of care with an emphasis on continuity, even post-reunification.

And their individual needs

Blue Cross NC draws from decades of experience working with North Carolina’s families to determine – and meet – their health care needs through family-centered, Medicaid managed care. With our Healthy Blue plan, families have access to a coordinated care team who can help design personalized health plans that address their specific needs at every stage of treatment, setting long-term goals and working toward the eventual re-unication of families.

We’re working with experts across the state

A text quote
A text quote

By treating trauma and addressing behavioral health in an evidence-based, family-centered way, children can achieve optimal health and well-being.

authors photo

Dana Marie Hagele, MD, MPH

Clinical Director, Children's Advocacy Centers of North Carolina

A text quote
A text quote

Collaborating with local DSS partners and our statewide provider network, the Healthy Blue team will focus on strengthening families, providing proactive interventions and enhanced crisis response with family-centered accountability.

authors photo

Mark Washington

Executive Director, Healthy Blue North Carolina

A text quote
A text quote

Strong communities support strong families through whatever they're going through. Let's support North Carolina's most vulnerable youth and their families too!

authors photo

Carmelita Coleman

Program Director, SaySo

Related news

June 14, 2022

Providing a Safe and Affirming Space for LGBTQ Teens

An Alexander Youth Network therapeutic foster parent shares her experience caring for LGBTQ youth in foster care.

June 9, 2022

When it Comes to Mental Health, Outdoor Play is Serious Business

Every child should have a safe place to get outdoors and stay active. That’s why we help build play spaces for all kids to get the full emotional and physical benefits of outdoor play.

April 25, 2022

NC Mom Helps Fellow Foster Parents Care for Vulnerable Children

Gail Osborne is working to fix our foster care system, recruiting new foster and adoptive parents and providing assistance and training to existing families.

December 7, 2021

Support For Transition Age Youth

A new initiative aims to provide eligible youths with housing assistance as they age out of foster care.

May 25, 2021

Former Foster Youth Helps Others Navigate Adulthood

Trent Taylor reflects on his foster care experience and his plans to assist other foster youths in making the transition to independent adulthood. 

It’s about more than just health care. A statewide plan must provide comprehensive, whole-person care that addresses both physical and behavioral health needs for youth in foster care and their families, recognizing the complex trauma that many of these individuals battle each day. It needs to provide adequate crisis support that works locally but coordinates closely with providers across the state. And it needs to offer an accessible, holistic array of services based on trauma-informed and evidence-based treatment models.

North Carolina has over 16,000 children and young people currently in foster care

By age 17, over half of youth in foster care have experienced an arrest, conviction, or overnight stay in a correctional facility

At 18, 20% of the children who age out of foster care will become instantly homeless

50% of youth who age out of the system develop a substance dependence

Supporting behavioral health

Youth in foster care often have a history of adverse childhood experiences and complex trauma. The statewide plan should ensure that all youth have a trauma-informed comprehensive clinical assessment utilized across the system. This informs a culturally competent service plan that supports both child and family.

January 9, 2021

LGBTQ Foster Youth Need A Tailored Approach

Therapeutic foster care helps ease the severe instability and challenges that threaten their well-being.

Keeping families together

In placements or after family re-unification, it’s important that the plan creates stability that prevents re-traumatization for youth involved with the child welfare system. It’s not just about youth in foster care, but those who have been and those that might be vulnerable. The plan should include proven, community-based programs that strengthen families and reduce the need for foster care placement.

October 20, 2021

Randolph County Program Sparks Hope

Blue Cross and Blue Shield of North Carolina has partnered with Open Table to develop a model program to help youth in foster care as they transition into life as independent adults.

May 25, 2021

Former Foster Youth Helps Others Navigate Adulthood

Trent Taylor reflects on his foster care experience and his plans to assist other foster youths in making the transition to independent adulthood. 

Delivering accessible care

A statewide plan means that all available resources and programs will be accessible for youth in foster care and their families, no matter where in the state they live. We’re committed to eliminating barriers to care that all participants, regardless of background or geography, receive the comprehensive care they need to thrive.

March 27, 2022

Aid For Youths Leaving Foster Care

The Flex Fund is working to provide assistance for youth who have aged out of the foster care system and need housing support.

December 15, 2021

UNC Pembroke Tackles Student Homelessness

UNC Pembroke’s ASPIRE Program is providing homeless students mentorship, community, and support to keep them on the path to success.  

Related news

August 3, 2022

Access to Stigma-free Mental Health Care

Dr. Stephen Friedhoff shares his experience on the importance of integrating behavioral health into primary care, making it easier for young patients to access.

July 25, 2022

Aging out of Foster Care

Young adults can face significant hurdles when transitioning to independent living without the right resources. Healthy Blue is collaborating with SaySo and Open Table to provide supports to help young adults thrive.

June 29, 2022

Supporting Student Mental Health

East Duplin High School is putting the focus on youth mental health. The school’s “disconnectED” program gives students the opportunity to break down stigmas and connect with local resources.

Advisory council members

The Foster Care Advisory Council is a valuable resource that helps ensure foster youth and their families receive the highest quality of coordinated, trauma-informed, family-centered care.

Craig Bass

Chief Executive Officer, Alexander Youth Network

Will Jones

CEO, Thompson Child & Family Focus

Jan Elliot

Retired County Director (Pitt County)

Jacqueline McKnight, PhD

Deputy County Director, DSS Child Welfare Division, Mecklenburg County

Dana Marie Hagele, MD, MPH

Clinical Director, Children’s Advocacy Centers of North Carolina

Trent Taylor

Founder and CEO, Watch Me Rise

Heather Johnson, JD, MSW

Executive Director of Council for Children’s Rights

Derrick L. Wilkins, PhD

Guardian ad Litem for the NC 2nd Judicial District

Former Vice Chancellor and Chief of Staff at Elizabeth City State University