North Carolina has more than 30,000 children and youth currently or formerly involved in the foster care system, and the services available to them vary substantially depending on where they live.
With a statewide, collective focus to improve the health and wellbeing of this population, organizations and community partners alike are showing a commitment to building a strengthened system of care that caters to the myriad needs of children in foster care and other out-of-home placements.
One nonprofit working to address those needs is Youth Villages. Through evidence-based programming, the organization supports children and young adults with emotional, mental and behavioral struggles. Based in Memphis, Tennessee, Youth Villages launched its model services in North Carolina in 2005 and has continued to expand its presence in the state since, serving over 19,000 youth to date.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is partnering with Youth Villages, through its Healthy Blue Medicaid plan, to extend the reach of the nonprofit’s community-based services to some of North Carolina’s most vulnerable communities.
The collaboration focuses on keeping families together to prevent children from entering foster care. At the other end of the spectrum, it helps young adults aging out of foster care make a successful transition to adulthood.
“We know the value that home, family and community have on the health of all people, but especially young people,” said Fran Gary, Blue Cross NC senior vice president of government markets. “We see it every day, and we are committed to creating opportunity for every child and family across all of our communities to thrive.”
Keeping Families Together
There is no replacing the value of a stable family and the long-term impact it has on health, well-being and success. Blue Cross NC is supporting Youth Villages with a $50,000 Healthy Blue investment to launch Intercept, a program dedicated to keeping families unified, in New Hanover and surrounding counties.
When children are at high risk of entering the foster care system or a group home, Intercept services help change the family’s trajectory with intensive support, new parenting and communication skills and evidence- and strengths-based mental health intervention services. Family intervention specialists work with both the child and caregiver, meeting multiple times a week and providing around-the-clock on-call crisis support. The comprehensive treatment approach includes advocating extensively to access community resources and linking to long-term, ongoing support.
Three separate evaluations of Intercept were conducted by the Center for State Child Welfare Data at Chapin Hall using data made available by the state of Tennessee Department of Children’s Services. In the first, researchers found that Intercept reduces the chances of out-of-home placement by 53 percent following an abuse or neglect investigation. The effect of Intercept is sustained at six and 12 months after services end. In the second evaluation, the data showed the odds of achieving permanency in home placement were approximately 24 percent higher for Intercept participants than a comparison group.
“Youth Villages is grateful for Blue Cross NC’s vision to improve the health of vulnerable young people in our state,” said Paul Enderson, executive director of Youth Villages North Carolina. “Together, we can help children avoid out-of-home placements by facilitating consistent support and intervention to families and young people to pave the way for a healthier future.”

Successfully Becoming an Adult
Children who grow up in the foster care system are often without stable, consistent family support, and they are more likely to struggle when making the transition to adulthood. In 2019, Blue Cross NC made a $1 million Healthy Blue investment in Youth Villages’ LifeSet program, which helps people ages 17 to 22 who have been in foster care, juvenile justice or behavioral health programs create a path to a successful adult life. Funds from the state tripled the investment to $3 million, which has expanded the program to 80 counties statewide and helps more than 300 young people.
“Each young adult who transitions out of state care with LifeSet’s support has their own unique, important story,” said Enderson. “Our goal is not just to build up their confidence and help them achieve their goals, but also to ensure they know they are supported and loved. Partners like Blue Cross NC are invaluable to ensuring kids don’t fall through the cracks when they age out of foster care.”
Trained LifeSet specialists meet with program participants once a week and make themselves available at all hours 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. In November 2019, LifeSet saw success with 90% of participants living with family or independently; 86% in school, graduated or employed; and 83% with no legal involvement.
“Providing life-changing opportunities for more youth aging out of foster care and enhancing child welfare programs in North Carolina is a priority for Blue Cross NC,” said Jesse Thomas, VP of Medicaid and chief executive officer of Healthy Blue for Blue Cross NC. “The stability this program provides comes at a crucial time in the lives of these young people, delivering services proven to help build a foundation for long-term success.”