🗽 CIVIC ACTION BATTLE PLAN
📰 TARGET: The Machine: How America's Child Welfare System Generates Revenue From Family Separation
FULL REPORT HERE!
PROJECT MILK CARTON INSURGENT TOOLKIT
SHADOW PATRIOT OPERATIONAL BATTLE PLAN
“The Machine Stops When Citizens Start”
EIN: 33-1323547 | projectmilkcarton.org
Date: March 3, 2026Classification: CIVIC ACTION — PUBLIC DISTRIBUTION
Based on: “The Machine: How America’s Child Welfare System
Generates Revenue From Family Separation”
Published: March 1, 2026 | The Constitutional Republic / 17th SOG
STRATEGIC INTELLIGENCE SUMMARY
THE PROBLEM
America’s child welfare system generates $200–250 million annually in Medicaid capitation payments to private managed care organizations (MCOs) BEFORE investigations determine whether abuse or neglect actually occurred. 82% of investigated children are found NOT to be victims. There is no clawback mechanism. Centene Corporation ($163.1B revenue) holds monopoly or dominant MCO contracts in Texas, Missouri, Florida, Oklahoma, and Washington. The money starts on Day Zero. The investigation takes 30–90 days. Families are destroyed. Corporations are enriched.
ALINSKY FRAMEWORK APPLIED
Rule 1 (Power): Our power is people — millions of parents, grandparents, and citizens
Rule 3 (Experience): Go outside the experience of the enemy — they expect apathy, give them organized fury
Rule 4 (Make them live by their own rules): They claim to protect children — demand they prove it
Rule 5 (Ridicule): "You're telling me you paid a corporation $18,672 per child before you even PROVED abuse?"
Rule 8 (Constant Pressure): 12-week sustained campaign with escalating intensity
Rule 9 (The Threat): FOIA, qui tam, grand jury — the threat alone changes behavior
Rule 13 (Personalize): Name the MCO. Name the contract. Name the official who signed it.
FIVE TARGETS
Congress — Title IV-E reform, Medicaid MCO audit mandate
State Attorneys General — Medicaid fraud investigation into MCO capitation
HHS/ACF — Federal oversight of pre-substantiation payments
Centene Corporation — Shareholder pressure, SEC disclosure, public accountability
State CPS/DFPS agencies — FOIA for removal-to-payment timelines
🎯PHASE 1 — IMMEDIATE PRESSURE
“Flood the Switchboard” — Weeks 1–3
CRITICAL CONTACTS
US Capitol Switchboard: (202) 224-3121
SENATE HEALTH, EDUCATION, LABOR AND PENSIONS (HELP) COMMITTEE
Chair: Sen. Bill Cassidy (R-LA) (202) 224-5824
Ranking: Sen. Bernie Sanders (I-VT) (202) 224-5141
Sen. Josh Hawley (R-MO) (202) 224-6154
Sen. Markwayne Mullin (R-OK) (202) 224-4721
Sen. Ashley Moody (R-FL) (202) 224-5274
Sen. Jim Banks (R-IN) (202) 224-5623
Sen. Tim Scott (R-SC) (202) 224-6121
SENATE FINANCE COMMITTEE
Chair: Sen. Mike Crapo (R-ID) (202) 224-6142
Ranking: Sen. Ron Wyden (D-OR) (202) 224-5244
HOUSE WAYS AND MEANS COMMITTEE
Chair: Rep. Jason Smith (R-MO) (202) 225-4404
Ranking: Rep. Richard Neal (D-MA) (202) 225-5601 Rep.
Kevin Hern (R-OK) (202) 225-2211 Rep.
Beth Van Duyne (R-TX) (202) 225-6605
KEY STATE SENATORS (Article States)
Sen. Ted Cruz (R-TX) (202) 224-5922
Sen. John Cornyn (R-TX) (202) 224-2934
Sen. Eric Schmitt (R-MO) (202) 224-5721
STATE ATTORNEYS GENERAL
Texas AG (512) 463-2100 PO Box 12548, Austin, TX 78711
Missouri AG (573) 751-3321 PO Box 899, Jefferson City, MO 65102
Oklahoma AG (405) 521-3921 313 NE 21st St, Oklahoma City, OK 73105
California AG (916) 445-9555 1300 I Street, Sacramento, CA 95814
Washington AG (360) 753-6200 PO Box 40100, Olympia, WA 98504 Florida AG (850) 414-3300 The Capitol PL-01, Tallahassee, FL 32399
VERBATIM CALL SCRIPT — CONGRESS
Call Script 1: For Your US Senator / Representative
"Hello, my name is [YOUR NAME] and I'm a constituent from [CITY, STATE]. I'm calling about the child welfare-to-Medicaid pipeline. A forensic investigation by Project Milk Carton, a 501(c)(3), has documented that managed care organizations — particularly Centene Corporation — receive per-member-per-month capitation payments for children removed from their homes on an emergency basis BEFORE any investigation determines whether abuse or neglect actually occurred. In Texas alone, Centene's subsidiary Superior HealthPlan receives $1,556 per month per child — and 82% of investigated children are found NOT to be abuse or neglect victims according to HHS data. There is no clawback mechanism for these payments. I am asking [SENATOR/REPRESENTATIVE NAME] to: ONE — Request a GAO investigation into Medicaid MCO capitation payments for children in foster care during the pre-substantiation investigation period. TWO — Support legislation requiring a clawback mechanism for MCO payments when removals are found to be unsubstantiated. THREE — Hold hearings on Centene Corporation's monopoly foster care Medicaid contracts across multiple states. I would like a written response. My name again is [YOUR NAME], and my address is [ADDRESS]. Thank you."
VERBATIM CALL SCRIPT — STATE ATTORNEY GENERAL
Call Script 2: For Your State Attorney General
"Hello, my name is [YOUR NAME] from [CITY, STATE]. I'm calling to request that the Attorney General investigate potential Medicaid fraud in the state's child welfare managed care contracts. A forensic investigation has documented that managed care organizations receive per-member-per-month Medicaid capitation payments for children removed from their homes BEFORE any abuse or neglect finding is made. In [STATE], the MCO [NAME — e.g., Superior HealthPlan/Centene in TX] holds a [sole-source/dominant] contract covering foster children statewide. When the removal is ultimately found to be unsubstantiated — which happens in approximately 82% of cases nationally — there is no mechanism to recover the Medicaid payments already made. This may constitute Medicaid fraud under state and federal law if payments are being made for services predicated on a custody determination that was never substantiated. I am requesting: ONE — A formal investigation into the state's MCO contracts for foster care Medicaid. TWO — An audit of capitation payments made during pre-substantiation periods for children ultimately returned home. THREE — A review of whether the state's MCO contract structure creates financial incentives for unnecessary child removals. My contact information is [NAME, ADDRESS, EMAIL]. I would like a written response. Thank you."
VERBATIM CALL SCRIPT — GOVERNOR
Call Script 3: For Your Governor
"Hello, my name is [YOUR NAME] from [CITY, STATE]. I'm calling about the financial relationship between the state's child protective services and managed care organizations profiting from child removals. Research by Project Milk Carton, a 501(c)(3), has documented that [STATE]'s child welfare system generates Medicaid capitation revenue for managed care corporations beginning on the day a child is removed — before any investigation determines whether abuse or neglect occurred. Nationally, 82% of investigated children are found NOT to be victims, yet there is no clawback for the Medicaid payments already made. I am asking the Governor to:
ONE — Order an executive review of the state's MCO contracts for foster care Medicaid.
TWO — Direct the state health and human services agency to report on pre-substantiation Medicaid expenditures.
THREE — Support legislation requiring a substantiation finding before MCO capitation payments begin.
My name is [YOUR NAME] and I'm a voter. Thank you."
🎯PHASE 2 — TRANSPARENCY WARFARE
"Weaponize FOIA" — Weeks 2–6
Instructions: Print, sign, and mail or email each letter. Keep a copy. Track response deadlines (20 business days federal, varies by state). If denied, appeal. If ignored, file complaint with FOIA ombudsman (ogis@nara.gov, 877-684-6448).
FOIA LETTER 1: HHS / ACF
[YOUR NAME]
[YOUR ADDRESS]
[DATE]
FOIA Officer Administration for Children and Families
U.S. Department of Health and Human Services
330 C Street SW Washington, DC 20201
Email: hhsfoia@hhs.gov
Re: Freedom of Information Act Request
Dear FOIA Officer:
Pursuant to the Freedom of Information Act, 5 U.S.C. § 552, I request access to and copies of the following records:
All records, reports, memoranda, and correspondence regarding Medicaid managed care organization (MCO) capitation payments for children in foster care during the pre-substantiation investigation period (from date of emergency removal to date of abuse/neglect finding), for fiscal years 2020 through 2025.
All contracts, amendments, and pricing schedules between state child welfare agencies and Medicaid managed care organizations for foster care populations, submitted to or reviewed by ACF, for fiscal years 2020 through 2025.
All AFCARS data submissions that include or reference the timing relationship between emergency removal dates and substantiation finding dates, for fiscal years 2020 through 2025.
All internal analyses, audits, reviews, or studies conducted by or commissioned by ACF examining (a) financial incentives in the child welfare-to-foster care pipeline, (b) MCO capitation payment structures for foster children, or (c) the relationship between TANF policy and foster care entries.
All correspondence between ACF and Centene Corporation (or any subsidiary including Superior HealthPlan, Home State Health, Sunshine Health, Complete Health, and Coordinated Care) regarding foster care Medicaid contracts, for fiscal years 2020 through 2025.
The December 2024 ACF Dear Colleague Letter regarding TANF access and foster care reduction, and all internal drafts, supporting analyses, and correspondence related to its development.
I request a fee waiver pursuant to 5 U.S.C. § 552(a)(4)(A)(iii) as this information is sought for noncommercial purposes and will contribute significantly to public understanding of government operations. I am affiliated with Project Milk Carton, EIN 33-1323547, a 501(c)(3) organization.
If this request is denied in whole or in part, I ask that you justify all deletions or denials by reference to the specific exemptions of the Act.
I expect a response within 20 business days as required by law.
Sincerely,
[YOUR NAME]
[YOUR EMAIL]
[YOUR PHONE]
FOIA LETTER 2: HHS — OFFICE OF INSPECTOR GENERAL
[YOUR NAME]
[YOUR ADDRESS]
[DATE]
FOIA Officer
Office of Inspector General
U.S. Department of Health and Human Services
330 Independence Avenue SW Washington, DC 20201
Re: Freedom of Information Act Request
Dear FOIA Officer:
Pursuant to the Freedom of Information Act, 5 U.S.C. § 552, I request access to and copies of the following records:
All audits, evaluations, and reports conducted by OIG examining Medicaid managed care payments for foster care populations, for fiscal years 2015 through 2025.
All records regarding OIG investigations or inquiries into Centene Corporation or any subsidiary (including Superior HealthPlan, Home State Health, Sunshine Health, Complete Health, Coordinated Care) related to Medicaid payments for foster children.
All records regarding OIG review of the validity of Medicaid capitation payments for children removed from homes on emergency basis where the underlying abuse/neglect allegation was subsequently unsubstantiated.
All OIG work plans, audit schedules, or investigative priorities that include or reference child welfare Medicaid, foster care managed care, or MCO payments related to child protective services removals.
I request a fee waiver as described above. I am affiliated with Project Milk Carton, EIN 33-1323547, a 501(c)(3).
I expect a response within 20 business days.
Sincerely,
[YOUR NAME]
[YOUR EMAIL]
[YOUR PHONE]
FOIA LETTER 3: GAO / FraudNET REFERRAL
[YOUR NAME]
[YOUR ADDRESS]
[DATE]
Government Accountability Office
441 G Street NW
Washington, DC 20548
Email: fraudnet@gao.gov
Phone: (800) 424-5454
Re: Request for Investigation / FraudNET Referral
Dear GAO:
I am writing to request a formal investigation into potential waste and mismanagement of federal Medicaid
funds related to managed care organization capitation payments for children in foster care.
ISSUE: Managed care organizations receive per-member-per-month Medicaid capitation payments for children removed from homes on emergency basis before any investigation determines whether abuse or neglect actually occurred. The investigation period is 30–90 days. According to HHS Child Maltreatment Report FFY 2023, approximately 82% of investigated children are found NOT to be victims. There is no clawback mechanism.
ESTIMATED ANNUAL EXPENDITURE: $200–250 million in pre-substantiation MCO revenue nationally, of which approximately $160–200 million is generated for children on ultimately unsubstantiated cases.
SPECIFIC CONCERNS:
GAO has audited MCO capitation payments for deceased enrollees, incarcerated enrollees, and invalid immigration status — but has NEVER audited payments for unsubstantiated removals.
Centene Corporation holds monopoly or dominant MCO contracts for foster care in at least five states (TX, MO, FL, OK, WA).
Federal data systems (AFCARS, NCANDS) do not link removal timing to payment data, creating a structural audit blind spot.
REQUESTED ACTION: A formal GAO study examining (1) the volume and cost of Medicaid MCO payments during pre-substantiation periods, (2) the adequacy of existing federal oversight of these payments, and (3) the extent to which MCO contract structures create financial incentives for child removal.
Sincerely,
[YOUR NAME]
[YOUR EMAIL]
[YOUR PHONE]
FOIA LETTER 4: STATE CPS / DFPS (Template)
[YOUR NAME]
[YOUR ADDRESS]
[DATE]
[STATE AGENCY NAME]
[STATE AGENCY FOIA OFFICER/ADDRESS]
Re: Public Records Request / FOIA Request
Dear Records Officer:
Pursuant to [STATE PUBLIC RECORDS ACT], I request access to and copies of the following records:
All contracts and amendments between [STATE CPS/DFPS AGENCY] and managed care organizations for the provision of Medicaid services to children in foster care, for fiscal years 2020 through 2025.
All data regarding (a) the number of children removed on emergency basis, (b) the number of those removals subsequently substantiated vs. unsubstantiated, and (c) the average duration between removal and substantiation finding, for fiscal years 2020 through 2025.
All per-member-per-month (PMPM) rate schedules, rate change documentation, and actuarial analyses for foster care Medicaid managed care contracts.
All correspondence between [STATE AGENCY] and [STATE MCO — e.g., Superior HealthPlan, Home State Health, etc.] regarding contract performance, payment disputes, or program changes.
All internal memoranda, reports, or analyses examining the relationship between emergency removal rates and Medicaid enrollment/payment timing.
I request a fee waiver as I am affiliated with a 501(c)(3) organization and this request serves the public interest.
Sincerely,
[YOUR NAME]
[YOUR EMAIL]
[YOUR PHONE]
🎯PHASE 3 — GROUP MOBILIZATION
"Build the Army" — Weeks 3–8
PRECINCT RESOLUTION
Ready to introduce at any party precinct meeting, county convention, or local party gathering:
RESOLUTION ON CHILD WELFARE MEDICAID TRANSPARENCY
WHEREAS, approximately 176,000 children entered foster care nationally in FFY 2023, with 80–85% removed on an emergency basis before any investigation of abuse or neglect was completed;
WHEREAS, Medicaid managed care organizations receive per-member-per-month capitation payments beginning on the date of removal, prior to any substantiation finding;
WHEREAS, approximately 82% of investigated children are found NOT to be victims of abuse or neglect according to the HHS Child Maltreatment Report;
WHEREAS, there is currently no federal or state mechanism to recoup Medicaid payments made on behalf of children whose removal was ultimately found to be unsubstantiated;
WHEREAS, a single managed care corporation (Centene) holds monopoly or dominant MCO contracts for foster care Medicaid in at least five states;
THEREFORE BE IT RESOLVED, that [PRECINCT/COUNTY/STATE PARTY] calls upon our elected
representatives in Congress and the state legislature to:
Require a GAO audit of Medicaid MCO capitation payments during pre-substantiation investigation periods;
Enact legislation requiring a substantiation finding or judicial order before MCO capitation payments begin;
Establish a federal clawback mechanism for Medicaid payments when removals are unsubstantiated;
Investigate monopoly MCO contracts in state foster care systems for potential antitrust violations;
Restore TANF purchasing power to reduce poverty-driven child removals.
Adopted this ___ day of _________, 2026, by
[PRECINCT/COUNTY/STATE PARTY].
LETTER-WRITING PARTY — HOST INSTRUCTIONS
Materials Needed
Printed copies of this toolkit (one per participant)
Paper, envelopes, stamps (or laptops for email)
Contact list for local, state, and federal officials
Snacks and refreshments (this is a social event too)
COORDINATED CALL DAY
Pick one day per week. Everyone calls the SAME office on the SAME day.
PUBLIC TESTIMONY TEMPLATE
State Legislature / Congressional Hearing
PUBLIC TESTIMONY TEMPLATE
“Chairman [NAME], Ranking Member [NAME], and distinguished members of the committee:
My name is [YOUR NAME], and I am [a parent / a grandparent / a foster parent / a concerned citizen / a social worker / a former CPS employee] from [CITY, STATE].
I am here today to testify about the financial incentive structure that drives child removal in [STATE].
[PERSONAL STORY — 2–3 sentences about why this matters to you personally]
The data is clear: According to HHS, 82% of investigated children are found NOT to be victims of abuse or neglect. Yet managed care organizations begin receiving Medicaid capitation payments on the day of removal — before the investigation even begins.
In [STATE], [MCO NAME] receives $[AMOUNT] per child per month. For the 30 to 90 days it takes to investigate, that corporation is paid regardless of outcome. If the allegation is unsubstantiated, there is no refund.
This is not child protection. This is a revenue pipeline that processes children as billing units.
I respectfully ask this committee to:
1. Require a substantiation finding before MCO payments begin
2. Establish a clawback mechanism for unsubstantiated removals
3. Audit existing MCO contracts for conflicts of interest
4. Restore TANF funding to address the poverty that drives 64% of foster care entries
Thank you for your time. I am happy to answer questions.”
🎯PHASE 4 — ELECTORAL ACCOUNTABILITY
“Vote Them Out or Recall Them” — Weeks 6–12
CANDIDATE SCORECARD TEMPLATE
Create a “Child Welfare Accountability Scorecard” for every candidate in your district:
FEC CAMPAIGN FINANCE — KEY SEARCH
Website: fec.gov
Search for: Centene Corporation PAC, Centene employee contributions
Cross-reference: Your state’s elected officials who oversee CPS or Medicaid contracts
If you find contributions → include in your call scripts: “I note that [OFFICIAL] received $[AMOUNT] from Centene’s PAC in [YEAR]...”
RECALL / BALLOT INITIATIVE
Research your state’s recall threshold (varies: 10–25% of last election’s votes)
Research your state’s ballot initiative process for citizen-initiated legislation
Key legislation to propose:
“Child Welfare Transparency Act” — requires public reporting of removal-to-substantiation timelines and MCO payments
“Medicaid Integrity Act” — requires substantiation before MCO capitation begins
“Family Preservation First Act” — mandates preventive services before removal
🎯PHASE 5 — MEDIA AND OVERSIGHT ESCALATION
“Go Nuclear” — Weeks 8–12
PRESS RELEASE TEMPLATE
FOR IMMEDIATE RELEASE
[DATE]
CONTACT: [YOUR NAME]
[YOUR EMAIL]
[YOUR PHONE]
[YOUR CITY, STATE]
[YOUR ORGANIZATION/NAME] today called for a federal investigation into the child welfare-to-Medicaid pipeline that generates an estimated $200–250 million annually in managed care payments for children removed from their homes before any abuse or neglect finding is made.
According to a forensic investigation by Project Milk Carton (projectmilkcarton.org), a 501(c)(3) nonprofit, managed care organizations begin receiving per-member-per-month Medicaid capitation payments on the day of emergency child removal — typically 30 to 90 days before an investigation determines whether abuse or neglect actually occurred.
The HHS Child Maltreatment Report for FFY 2023 found that 82% of investigated children are NOT victims of abuse or neglect. There is no mechanism to recoup payments.
“We are not protecting children from abuse. We are punishing families for being poor and paying corporations to house the children we take from them,” said [YOUR NAME/SPOKESPERSON].
Key findings include:
Centene Corporation ($163B revenue) holds monopoly foster care MCO contracts in at least 5 states
Texas PMPM rate: $1,556.08 per child — a 60% increase in one year
64% of foster care entries are for neglect, which research consistently links to poverty
TANF assistance reaches only 21 per 100 families in poverty; benefits are below 20% of poverty line in 17 states
[YOUR ORGANIZATION] is calling on Congress to mandate GAO audits of pre-substantiation MCO payments and establish clawback mechanisms for unsubstantiated removals.
Project Milk Carton’s full investigation is available at:
MEDIA TIP TEMPLATE
Subject: Investigation Tip: Child Welfare Medicaid Revenue Pipeline
Dear [JOURNALIST NAME]:
I’m writing to share findings from a forensic investigation that documents how America’s child welfare system generates revenue for private managed care corporations through child removal.
The investigation, conducted by Project Milk Carton (501(c)(3), EIN 33-1323547), analyzed 340 million records and $148 billion in tracked grants to document:
MCOs receive Medicaid payments beginning on Day Zero of child removal — before investigation
82% of investigated children are not victims (HHS FFY 2023)
No clawback mechanism exists for unsubstantiated removals
One corporation (Centene) holds monopoly contracts in 5+ states
100,000–300,000 children annually are in “hidden foster care” not captured in federal data
Full article: https://17sog.substack.com/p/the-machine-how-americas-child-welfare
I’m available for interview and can connect you with the investigators.
[YOUR NAME]
[YOUR PHONE]
[YOUR EMAIL]
NUCLEAR OPTIONS
ESCALATION TOOLS — USE WHEN STANDARD CHANNELS FAIL
1. QUI TAM / FALSE CLAIMS ACT (31 U.S.C. §§ 3729–3733)
If you have direct knowledge of Medicaid fraud — payments made for services not rendered, false eligibility claims, kickbacks — you can file a qui tam lawsuit.
2. GRAND JURY PETITION
In some states, citizens can petition for a special grand jury to investigate government misconduct.
Research your state’s grand jury petition process
Typically requires a written petition to the chief judge of your county/district court
Must allege specific criminal conduct (fraud, abuse of office)
3. CONGRESSIONAL REFERRAL
Write to the chairs of the relevant committees requesting a formal investigation:
4. GAO / OIG REQUESTS
5. SEC COMPLAINT (Centene)
If Centene is not adequately disclosing foster care Medicaid revenue or related legal risks in SEC filings:
🎯12-WEEK BATTLE CALENDAR
March 3 — May 25, 2026
🏛️WEEK 1 (Mar 3–9): PHASE 1 LAUNCH
Read the article. Print this toolkit.
Call both US Senators (use Script 1).
Share article on social media with #TheMachineStops
Recruit 3 people.
🏛️WEEK 2 (Mar 10–16): CONGRESSIONAL PRESSURE + FOIA
Call US Representative (Script 1).
Mail FOIA Letter 1 (HHS/ACF) and FOIA Letter 2 (HHS-OIG).
Email FOIA Letter 3 (GAO FraudNET).
Post call results on social media.
🏛️WEEK 3 (Mar 17–23): STATE PRESSURE
Call State Attorney General (Script 2).
Call Governor (Script 3).
Mail FOIA Letter 4 (State CPS) customized for your state.
Host first letter-writing party (or attend one).
🏛️WEEK 4 (Mar 24–30): ESCALATION
Follow up with all offices that haven’t responded.
Submit precinct resolution to local party.
Contact local newspaper editor about the issue.
Coordinated call day: All call both senators SAME DAY.
🏛️WEEK 5 (Mar 31–Apr 6): MOBILIZATION
Host or attend second letter-writing party.
Send media tip to 3 local journalists.
Post candidate scorecard for your district.
File FOIA appeals if any denials received.
🏛️WEEK 6 (Apr 7–13): ELECTORAL + MEDIA
Send scorecard to all candidates.
Contact local TV news assignment desk.
Request meeting with congressional staff.
Coordinated call day: Governor + AG.
🏛️WEEK 7 (Apr 14–20): TESTIMONY PREP
Prepare written testimony (use template).
Identify upcoming legislative hearings (state or federal).
Submit written testimony even if you can’t attend.
Social media push: #TheMachineStops Day of Action.
🏛️WEEK 8 (Apr 21–27): OVERSIGHT ESCALATION
File GAO/OIG complaints if not yet done.
Send press release to all local media.
Coordinated call day: Both senators + representative.
Recruit 10 new participants.
