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Florida Moves To Manage Health Care For Foster Kids

WebMD News from Kaiser Health News

By Marissa Evans

Tue, Feb 11 2014

Chris and Alicia Johnson have 10 kids -- three biological, five adopted out of foster care and two foster children -- all under one roof on the outskirts of Orlando, Fla.

While providing love, support and encouragement for their foster kids, they’ve sometimes run into roadblocks trying to get them health care, including needed mental health services, because few providers take Medicaid insurance.  Another problem? Not being able to take foster children in different health care plans to the same doctors.

Those difficulties are not unusual for the nation’s nearly 400,000 foster children, whose health care can be complicated by cycling from one placement to another, undiagnosed childhood trauma and a failure to receive preventive care, according to experts.

They face an array of problems. According to the National Institute for Health Care Management, nearly 60 percent have at least one chronic disease, and nearly 70 percent have moderate to severe mental health disorders.

Florida is creating a special Medicaid plan to closely manage the care of this population, beginning in May.  The plan is designed to cover the estimated 31,600 Florida children in the welfare system, including those in foster care, placed with relatives or in group homes. In the Miami-Dade and Monroe region alone, there are 3,125 children eligible, according to the Florida Agency for Health Care Administration (AHCA).

In Florida, foster children are automatically enrolled in Medicaid, the joint-state federal health program. Sunshine Health, a subsidiary of Centene Corp., is responsible for Florida’s Child Welfare Specialty Plan. The five-year contract is valued at $1.1 billion, according to agency officials.

Sunshine Health said it is taking a holistic approach, covering physical and behavioral health, dental care and other services, with a network of more than 30,000 providers. Care managers help oversee children’s social needs, as well as their health.

“It’s all integrated,” said Sunshine Health CEO Chris Paterson. “If there’s a missing piece of health care, say a child is missing a vaccine, the community-based person is going to know that and help us get that child to the doctor.”

Paterson also said the company believes it can’t provide quality health care without looking at the children’s social needs. The plan allocates about $150 per child, to be spent at the care manager’s discretion, for items such as a baseball glove for a kid who wants to try out for a team or a new dress for a girl who wants to go to a school dance.

The idea is to close some of the gaps in care that often occur with children in foster care. When children have been moved around, “it’s hard to put the pieces of the puzzle together,” says Dr. Moira Szilagyi, chairwoman of the National Council on Foster Care, Adoption and Kinship Care for the American Academy of Pediatrics.

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