Council of Family and Child Caring Agencies, Inc.

In 2012, the Medicaid Redesign Team required that all children in foster care be enrolled into Medicaid managed care.

The transition to managed care for this population represents a massive overhaul of the current service delivery system for New York’s 22,000 foster care children and youth. The system will face challenges in coordinating and documenting health care services between the different organizations responsible for implementing foster care. In addition, the current payment system for health services for this population is financially unsustainable and a key barrier to accountability of care in the foster care system. With support from NYHealth, the Council of Family and Child Caring Agencies (COFCCA) designed a managed care model that is financially viable and addresses the range of physical and behavioral health needs of children in foster care in the short and long terms.

The project addressed key issues and questions around acceptable program features and reimbursement rates, such as the network of service providers, and which services must be available; medication management, and how prescription drug coverage should be addressed; information sharing and documentation, and how providers should exchange and document information on services provided; and identifying effective model(s) of care, and their implications for future planning. Together with the Citizens’ Committee for Children of New York, COFCCA convened an oversight committee to provide input on the managed care model, and engaged consultants in health policy and Medicaid managed care in New York to examine the strengths and weaknesses of the existing foster care infrastructure. A final set of recommendations was produced for the State and was disseminated to stakeholders in conjunction with NYHealth.

Read the report associated with this grant, “Raising the Bar for Health and Mental Health Services for Children in Foster Care: Developing a Model of Managed Care.”