Presentation to the Senate Human Services & Corrections Committee July 17, 2018
Program Overview • Previously, Medicaid medical benefits for children in the foster care program were provided on a fee-for-service (FFS) basis • Legislation passed in 2014 directed HCA to move the medical coverage from FFS to managed care through a competitive RFP process in 2015 • Apple Health Foster Care program began April 1, 2016 • Coordinated Care’s name for Apple Health Foster Care program is Apple Health Core Connections 2
Who Does Apple Health Core Connections Serve? Coordinated Care is serving approx. 24,000 members in this program across the state (ALL 39 COUNTIES): • Children and youth in out-of-home placements • Children and youth receiving Adoption Support • Extended Foster Care (18-21) • Alumni of Foster Care (aged out the month of their 18 th birthday or after, enrolled until 26) **American Indian or Alaska Native may choose AHFC/Apple Health Core Connections but will not be automatically enrolled Note: Extended Foster Care and Alumni are all referred to as “Alumni” for the purposes of available benefits. 3
National Expertise Coordinated Care (through our parent company – Centene) has operational, clinical, and policy leadership in delivering managed Medicaid services to children in child welfare. • Established first Managed Care program specifically for children in Foster Care (Texas) • Currently provides managed Medicaid services to foster care children in 10 States – California, Florida, Kansas, Louisiana, Mississippi, Missouri, New Hampshire, Indiana, Texas, Washington 4
Alignment with National and State Goals Support Child & Family Services Review (CFSR) which include Safety , Permanency and Well-being Outcome Measures Solution tailored to align with states’ initiatives and goals aimed at fully integrating care and services for vulnerable populations • Improve access to care by establishing an integrated medical home • Improve coordination of physical and behavioral health services • Support improvement of functional outcomes and overall stability of children and youth in foster care through enhanced quality of services 5
Apple Health Core Connections Benefits • • Medical services Emergency Room visits • • Doctor office visits Physical therapy • • Including urgent care Specialty therapies • • Vision exams Mild to Moderate Behavioral health • Prescriptions outpatient • Hearing exams • Lab tests/x-rays • Hearing aids (under 21) • Transplants • Durable Medical • Family planning Equipment (DME) • Disease management • Hospital care • (Asthma, Diabetes, etc) • Home health • Transgender Benefits 6
At the Heart of the AHCC Model • Health Care Coordination Teams staffed by: – Behavioral Health Care Managers – Nurse Care Managers – Health Care Social Workers – Community Health Workers 7
Our Members 23,966 Total Members Alumni 1717 7% Foster Care 11,222 47% Adoption 11,024 46% Foster Care Adoption Alumni 8
Programs, Pilots, Processes • Zero Suicide Education/Retraining • WISe Outreach • ABA Outreach – Over 800 members • SOGIE (Sexual Orientation Gender Identity) • Emergency Room (ER) Diversion • a2A (adolescent to Adult) 9
We Care (homeless youth shelter outreach) 10
2017 11
2017 Outcomes • Increased Mental Health visits: 20.14% • Decreased preventable ER visits: 10.01% • Decreased inpatient admissions: 44.92% 12
Integrated Managed Care Jan 1, 2019 • Whole-person care: behavioral health services integrated with physical service, including social determinants of health • No Access to Care standards • Low, moderate and high-intensity • Services available inside and outside of county • Members can self-refer • Easier access to outpatient services • Collaboration early, often with providers and allied health systems • Trauma-informed care 13
No-Cost Training Increased 900 12,000+ community trainings people knowledge COMMUNITY TRAININGS AHCC Program Overview or Topics Trauma Informed Care Hope for Healing Resilence Other Clinical Topics 14
No-Cost Training • • ACEs (Adverse Childhood Suicide Prevention Experiences) • Things I Wish My Therapist Knew • Adolescent 2 Adult program (about the foster care system) overview (a2A) • Trauma-Informed Care for • AHCC Overview Educators and School Counselors • Child Development • Trauma-Informed Care for • Coping with Holiday Stress Caregivers • Hope for Healing • Trauma-Informed Care for • Resiliency Providers • Sexual Health in Foster Care • Whole Brained Parenting • Substance Use Disorder 15
When Advocates Work Together: Passage of HB 2530 • July 1, 2018 Extends AHFC benefits for one year • Jan 1, 2019 Behavioral Health Integration 16
Questions? Andrea (Tull) Davis Director of Government & External Relations Coordinated Care atull@coordinatedcarehealth.com Julie Lowery Manager of Operations, Apple Health Core Connections , Coordinated Care Julie.M.Lowery@coordinatedcarehealth.com 17
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