SPRINGFIELD – Nearly two months after Illinois launched a major change in the way it provides health care to children in foster and adoptive homes, state lawmakers are hearing mixed reviews about how well the new system is working.
On Sept. 1, an estimated 19,000 children in state care were shifted to a managed care health system within the state’s Medicaid program. And while Marc Smith, acting director of the Department of Children and Family Services, declares the transition a “great success,” outside observers say a large number of children still are not getting the care they need.
“I want to be clear. There are children in Illinois who are not receiving critical health services that they need when they need to have it,” ACLU attorney Heidi Dalenberg told a legislative committee Thursday.
The state is responsible for providing health care to children in foster care as well as those who have been adopted out of foster care or who have aged out of the system but are still younger than 21.
Those who have aged out of foster care were shifted to the new managed care system, known as YouthCare, in February. All other children in state care moved into the new system Sept. 1.
Under managed care, a private insurance company, in this case Centene Corporation, is in charge of putting together a network of health care providers and coordinating all of the health care that those people receive.
Illinois has used a managed care system for most other Medicaid patients for several years. But the transition of current and former foster children into that kind of system took much longer because those are typically children who have been victims of severe abuse or neglect.
“Current and former youth in care are among the most vulnerable in our state and often facing complex and challenging needs,” Smith told the Senate Human Services Committee during a virtual hearing Thursday.
“Our department testified previously before this committee about our commitment to supporting families and ensuring that when managed care was fully implemented, our children would receive a level of care and access to critical services that did not exist before,” Smith said. “I can reaffirm this commitment to you and say to you, we consider the transition of youth care to be a great success.”
The launch of managed care for current and former foster children had been delayed several times, mainly due to concerns from children’s advocates and lawmakers that the new system wasn’t ready to take on the challenge.
But Shawnte Alexander, vice president of child welfare programs at Centene, said YouthCare now has a provider network more than three times that of the previous network. In addition, she said, it offers a team of care coordinators who work with families to find the providers they need, including specialists, relieving those parents of the burden of navigating a complex health care system.
“We have dedicated teams that are there to help our members troubleshoot any issues that may arise as they're trying to work with providers,” she said. “Often there can be a disconnect between the member and their provider, and we want our staff to be able to jump in and speak some of that language for them.”
But Danielle Gomez of the Cook County Public Guardian’s office, an agency that acts as attorneys for abused and neglected children, provided a much different picture of the managed care system.
“I'm happy to hear that there are some positive stories. I think that's great,” she said. “But those stories are not happening statewide and that level of service is not available to every child who is enrolled in YouthCare yet.”
Gomez spoke about one family with a 7-year-old adopted boy and a 5-year-old foster girl, both of whom have had to switch pediatricians because their former physicians do not participate in YouthCare. She said the father in that family tried using YouthCare’s online database to find another doctor but soon learned the database is replete with errors.
“He said one provider even yelled at him because they were so frustrated,” Gomez said. “They indicated that so many people had called and asked about whether or not they take YouthCare and they don't.”
The panel also heard from a number of individual foster parents about their experiences with YouthCare. Most gave it generally favorable reviews, although some said they’ve had difficulty finding specialists near their homes.
Following the hearing, Sen. Julie Morrison, D-Lake Forest, who chairs the committee, issued a statement saying lawmakers would continue monitoring the progress of YouthCare.
“Today’s hearing was the first step toward tackling issues with YouthCare in an effort to make sure every child gets the care they need and deserve,” she said. “Together, through communication and a willingness to put children’s health first, Illinois can soon have some of the most robust care for children in need.”
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