Coordinated Care  - https://www.coordinatedcarehealth.com/  - 1-844-354-9876 – fostercareMGMT@coordinatedcarehealth.com

• Jennifer Estroff, Liaison, Tribal Outreach and Apple Health, Coordinated Care - JESTROFF@coordinatedcarehealth.com
• Excited to be here – just moved back to Pierce County – was born in Gig Harbor
• Coordinate Care – one of 4 managed care plans in Pierce County. 
• Apple Health Core Connections  
  • Program for youth adopted out of foster care and alumni of the foster care program
  • Provide these services this statewide.
  • Every kid should have an annual exam – for kids out of the foster care system, call 1-844-354-9876
• Who do we serve
  • 25k members –
    • Children/ youth in out-of-home placement (meaning Child Protective Services is involved – the state is the legal guardian)
    • Children adopted out of foster care – can stay on state Medicaid
    • 18-21 youth can pick this when they age out of foster care extended foster care
    • Foster care alums – 18-26
    • Children and youth reunited with parents get coverage one year post-dependency.  Theresa – this is great. Jennifer – thanks. – from house bill 2530 (https://app.leg.wa.gov/billsummary?BillNumber=2530&Year=2017 –ed.) – families must be Medicaid eligible. 
    • Al – languages?  Jenn – we will make sure it works.
    • Exceptions - There are some exceptions – if foster care folks get coverage through other entities, like undocumented or Native American.  Youth in detention get healthcare through the detention facility.
• Program and benefits
• What is new in 2019
  • Behavioral Health
    • Kids – lots of words about restrictions in care that aren’t there anymore
    • Program is now state-wide.  Kids can move around and more easily get service wherever.  Questions – is this all areas of the state?  Jenn – not all regions in the state.  For foster care – state wide.  Other clients, perhaps issues.
    • Client can get in Behavioral Health – even if getting healthcare from Medicare or tribal health, can get just behavioral health from coordinate care – but only in counties that are integrated, and Pierce County is integrated.
    • Trauma informed care – all staff, especially in foster care, will have trauma informed training. 
      • Trauma informed means we are working on asking questions in a more normal way – understanding that there is always trauma involved in the lives of kids in the foster care system.
    • Establish a Primary Care Provider and a medical home.  One physician can oversee all treatment and bring it together.  Know medications, therapies.  If can identify two therapists doing similar treatments and work to coordinate care.  When we do this right, youth get right care at the right time.
  • Eligible members are automatically enrolled
    • Will receive a welcome packet.  May get a welcome call.  At enrollment, will work to use someone’s current providers.  We do a ton of care coordination to help families meet the needs of their kids.
• Local approach.  Based in Tacoma, but have Yakima, Wenatchee and Seattle locations. Looking at Spokane.
• Have liaisons – regionally based supports
• Have Community Educators – can do training on trauma informed care at no cost.  I you are serving a population that includes clients on Medicaid, contact us to coordinate training.
• Try to make things easier
  • Being in the foster care system is challenging. 
  • Ensure timely access, assist care workers and care givers.
  • Results
    • Improved functional outcomes
    • Fewer placements
    • Better prescription medicine oversight
    • Improved school performance
    • Higher member/caregiver satisfaction
• Clients don’t need to show card to receive service - although many provider like to see it (does showing the card actually work to prevent fraud or something?  I’ve always been puzzled by this –you’d think some ID would do the trick. –ed).
• We don’t cover dental, but that phone number is on the card.
• Interim vouchers allow instant access to healthcare providers while youth is in the process of getting enrolled.  If there are issues with voucher, 24 hour phone support will make it all happen.
• Will provide 90 days of continuity of care for kids with existing providers that aren’t in the system.  Will try to get those provider in network so they can continue to provide care.
• Find provider on the website, or call us.  
• Question – what about children homeless with their families?  Jenn – not the foster care plan, but they would most likely be eligible for regular state healthcare through Coordinated Care

Benefits –

• Medical services
• Doctors office visits
• Urgent care
• Vision exams
• Prescriptions
• Hearing exams
• Hearing aids
• Durable medical equipment
• Hospital care
• Home health
• Emergency room visits
• Physical Therapy
• Specialty therapies
• Lab tests/x-rays
• Transplants
• Family planning
• Disease management (asthma, diabetes, etc.)
• Transgender benefits
• Behavioral health outpatient and inpatient
• Drug and alcohol treatment
• Vision Health Benefits
  • 20 years and younger – exam with refraction once per calendar year.  Also, Hardware (glasses + lenses or contact lenses) with ProviderOne Card
  • 21 year and over, one eye exam with refraction every 2 calendar years
• Behavioral Health
  • Wraparound with intensive services
  • Program of assertive community treatment
  • Substance use disorder treatment - outpatient, intensive outpatient, residential, detox, mediation assisted treatment (MAT)
  • Crisis Service- call crisis lines
• Al – cover partial hospitalization?  Jenn – yes, if medically necessary. 

• Al – do you address other social determinates of health?  Jenn – yes
• System of Care – member is at the center, we surround the member with community based supports, providers, wrap around services, crisis services.  We work to serve the people serving our members.  We have lots of liaisons.  Have a tribal liaison.   We do a lot of care coordination
• We get lots of questions about CLIP – Children’s Long-Term InPatient – there are very specific beds in the state.  I don’t know much about this – we can bring a presentation in about this.  If outpatient doesn’t work and we’ve tried everything – this is the last resort.  (I often think people just make up new acronyms to keep me on my toes, but as always, it is a real thing - http://clipadministration.org/ -ed.)
• We do lots of care coordination and care management. 
  • Use data to inform risks, find care gaps, etc. (glad to hear it – that is what data is for. –ed)
• Larry – with court involvement – courts may disrupt plans.  Jenn – what the court has dictated may not be medically indicated for the child.  We provide medical care documentation back to the court to get better info into the court’s hands.
• Can help with placement transitions.  Can make sure that equipment and medications properly follow the children.  Have suicide prevention and safety planning protocol. 
• Provider One – still covers usual stuff – call us to find out who will cover what. 
• Question about Transportation? – Coordinated Care will cover medically necessary transportation – for all clients.
• Lots of value add
  • Nurse line
  • Pregnancy supports
  • Adoption success
  • Zero suicide
  • Adolescent to adult
  • We care – go out to youth shelters to see if kids are covered and accessing services
  • Psychotropic medication utilization review- make sure clients are on appropriate medications
  • Health library
  • Cell phone program
• Patricia – overarching question – what are the effects on kids in foster care if the foster family is about to be homeless?  The sooner Coordinated Care knows, the easier a time we have providing services (I’m no expert, but I can’t image you would continue to be a foster family if you lost your housing.  –ed.) 
• Al – you can call a provider and talk to them about your client, but they can’t acknowledge that they know the client.  but if you have information to pass on, you can share that.
• Al – do you follow up to make sure they make a connection when a referral to services is made?  We have to follow-up once every 30 days at least, we’ll always check in if they reached out or engaged services.
• Al – the ACH is looking at having physicians prescribe food, and someone lives in a food desert, would Coordinated care extend transportation to assist with getting to food?  Jenn – we cover Medicaid benefits – we cover what we have to, but during the EPSDT (Early and Periodic Screening, Diagnostic and Treatment – essentially well child exams), if a doctor prescribes something, we have to cover it.  In our regular health plan, I’m not sure what we’d do. 
• James – on one night at the youth shelter, some 40% of youth were ex-foster youth.  Coordinated care came out to review youth benefits, at a time convenient for our youth – which was super helpful.