Physical and behavioral health problems are critical issues for children on welfare. About 75% of children entering foster care struggle with these problems. To explore ways to improve health services for children on Medicaid, CareOregon has been selected to be part of a national collaborative comprised of 11 health plans from across the country. The 24-month initiative begins in January 2007.

The coalition – “Improving Outcomes for Children Involved in Child Welfare” – is headed by The Center for Health Care Strategies, a nonprofit group devoted to improving the quality of health services for beneficiaries served by publicly financed care. CHSC is focused on improving health care quality, reducing racial and ethnic disparities, and integrating acute and long-term care.

Access to physical and behavioral health services for children in foster care varies drastically across the country, with some youth receiving too much and disjointed care, and others receiving too little care. In addition, Medicaid's costs for physical and behavioral health services for these high-needs children are disproportionately large relative to the population's share of Medicaid enrollment.

CareOregon has more than 64,000 members age 18 or younger. About 2,755 of these members are served by Children’s Services Division. Roughly half of these children are younger than age 10, and they may either reside at home with supervision or in a foster care setting.

As part of the collaborative, CareOregon proposes to evaluate multiple factors related to the diagnosis and treatment of children with Attention Deficit Hyperactivity Disorder (ADHD), with special emphasis on prescribing use of non-drug behavioral therapy.

“We look forward to collaborating with the Portland Public School District, the Department of Human Services, mental health organizations, pharmacists, pediatricians, and parents to develop strategic interventions to ensure that our members are receiving safe and effective treatment that is consistent with scientific evidence,” said Dr. Margaret Rowland, Chief Medical Officer.

Through these interventions, CareOregon will develop a model for better care coordination and integration of prescribing ADHD medication to children. Other managed care organizations that are part of the national collaborative include:

• Connecticut Behavioral Health Partnership
• Health Net of California
• Magellan of Florida, Magellan Public Sector Solutions, Magellan Health Services
• The Massachusetts Behavioral Health Partnership
• Mid Rogue IPA (Oregon)
• Neighborhood Health Plan of Rhode Island
• Priority Partners MCO (Maryland)
• University of Pittsburgh Medical Center Health Plan
• Volunteer State Health Plan (Tennessee)
• Wraparound Milwaukee

Throughout the project participants will have access to expert technical assistance and a peer-learning network. These organizations will develop and pilot approaches to meet the health and behavioral care needs of children and youth in the child welfare system.
Project summaries will be available shortly. The initiative is funded by the Annie E. Casey Foundation. For more information, e-mail sneesetodd@chcs.org.