Electronic Information Exchange: Elements that Matter for Children in Foster Care " Beth Morrow Director, Health IT Initiatives The Children’s Partnership SPARC Webinar, January 31, 2013
Children in foster care face unique challenges that require additional care coordination."n Childhood trauma."n Frequent movement among placements, caregivers, and schools."n Higher rates of special education needs, psychotropic medications, and chronic health conditions."n Enter adulthood without family support system." www.childrenspartnership.org
Unique challenges face states/localities too"n The average cost of Medicaid per child in foster care is over 3 times the average cost for nondisabled children."n Children in foster care account for 28% of all Medicaid expenditures on inpatient psychiatric services (or, 46% of such expenditures on nondisabled children)."n During their early adult years, these youth are much more likely than their peers to forego higher education, describe their general health as fair or poor, become homeless, and rely on public supports. " www.childrenspartnership.org
What can be done? "n Children in foster care need cross-sector, coordinated, continuous behavioral and medical care."n Key to this coordination: Communication and information sharing by the adults caring for these children."Ø Electronic information exchange and electronic records can help." www.childrenspartnership.org
Better Outcomes at Lower Cost"n Early efforts are making a difference:"• Wraparound Milwaukee (WI) – Improved coordination has resulted in reduced inpatient psychiatric care, residential treatment, and juvenile corrections placements."• UPMC For You (PA) – Improved coordination has increased the proportion of foster children receiving annual well-child and dental visits."n We will hear from Texas and San Diego next about how electronic information exchange has made a difference for foster children in those communities. " www.childrenspartnership.org
What needs to happen:"n Bring stakeholders together "-- develop champions "-- work together to address key hurdles (information sharing agreements, back-end IT capabilities, and funding)"-- leverage existing efforts that can help (initiatives, systems projects, etc.)"n Use Health Education Passport as starting point" www.childrenspartnership.org
Contact" Beth Morrow! Director, Health IT Initiatives" (718) 832-6061! email@example.com! http://www.childrenspartnership.org/our-work/foster-care-coordination" " "
Texas STAR Health ProgramRebecca Alejandro, Texas HHSC Health Plan Specialist January 28, 2013
Star Health Program Background• In 2005, the Texas Legislature required the Texas Health and Human Services Commission (HHSC) to design a comprehensive medical services delivery model to meet the healthcare needs of children in foster care.• In April of 2008, the STAR Health program was implemented.• Eligible clients include: • Children and young adults in conservatorship of the Texas Department of Family and Protective Services (DFPS). • Youth age 18-21 who voluntarily continue in a foster care placement. • Former foster care youth who continue to receive Medicaid benefits through age 21. • Former foster care youth enrolled in higher education.
Main Objectives• Immediate eligibility• A statewide network of providers• An increased focus on behavioral health services• Service management and coordination teams• Psychotropic drug utilization review• Health Passport
Health Passport• Medical, behavioral health, vision, dental, and prescription claims• Lab results• Immunization records• Allergies and known reactions, vital signs, weight, height, and other such details• Forms including Healthcare Service Plans, Psychotropic Utilization reviews, Texas Health Steps exams, and psychological evaluations
Health Passport• A DFPS caseworker can view all information in the child’s record.• A foster parent can view all information except for the Behavioral Health tab.• DFPS contracted residential providers have a few designated staff who have the same viewing rights as foster parents.• A network provider can view all information as well as interact with the system to enter data and upload forms.• Access is restricted to comply with HIPAA privacy and security rules.
Making it Happen• Interagency and Public-Private Collaboration• Extended Timeline• Cost of Implementation• Performance Metrics• Availability of Data
ConclusionA complete training video on the Health Passport can be accessed on Superior HealthPlan’s website at: http://www.superiorhealthplan.com/wp-content/training/ clinicalTX/default.html For additional information, contact: Rebecca Alejandro Texas HHSC Health Plan Specialist Rebecca.Alejandro@hhsc.state.tx.us 512-491-1864
Information Sharing to Increase Education Outcomes for Students in Foster Care Michelle Lustig, Ed.D, MSW, PPS San Diego County Of<ice of Education Student Support Services Foster Youth and Homeless Education Services
California: County Offices of EducationCounty Of*ices of Education õ There are 58 County Of<ices of Education (COEs) which provide services to school districts. COEs: ô Support school districts by performing tasks that can be done more ef<iciently and economically at the county level ô COEs provide a wide range of services including <iscal oversight, special and vocational education, programs for youths at risk of failure, and instruction in juvenile detention facilities
Foster Youth Services ProgramsFoster Youth Services (FYS) Programs õ Provide support services to foster children who suffer the traumatic effects of displacement from family and schools and multiple placements in foster care ô Services are designed to improve the childrens educational performance and personal achievement, directly bene<iting them as well as providing long-‐range cost savings to the state ô Mandates are incorporated into Education Code
California Law Relating to the Education of Students in Foster CareCalifornia Education and Welfare an Institutions Code ô School of Origin rights/proximity to school ô School Stability Provisions ô Equal access-‐curricular and extra curricular (CIF) ô Immediate Enrollment ô Stay put rule ô Least restrictive ô Foster Care liaison ô Best Interest determination ô Noti<ication to schools districts ô Transfer of records ô Partial credit protection ô Graduation requirements ô Notice of manifestation, suspension, expulsion
Relationship Between Data Sharing and Educational Outcomesõ Increased ô Awareness ô Cooperation ô Collaboration ô Responsibility ô Matriculation ô Academic performance ô Graduation rates ô School stability
Background and HistorySan Diego County Of*ice of Education, Foster Youth Services (SDCOE, FYS) õ Court Leadership õ Collaborative history õ Court Orders (2002, 2003, 2005, 2008, 2011) õ Database Agreement (2006-‐2011, 2011-‐2016) õ Interagency Agreement (2006-‐2011, 2011-‐2016)
Considerations and Lessons Learned Cross System Data Sharing Begin with the end in mind. Engagement of all stakeholder groups youth and caregivers Determine the best way to meet competing demands, policies, mandates and restrictions. Shared understanding and interpretation of FERPA, HIPPA and SACWIS: intersections and hurdles. Consideration of who maintains the database who owns the data who owns the intellectual property that is the physical database
What needs to happen:!n Bring stakeholders together !-- develop champions !-- work together to address key hurdles (information sharing agreements, back-end IT capabilities, and funding)!-- leverage existing efforts that can help (initiatives, systems projects, etc.)!n Use Health Education Passport as starting point! www.childrenspartnership.org