CHARLESTON, W.Va. — Foster children in West Virginia would be transitioned to managed care programs through Medicaid under a proposed bill that’s now pending in the House Finance Committee.

As proposed, HB 4241 allows for coordinated acute care, including medical, pharmacy, dental and behavioral health services, as opposed to the current fee per Medicaid service model used for the more than 6,300 kids currently in foster care.

“We’re supportive of the concept and have been working on something very similar,” said Jeremiah Samples, deputy secretary for the state Department of Health and Human Resources.

“It’s not agency legislation, but we have been working with legislators on this topic.”

The bill advanced out of the House Health and Human Resources last week.

As written, the changeovers would happen by Jan. 1, 2019 if the bill is approved.

In part, the bill reads like this: “The program shall be statewide, fully integrated, and risk based; shall integrate Medicaid-reimbursed eligible services; and shall align incentives to ensure the appropriate care is delivered in the most appropriate place and time.”

Also, payments shall be made “for the eligible services, including home and community-based services, using a managed care model.”

“Once a child enters the foster kid system, the complexity of need that that child has is going to dictate that sometimes they are moved across the state. Some of these children are even placed out of state,” Samples said.

“It just becomes very difficult in the state bureaucracy to be able to properly manage that.”

The proposal the DHHR has been working goes further than the pending legislation, Samples said.

Those with DHHR, he said, would like to see every child in foster care have a care manager with family care managers established for kids at risk of entering foster care.

“All with the goal of ensuring that we’re properly managing and coordinating the medical and behavioral health needs of this very complex population,” Samples told MetroNews.

“Doing this through a managed care portfolio really would enhance the ability to ensure that these kids are properly cared for and that someone always has eyes, not just on their social service needs, but on their medical and behavioral health needs.”

The 2018 Regular Legislative Session runs through March 10.

Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy.

bubble graphic

bubble graphic
Comments