HCA selects contractor for coordinated foster youth health care services & Adoption Support

News Release
For immediate release
August 24, 2015
HCA selects contractor for coordinated foster youth health care services

Coordinated Care of Washington will manage services for more than 25,000 children and youth participating in the adoption support, foster care, and young adult foster care alumni programs.
OLYMPIA – A 3-year-old girl entered foster care due to substantiated allegations of abuse and neglect. She appeared healthy, but there was evidence of methamphetamine use in the home from which she was removed, and there was no food in the home. Her parents report she had not seen a doctor in two years.

This real case helps illustrate the complex care needs for many children and youth in foster care. The Washington State Health Care Authority (HCA) announced today that Coordinated Care of Washington (CCW) is the apparent successful bidder selected to provide health care to more than 25,000 foster children and youth who receive foster care and adoption support services. The program is also available to young adults who have aged out of the foster care system.

HCA is moving to a single managed care organization (MCO) to better manage the physical and mental health care for foster and adoption support youth enrolled in Apple Health (Medicaid). The move is expected to provide a system of consistent and coordinated health care services. Health care for children and youth in the foster care and adoption support programs is currently offered in a fee-for-service arrangement, which can lead to lack of coordination among a child’s health care providers.

CCW will offer a comprehensive and coordinated medical benefit, including primary care; ancillary services such as tests, imaging and urgent care; pharmacy; and an outpatient mental health benefit. CCW also will ensure continuity of care if a child has a change in foster care placement.
“A single care plan will help ensure youth in foster care get access to the physical and mental health care they need,” said HCA State Medicaid Director MaryAnne Lindeblad. “This is a complex and vulnerable population of kids and young adults who may have experienced trauma and toxic stress in their young lives. We want to be sure we are offering comprehensive, high-quality care and smooth transitions among multiple health care providers so that treatment, medication and equipment are well-coordinated.”

“It is really important that these kids have the best health care available,” said Department of Social and Health Services Children’s Administration Assistant Secretary Jennifer Strus. “We are glad this new system will help coordinate the services they are receiving.”

The move aligns with legislative direction over the past several sessions, including House Bill 1879, sponsored by Rep. Ruth Kagi, D-Seattle, which passed during the 2015 legislative session.
Several categories of youth in foster care are eligible for Apple Health in Washington, including those who are:
• Under the age of 19 and in foster care.
• Children and youth receiving adoption support.
• Under age 21 and participating in the Extended Foster Care program.
• Between 19 and 26 years old and either were in foster care and enrolled in Apple Health on their 18th birthday or were older than 18 when their foster care assistance ended.

Back to school

It is that time of year again and if your home is anything like mine, the energy is peaking in your home.   I have one daughter whose excitement is almost impossible to contain.  She can’t wait to see her friends every day and to hangout.  I have another that is so nervous about who will be in her class and how everyone will get along and what everyone will wear and, and….and….  I am sure all of you can relate.  This time of year is exhausting.  Yet alone, us as parents trying to get our school supplies purchased, do we have enough socks for the week and undies so we can make it to Saturday to get laundry done?  Does my child have the “right” kind of this or that?  We worry that our kids will get bullied, especially our kids with special and unique personality characteristics.  How do we not pull every hair out of our head and end up on a psychiatrist chair ourselves?  Because we do all this out of the love we have for our kids and because we want what is best for them.  If you focus on that, you will make it through. 


TreeHouse has some great ideas: http://www.treehouseforkids.org/back-to-school-success/

Some helpful hints to survive back to school:

1.       TOUR Do bring your child to school and let them see where their classroom is, even if they have been there before, even if they know the campus like they know their home.  It is comforting and will help them on their first day.  It will remind them.  They have never been in their new class (well not likely).

2.       TEACHER If you can make it work, make sure they meet their teacher before their first day of class.  If not, look them up online.  Most school have listing online with their teachers.  See if you can find a photo and show your child.  Research anything you can on them.  Are they on Facebook?  Ask around, if you can find an older child who had the teacher…let them tell your child how great they are (but only if they are going to say that.)

3.       TELL Find out who else is in their class (good, bad, or indifferent) better to have your child prepare for this than worry about that what ifs.  If your child is new to their school, ask around the neighborhood, church, etc…see if you can find another child in school.  See if they can have a buddy/a familiar face. If possible, find an older kid who is willing to be a bus buddy from the neighborhood.  It can be a huge help. 

4.       enTITLEment Have your child help pick out their school supplies and especially their first day of school outfit.  Controlled choices are good, especially on a budget.  But if their favorite color is blue, let them pick out a blue pencil box and backpack.  The more they “like” their supplies and the clothes they are wearing, the more confidence they can exhibit.  Even if it is on a shoestring budget. The ownership leads to more comfort.

5.       TRANSITIONAL objects are also a huge help. Let them have a clip-on teddy for their backpack.  It is trendy and allows them to have a stuffy at school.  They can also have a special friend in their bag.  It can really help for younger kids (and even some older ones).

6.       TICK-TOC Routine is so important.  If you have let your kids be a little more lax about bed time and getting up in the morning.  Now is the time to begin getting back into a routine.  Your kids may not be thankful now, but they will be later. 

7.       TACKLE the paperwork, does the school have everything they need.  If your child is a new foster child or a new adopted child, does the school have all the paperwork proving they are who you say they are?  Now is the time to get the school paperwork up to speed if you have not done so. 

     a.       Copy of the former schools Individualized Educational Plan (IEP) if there is one

     b.      Immunization Records-are they current and does the school have them?

     c.       If an adopted child, be sure you have a copy of your child’s new birth certificate and   
            adoption decree if they have attended the school under a previous name.

     d.      This is a good list of paperwork to consider having for school for foster children:
            http://adoption.about.com/od/parenting/a/schoolpapers.htm

8.       TRUTH Protecting your child’s truth is something you all need to think about with school.  Everyone, including school staff, friends, parents of friends, and others do not need to know your child’s history or circumstance.  In reality it is their truth to tell.  The school needs to know if the child is still a dependent child, but the child has a right to confidentiality.  

The question:  What is your child’s cover story?  Who are you to them if you are foster parents?  How did they join your family?  What do they tell their friends?  It is your job to prepare them. 

The following was created by Laurie Washington (FKA Mayer), MSW

THE COVER STORY: Helping Children

When children must live apart from their family of origin, whether in foster care or adoption, they need to master the telling of WHO they are and HOW they came to be living apart from their families of orgin.  Placement workers, beset by the complexities of locating willing substitute families, grappling with the logistics of moving child and belongings intact to a new family, faced with a veritable blizzard of paperwork to approve and finance the plan, may overlook this problem.  Before the dust has barely settled, the child will be called on to explain his person, his presence, and his history to a long list of inquirers.  New neighbors, teachers, playmates and acquaintances will ask questions about him/her and his/her status.  Sometimes the questions will be casually asked; sometimes he/she will be grilled like a suspect.  The child left to fend for him/herself in these circumstances is usually forced to say too much or too little.  Sometimes he/she “embroiders” the truth and gains a reputation as a liar.  Sometimes he/she volunteers lurid detail and becomes an instant, exotic attraction.

An experienced placement worker knows this in advance and equips the child with a cover story.  (Place note—a cover story, not a cover-up story!  In the business world the cover letter is a generally well phrased, all-purpose letter used to summarize more elaborate information provided elsewhere.)  In placement, the child can easily learn that his/her cover story, his/her short version of who he/she is, is an appropriate response when people ask him/her leading questions like…”Just where did you come from?”…”How come you don’t live with your folks?”…”But who are you?”  Without help in preparing the answers, the child founders.  With help, he/she can respond confidently, truthfully and yet avoid trapping himself into betraying private matters.

The easiest way to prepare a cover story with a child is to imagine the potential questions, review what is appropriate information to share, and role-play questions and answers.  This technique works with children of all ages, as long as they have basic language skills and can learn appropriate social responses.  Pre-schoolers, teenagers, developmentally delayed children and even emotionally disturbed children can all benefit from such help, as can the families caring for them.  To provide the new family with background or current functioning information on a child to be placed and then leave the question of appropriate handling of that information entirely to their good judgment is foolish.  Excitement, surprise or sheer foolhardiness can lead families into sharing intimate information about a child with people who have no business knowing these things.  Placement families must always be warned about that impulsive phone call to a best friend or family member.  The simple trigger of a question like “Well?  Tell me what the worker told you about him!” can result in confidences shared that can never be retracted.  The child is stripped and betrayed even before placement.

It becomes the job of the placement worker to help the child and his new family anticipate the difficulties and organize a three-step defense:

1.            Imagine the Potential Questions

Actually make a list of the various possibilities and the persons who may ask the questions.  This helps the child and family see the relevance of an abbreviated version of the story.  In the excitement and the fantasy surrounding the placement scenario, the everyday facts of living and forming new relationships may not loom large until it is too late and the child or family may be caught unaware and without defenses.

                     -Imagine introducing the child to your neighbor

-Envision the first day of school and the questions asked by classmates and teachers

-Picture the first family gathering and the remarks made by new grandparents, cousins, uncles, etc.

-Consider the first day in the new neighborhood, playing with children who are understandably curious about the new child

2.            Review the Appropriate Information to be Shared

Children often have trouble understanding the right to privacy.  They need help to understand that not all people are entitled to detailed answers to all questions.  They need help from adults to distinguish between what is known and what is shared.  This is a good opportunity to help children learn how to be truthful but appropriate in giving answers to personal questions.  It also protects them from disclosing information that might later be embarrassing to them or used against them in destructive or hostile ways.

Simple declaratory sentences are best: “…my name is John Smith…I used to live in Seattle…I’m gonna live here because my folks have problems…I have to live here until things get better at home…I’m being adopted…I got adopted because I couldn’t live with my other family anymore…”

Three basic responses are those most often needed:

-The child’s name (be consistent; use his legal name so he can make the same response at all times; using one name at home and another in school can be very difficult for the child)

-The child’s origin (offer the basics only; most people who ask where the child comes from are satisfied with the name of a state or town, more detail is not necessary; children can be taught to deflect more probing by responding with a question of their own: “…and where are you from?”

-The whereabouts or general circumstances of the child’s biological family (the implication is usually clear, the questioner wants to know why the child is not with them; children can answer briefly and truthfully without providing details.  If the questioner is persistent, the child should be comfortable in ending the conversation: “that’s family business…I have to go now…my family would have to answer that…”

3.         Role Play the Questions and Answers

Be sure the child knows the three most common concerns (as above) and can comfortably respond to questions about them.  The family should be able to respond in accord with the child.  A placement worker has a good opportunity to show the child and family they can cope with a new situation with confidence.  Everyone feels more competent.  They can share an essential social task in anticipating, analyzing and solving a real life problem.  By acting out the possible questions and answers together, they come to grips with a current problem and learn more about each other.  They develop a sense of unity.  They “put a little more money in the bank account,” meaning they accumulate some shared feelings to draw on later when difficulties arise between them.  They may even see this as one good way to solve other problems.

Every child entering a new living situation needs this preparation.  When it is a simple matter of a family moving to a new home, the answers to direct questions come easily.  When the child moves because of family distress, the answers become more troublesome.  Most children are not prepared to deal with the natural curiosity of children and adults they will meet.  It becomes the responsibility of the placement worker to help the child and his new family respond to the situation and the methods used can promote stronger ties between child and family and point the way toward resolving yet other problems.