* We discussed this a bit last week…
Illinois’ Department of Children and Family Services plans to put all 16,000 children in its custody on Medicaid health insurance. But at a hearing Tuesday, state lawmakers expressed skepticism, saying they’re worried those kids may fall through the cracks.
If you’ve ever moved from one insurance plan to another, you know it can be complicated. Now try doing that for thousands of foster care children at once.
That’s what DCFS, alongside the state’s Department of Healthcare and Family Services, is trying to manage for all the kids who are considered wards of the state. It wants to move them all to Illinois’ Medicaid plan, known as IlliniCare. […]
DCFS is planning to move the kids in its care to Medicaid by November 1.
* From state law…
The Child Welfare Medicaid Managed Care Implementation Advisory Workgroup is established to advise the Department on the transition and implementation of managed care for children. The Director of Children and Family Services and the Director of Healthcare and Family Services shall serve as co-chairpersons of the Workgroup. The Directors shall jointly appoint members to the Workgroup who are stakeholders from the child welfare community […]
Prior to transitioning any child to managed care, the Department of Children and Family Services and the Department of Healthcare and Family Services, in consultation with the Workgroup, must develop and post publicly, a transition plan for the provision of health care services to children enrolled in Medicaid managed care plans.
* Emphasis added because of Hannah Meisel’s revelation today…
[Rep. Mary Flowers] said she was more concerned with another body that was written into the law codifying the transfer of foster care children into Medicaid managed care: the Child Welfare Medicaid Managed Care Implementation Advisory Group, which was supposed to have been formed “effective upon becoming law,” Flowers said.
Flowers asked DCFS officials at last week’s hearing why that group had not yet gotten off the ground, and accused them of being “blatantly in violation of basically the entire law.”
DCFS spokesperson Jassen Strokosch told The Daily Line that the agency is finally moving forward on the Child Welfare Medicaid Managed Care Implementation Advisory Group, and said officials are “reach[ing] back out to the people who were appointed.”
“We’re scheduling meetings as quickly as we can,” he said.
Great. Just great. By law, DCFS cannot transition a single child into Medicaid managed care until the agency has developed and published a transition plan with a working group that hasn’t even met. And the deadline is November 1, which is only 44 days from now.
The future of 16,000 kids is at stake and they’re throwing together a working group at the last minute. Yeah, that report won’t be rushed at all. Nope. And I’m so sure its members won’t be pressured into rubber-stamping whatever plan the state has already come up with.
Also, way to stiff your stakeholders again, DCFS.
Governor, you have a lot of extra time on your hands these days since you’re not attending many events. How about you spend some of those precious moments making absolutely sure DCFS is doing this right? And if they’re not, then put this thing on hold.
- lakeside - Wednesday, Sep 18, 19 @ 10:44 am:
Are there any states doing child protective services very well? Can we learn from them? Because it really seems like we are just throwing our most vulnerable kids into a variety of untested systems.
==making absolutely sure DCFS is doing this right==
Like, absolutely, absolutely. Jeez.
- Stark - Wednesday, Sep 18, 19 @ 10:49 am:
Is there a more inept agency in all state of government more so than DCFS? No.
- Juvenal - Wednesday, Sep 18, 19 @ 10:51 am:
First develop a plan, then get people’s input is not how its supposed to work, kids.
- Oswego Willy - Wednesday, Sep 18, 19 @ 10:59 am:
===“reach[ing] back out to the people who were appointed.”===
For the love of Pete, this isn’t a “well, we hope they get back to us soon” kinda thing.
I’m confused, is there no sense of urgency, or is the wanted perception is to show no sense of concern?
“…“reach[ing] back out to the people who were appointed.”…”
Think on that. Does that sound prodded it act, they’re acting but are “fine” with a passive way of doing it… or worse, there was no plan and they’re getting to it now, just waiting on folks to respond?
I’m not even addressing the real issue because at this point this idea of how this business is being handled… this is not handling it well.
DCFS is an agency that can never be on an auto-pilot, or publicly be seen as something an administration sees as an afterthought.
There needs to be a reflection period here, and look at how they want their business done.
- Stuff Happens - Wednesday, Sep 18, 19 @ 11:45 am:
It’s not just for youth in care, either. Every child adopted through DCFS and under the age of 26 is also being transitioned. They’re no longer in care, but are impacted.
Families are being given 30 days to figure out what plan works for them. Many are stymied; a subsidized therapist might be covered under one plan, but second therapist might not. Adoptive parents are being forced to drop services for children.
- Last Bull Moose - Wednesday, Sep 18, 19 @ 11:51 am:
The idea of moving 16,000 people at once never made sense. Caseworkers are already stretched too far.
It might help to organize transition teams to take the lead on changing the support network for each child. This has to be done one child at a time for each child has their individual network.
- Earnest - Wednesday, Sep 18, 19 @ 12:06 pm:
Sadly, the only thing that has ever moved the needle for human services in Illinois is lawsuits. Left to their own devices our legislators have always said the right thing and done the no-thing. Advocates should just focus on lawsuits and not elected officials.
That said, I’m not ready to lump Pritzker in with them yet. He seemed to be moving slowly in the spring session but in the end achieved so much. Large state agencies make for slow course corrections–allocation of proper resources, hiring, training, digging into large projects in motion over time interfacing with state or federal requirements. There is a difference between long-term building and and the need for fast intervention though.
- the Patriot - Wednesday, Sep 18, 19 @ 12:11 pm:
We have the democrats that cry heartless republicans don’t want these types of programs while democrats like Pritzker and Raoul smile for the camera at the press conference and then do nothing to actually implement or enforce the law.
- Michigander in DuPage - Wednesday, Sep 18, 19 @ 1:03 pm:
Among many concerns with this move, what assurances have been provided by HFS about the adequacy of IlliniCare’s provider network? In my experience working with families and social service providers, this is not a plan accepted by many healthcare providers in our region. Why sole source the managed care of this population to one MCO - why not allow them to enroll in any of the MCOs? I just quickly looked at the DuPage area hospital systems’ websites and see that IlliniCare is not listed as an accepted plan for Northwestern (CDH), Edward-Elmhurst, and Advocate Good Sam.
- revvedup - Wednesday, Sep 18, 19 @ 1:07 pm:
This plan will end in tears, and a Federal lawsuit (Medicaid is under the Social Security Act; suits could also come under ADA and other laws). Wait for it. Clueless leadership, overloaded caseworkers, and likely children dying due to loss of healthcare, while three agencies hold endless meetings far too late to matter.
- a drop in - Wednesday, Sep 18, 19 @ 1:17 pm:
” put this thing on hold.”
Absolutely. Sounds like a page out of the Boris Johnson Brexit playbook (We will figure out how to do this later).
- RNUG - Wednesday, Sep 18, 19 @ 1:19 pm:
DCFS continues its’ string of (banned Marine term)’s.
This dysfunction has been going on far too long under too many Directors and Givetnors. When will the State hire a really good manager as Director AND give them the time, the resources and the flexibility to transform the agency?
/end of rant
- RNUG - Wednesday, Sep 18, 19 @ 1:21 pm:
I meant Governors … but the auto spell substitute is interesting.
- Candy Dogood - Wednesday, Sep 18, 19 @ 6:22 pm:
The headline really ought to be “Agency chronically underfunded for decades unable to meet statutory obligations.”
- dbk - Thursday, Sep 19, 19 @ 6:06 am:
Late to the thread, sorry; does anyone know of a really down-in-the-weeds investigative piece on how the agency (dys)functions that would allow us all to understand what’s happening a little more in depth?*
* Found the Chapin Hall report from May 2019 - it has a bibliography. Other scholarly sources which are open access would also be much appreciated.
Chronic long-term underfunding - understaffing - inappropriate appointments in leadership positions and rapid turnover of leadership/rank-and-file caseworkers - growing complexity of bureaucracy - outsourcing of service providers. It’s an unholy mess, but …
I agree with other commenters upthread re:
1) What state(s) has/have got it right? Couldn’t we look to them for answers/approaches/solutions? (No need to hire high-$$$ “consultants” - sb can just do the darn research already.)
2) The Gov needs to get involved personally - people (all stakeholders) should feel that he is deeply concerned and will ensure that what needs to get done, gets done. This doesn’t mean micro-management - JB doesn’t look to me like a micro-manager in any case - but it does mean that those charged with the agency’s functioning, smooth or otherwise, will be called upon to report to him on a regular basis until … well, as long as it takes. No governor can aspire to greatness unless s/he ensures that the state’s most vulnerable residents are as respected and cared-for as its least vulnerable.
3) Sorry I don’t recall the initial justification for shifting all 16,000 wards to IlliniCare - I’m assuming it was to (a) rationalize costs and (b) streamline bureaucracy (one provider, at least in theory, being easier to deal with than a multitude of providers).
4) 16,000 under-18 (+ adoptees under 26, see comment above) can’t be transitioned one by one in 44 days, it’s just not possible. Better walk that one back pronto.
5) Develop an action plan that doesn’t overburden already over-burdened caseworkers/supervisors. Agree on a weekly/monthly number of children to be transitioned and then stick to it - it takes as long as it takes. Develop criteria for transitioning - easiest cases first? most difficult, last? counties with multiple providers who accept IlliniCare first? Counties with no providers last?
6) Every county needs providers who accept IlliniCare! How can you transition children into a plan with no accepting providers? Does the state have means of pressuring providers in those counties to accept IlliniCare?
This is laborious work, complex work, sometimes disheartening work, but it’s really important work - and it’s not rocket science. Resources ($$$) + clear objectives + strong accountability and public awareness + gov’s personal interest/concern/involvement will all help.