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DCFS Delays Managed Care Rollout After Pressure From Officials

via BlueRoomStream.com
Officials from DCFS, HFS and IlliniCare wait to address a panel of state lawmakers at a House committee hearing on Sept. 10

Illinois’ Department of Children and Family Services is delaying a planned health insurance switch for children in its care, but the public guardian of the state’s largest county says there’s still a lot of work to be done.

DCFS wants to switch the nearly 36,000 current and former foster kids under its wing from the current fee-for-service health insurance plan to what’s called managed care. The idea is to save the department money by offering those children a specific group of healthcare providers in-state. Such a switch is required by a recent state law.

That was supposed to happen in November, but after pressure from state lawmakers and Cook County Public Guardian Charles Golbert, the agency says it’s delaying the move until February.

Golbert said the pause is “not a victory, but a breather,” and still maintains DCFS is focusing too much on potential cost savings.

“I think this financial pressure is penny-wise and pound-foolish, not to mention horrible for all of these kids," he said.

DCFS officials and others spoke to state lawmakers of the House Adoption and Child Welfare committee earlier this month on the change.

"We wanna get to the true value of managed care, and how the department and IlliniCare and providers can get to the promise of better outcomes for our members," Theresa Eagleson, director of Illinois' Department of Healthcare and Family Services, said at that time.

In a dramatic move at that hearing, state Representative and committee chair Sara Feigenholtz (D, Chicago) had polled members about whether they wanted more information about the proposed managed care switch, and nearly every hand went up.

"How does this work for children who don't have a parent or guardian? That is of grave concern for me," she told a panel of officials gathered for the hearing.

Charles Golbert and others have said DCFS and others have not yet answered many questions surrounding the rollout. They include whether substantial gaps in healthcare would be created by the move, how an appeals process would work if a claim were to be denied, and if the move would generate any conflicts with court-ordered treatments, which some kids on DCFS' watch are subject to.

That's all to say, Golbert explained, that children in foster care need to be treated carefully.

“A lot of these kids move around a lot, bounce around from foster home to foster home a lot, and these are kids and young adults with very complex medical needs and mental health needs who are particularly vulnerable to any disruptions in their care," he explained.

Golbert says more than a quarter of the healthcare providers relied upon by kids under DCFS are not covered by Illinois’ managed care organization, known as IlliniCare.

Sam is a Public Affairs Reporting intern for spring 2018, working out the NPR Illinois Statehouse bureau.
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