L. A. Cares for Kids: A model of managed care coordination for abused and neglected children

The 130th Annual Meeting of APHA

4278.0: Tuesday, November 12, 2002 - Board 7

Abstract #42322

Karen A. Goodyear, PhD, Medical Administration, L. A.Cares for Kids Program, L. A. Care Health Plan, 555 West Fifth Street, 19th Floor, Los Angeles, CA 90013, 213-694-1250, kgoodyear@lacare.org

The L. A. Cares for Kids Program is a three year grant supported program that was funded to develop and test a care coordination process that will assess and address some of the systems issues of children with histories of abuse and neglect . The proposed presentation will focus on the following (presented in an outline format):

1. The process of conceptualizing and developing the project
Developing an advisory committee of community based organizations, advocates, county social service workers, representatives of the court system, and members of special interest groups

Conducting separate focus groups for Department of Children and Family Services staff, families with children under the supervision of county children’s protective services, and physicians who serve relatively large numbers of children under child protective services.

2. Challenges encountered in implementing the project and how they are being addressed
Environmental changes impacting the project, including the restructure of the child protective services program targeted, fall-out from the September 11^th terrorist attacks, increased concern over public charge and deportation issues.

Logical assumptions made in the conceptualization of the project that have proven to be incorrect.

Unanticipated sources of resistance.

Problems encountered as a result of limitations related to data sharing

3. Evaluative measures and quality assurance indicators chosen to assess process and outcomes
Data needed to assess project.

Sources of these data, and how to obtain them.

Methods for gathering information, limitations of those methods.

4. Program findings to date
System-wide issues impacting access and availability of health care.

Health outcomes for those children participating in the project.

Most efficient procedures for obtaining information and for locating transient families.

5. Lessons to be learned and recommendations for others wishing to develop similar projects.
Understanding the differences between the perspective of the decision maker and of the line staff

Working with an outside evaluation team

Importance of flexible staffing for cost containment

Learning Objectives:

L. A. Care Health Plan (LACHP), the nation's largest Medicaid managed care health plan, has launched the "L. A. Cares for Kids Program" (LACFK). This program is designed to meet the unique health needs of children who have been abused or neglected. Eligible children are LACHP members under the age of 13 who live in their homes under child protective services (CPS) supervision. Program components include physician training, health care case management, and care coordination with the CPS system.

LACFK was developed with input from community practitioners, advocates, policymakers, and researchers. Project goals are to demonstrate an effective model of managed-care delivery to vulnerable children, and to collect data regarding the unique health care needs of these children, creating a baseline health profile to drive policy development. Program objectives are to establish

* A means to identify eligible children
* Provider trainings to enhance assessments/services provided
* Protocols for communication/coordination between healthcare and CPS systems
* Data collection and evaluation systems to gather information about these children and perform process and outcome analyses
As a result of this session, attendees should be able to
- * Articulate the health status and systems issues of abused/neglected children and their parents
- * Describe a model developed to address special needs of children in a Medicaid managed care environment, and
- * Discuss possible pitfalls in serving the Medicaid managed care population across health care and social service systems.
Keywords: Children With Special Needs, Community Outreach
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Services of L. A. Care Health Plan, the local initiative in Los Angeles, California and the Los Angeles County Department of Child and Family Services.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Children with special health care needs
The 130th Annual Meeting of APHA