UPDATE, June 22, 2013:
Michele Stillwell-Parvensky, at left, of the Children's Defense Fund-California reports the good news: the Legislature did approve the "gap funding" for foster youth who would have been ineligible for Medi-Cal coverage between July 1, 2013 and January 1, 2014 (affected 4,500 former foster children who fell in an administrative coverage gap under the new rulings that extend medical coverage to age 26; see full story below the jump.)
UPDATE, June 18, 2013: David Gorn, editor of California Healthlines, reported yesterday in his blog's "Capitol Desk," that Applied Behavior Analysis (ABA) therapy for children with autism (see story below) was not approved (on June 14) by the Legislature for Medi-Cal coverage.
June 6, 2013: The Children's Defense Fund-California alerts us to two pending budget issues regarding children's health: Medi-Cal coverage for former foster youth, and behavior health services for children with autism.
As CDFC policy and communications associate Michele Stillwell-Parvensky, at left, writes:
Last year, budget decisions transferred nearly 1 million children from Healthy Families into Medi-Cal (beginning in January 2013). However, Healthy Families provided Applied Behavior Analysis (ABA) services to children with autism -- and Medi-Cal does not. Instead, Medi-Cal pays for behavioral services through regional centers -- for which not all children qualify [Kristin Jacobson, co-founder of Autism Deserves Equal Coverage, estimates that three-fourths of Medi-Cal children with autism will not be elibigle for behavioral services at regional centers]. All Medi-Cal children should have access to needed ABA services. Our request to the legislature is to augment the Medi-Cal budget by $50 million from the general fund, and adopt a placeholder trailer bill to add ABA services to Medi9-Cal managed care for children ineligible for regional center services.
"Any change to our plans requires contractual changes, as well as building in the rates," Douglas said. "And we need to get approval from our federal partners, including amendments to our 1115 waiver to add this benefit, which will take several months." Douglas said July 1 was not "a realistic implementation date."
In a Senate subcommittee meeting in late May, Toby Douglas, director of the state Dept. of Health Care Services (that orchestrated the Healthy Families transition) voiced concerns about the timing of this proposal.
A second health issue involves the extension of medical coverage for former foster youth. Beginning on January 1, 2014, the federal Affordable Care Act (ACA) will allow former foster youth to stay on Medi-Cal up to age 26, in parallel with a provision that allows youth up to age 26 who are not in foster care to retain coverage from a parent’s health plan. However, there is a subset of newly eligible foster youth turning 21 between July 1, 2013 and January 1, 2014, who will lose coverage only to be eligible again later. If the current situation stands, these youth will not be tracked or informed of their Medi-Cal eligibility and are at risk of being uninsured. We are requesting that the legislature approve extending Medi-Cal coverage to the 4,500 former foster youth, ages 21-16, and adopt placeholder language to implement change as of July 1, 2013. Cost: $3 million from the state general fund.
The extension of coverage to former foster youth on a national basis was the subject of a teleconference in May sponsored by Georgetown University Health Policy Institute's Center for Children and Families. A full report from that discussion can be read here. During that discussion, Children Now, Oakland, supported the pre-enrollment for youths turning 21 in 2013, so that they do not experience an interruption in their Medi-Cal coverage before being able to enroll under the ACA provision.
Children Now also advised that contact information must be gathered for these newly-eligible youths so that they can be notified as soon as their states implement the extension of coverage. "Outreach and education will be critical for not only the youths themselves but also for foster parents, social workers and health care providers."