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Network News

Member Profile
Meet Network member Yvette Baptiste, who balances managing the Family Resource Center in East Los Angeles with helping her three children with special health care needs navigate adulthood. Read the full profile>>

Grant Opportunities
State Planning Grants
Health Resources and Services Administration – State Planning Grants for Improving Services for Children and Youth with ASD & other Developmental Disabilities  (Deadline: 6/10/13)
This program is intended to support applicants in the planning and development of activities that are designed to improve State systems of care for children and youth with autism spectrum disorders and related developmental disabilities, and increase access to comprehensive coordinated health care.

Direct Grants to Parents of CSHCN
United Healthcare Children’s Foundation offers direct grants of up to $5,000 to parents of CSHCN for services such as speech therapy or adaptive devices that commercial insurers may not cover. Parents whose children are covered by commercial insurance are eligible to apply. More information>>

CMS Announces the Health Care Innovation Awards Round Two Webinar
Under this announcement, the federal Centers for Medicaid/Medicare Services (CMS) will spend up to $1 billion for awards and evaluation of projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicaid enrollees. To give interested potential applicants the opportunity to hear more about the Funding Opportunity Announcement, CMS Innovation Center staff will be hosting a webinar on May 28, from 10-11:30 PST to provide an overview of the Health Care Innovation Awards Round Two and to answer questions. Advance registration is required. Register Here>>

National Health Policy
Habilitative Services 
In a new issue brief commissioned by the Lucile Packard Foundation for Children’s Health, Sara Rosenbaum, professor of health law and policy at the George Washington University School of Health and Health Services, examines coverage of habilitative services for children under the essential health benefits provisions of the Affordable Care Act.

Many parents face challenges in getting insurers to cover occupational or physical therapy or similar services for their children’s chronic conditions. The reason? Insurers often only will pay for “rehabilitative services” related to the medical condition – the patient must have had the skills already in place so they can be restored. As a result, insurers may cover physical therapy to help a 75-year-old stroke victim learn to walk again, but not for a 2-year-old child with cerebral palsy to learn how to walk for the first time.

This “hab-rehab” tension has vexed advocates and health policy experts for years. And the issue is heating up nationally as implementation of the Affordable Care Act (ACA) begins. In the issue brief, Rosenbaum concludes that while provisions of the ACA have advanced access to habilitative service coverage in individual and small group markets, federal regulations issued in February may cause health plans to favor more comprehensive adult rehabilitative services over child habilitative services. States will have a defining role in determining the level of habilitative services insurers must offer under ACA. In California, state health officials are in the process of examining which habilitative services will be required under essential benefits. The situation looks promising so far, and we will continue to monitor the decision process.

California Health Policy
Covered California Announces Health Insurance Plans and Rates
Covered California today announced 13 diverse health insurance plans that will be offered in 2014 to millions of Californians. The plans reflect a mix of large non-profit and commercial plans, along with well-known Medi-Cal and regional plans. Read more>>

Future of California Children’s Services (CCS)
As noted in the May 14 release of Calif. Gov. Jerry Brown’s “May revise” of the 2013-2014 state budget, state health officials plan to shift the financing of the California Children’s Services program from the counties to the state “over time.” According to Calif. Health and Human Services Secretary Diana Dooley and Calif. Department of Health Care Services Director Toby Douglas, there are no current plans to alter CCS services. 

Research
Study Looks at Transition to Adult Care for Children with Special Needs
DailyRx.com, May 12
Less than half of nearly 18,000 parents of 12- to 18-year-olds with special health care needs reported feeling effectively prepared to help their children transition to adult care, according to a study in the journal Pediatrics, DailyRx.com reported. Effective transition to adult care was highest among girls, white and non-Hispanic children, younger children and those in families with higher income, according to this analysis of the National Survey of Children with Special Health Care Needs.

Event
Meeting: Early Identification and Intervention Collaborative of Los Angeles County
Friday, May 24, Los Angeles
More information>>

Webinar
Regional Centers and Insurance Companies – Who Pays For What Services, May 29
Family Voices of California

Resources
Sound Advice on Mental Health (Audio): Interviews with Pediatricians
American Academy of Pediatrics

Pediatric Feeding Disturbances: It Takes A Team (video education)
FeedingMatters.org

Sending Your Child With Special Needs to Camp
KidsHealth.org

Establishing an Evidence Base for Systems of Care for Children and Youth with Special Healthcare Needs (click on link, then select "research projects" tab) 
Maternal and Child Health Bureau/MGH Center for Child & Adolescent Health Research and Policy

Issue Brief: Medicaid and Children in Foster Care
State Policy and Reform Center

In the News — Children with Special Health Care Needs
California Health and Human Services Director Forms Task Force to Examine Developmental Centers
California Healthline, May 23

Implementing Health Reform: Medicaid DSH Payments, Utah Exchanges, And More
Health Affairs, May 13

State Lands $600M in Federal Funds for People with Developmental Disabilities
Sacramento Business Journal, May 9 

Keep in Touch
Let us know what's happening with your organization or family. E-mail Network Manager Janis Connallon at at Janis.Conallon@lpfch.org with your news or updates.