Help build the Network — Forward this to your colleagues and encourage them to join!

NETWORK NEWS

Federal Funds to Boost Transition to Adult Care
Network member Peggy McManus and the National Alliance to Advance Adolescent Health have been awarded a five-year grant from the Maternal and Child Health Bureau to operate the new Center for Health Care Transition Improvement. The grant will build on the previous work of Got Transition? and expand the availability of effective health care transition supports to bridge pediatric and adult systems of care. Activities of the center will be directed to health care professionals; youth, young adults, and families; and policymakers. Read more.

State Official Discusses Healthy Families Transition to Medi-Cal
Jane Ogle, deputy director of the California Department of Health Care Services, was the guest speaker at a webinar August 21 sponsored by Network member Family Voices of California. She discussed the Healthy Families Transition to Medi-Cal. View her presentation and listen to the webinar.

CALIFORNIA POLICY

Legislature Weighing Program to Fund Care Coordination
The California State Senate is considering an optional federal program available through the Affordable Care Act (ACA) to establish “health homes,” a program that funds integration and coordination of care for people with chronic conditions.  If adopted, the new program would offer Medi-Cal reimbursement for many services. The majority of funding would be provided by the Centers for Medicaid and Medicare Services under Sec 2703 of the ACA. The California Assembly passed a bill (AB 361-Mitchell, D-Los Angeles) in May to authorize the program. The bill is currently in the Senate Appropriations suspense file awaiting further action. Network members have identified care coordination as one of the most challenging aspects of California’s system of care. If this legislation is of interest to you, consider contacting your California state senator regarding AB 361.

State Reaches Agreement with United HealthCare on Speech Therapy
On August 27, the Department of Managed Health Care (DMHC) announced an agreement with United Health Care (UHC) requiring the health plan to comply with state law and cover medically necessary speech therapy. UHC also will reimburse members who paid out-of-pocket for medically necessary therapy. Members and former members seeking reimbursement must do so prior to July 30, 2014. Find the details (PDF).

Tips for Signing Up for New Health Insurance Plans
Open enrollment for individuals and families begins October 1 for health insurance under Covered California, the state’s exchange. Many resources are available to assist families in navigating enrollment. Here are some helpful links:

Applied Behavioral Analysis Lawsuit Settled with Kaiser
To settle a class action lawsuit filed in 2009, Kaiser Permanente must establish a fund of up to $9 million to reimburse members who incurred out-of-pocket expenses for applied behavioral analysis or speech therapy before payment for those services was mandated by law in 2012. Read more.

NATIONAL POLICY

Separate and Unequal in Community Living
A new report from US Sen. Tom Harkin, chairman of the Health, Education, Labor and Pensions Committee, assesses how states are faring in implementing the 1999 Supreme Court Olmstead decision, which said that unnecessary segregation of individuals with disabilities is a violation of the Americans with Disabilities Act. The report is titled Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act.  Read the report (PDF).

CSHCN IN THE NEWS

NPR Highlights Special Health Care Needs
Two recent National Public Radio stories feature children with special health care needs. Kids with Costly Medical Issues Get Help, but Not Enough follows the Doderer family of San Antonio, Texas, whose 15-year-old daughter has serious chronic conditions. The story notes her successes, but also documents the financial and emotional strains on the family, despite the fact that the mother until recently was the CEO of the children's hospital in San Antonio and understands the system better than most. For Kids with Special Needs, More Places to Play notes that although the Americans with Disabilities Act requires that public playgrounds have wheelchair-friendly surfaces and accessible equipment, many communities are not yet in compliance. The report includes a mapping program to help families find accessible playgrounds in their communities.   RESOURCES

Medical Home: Putting the Family at the Center of Care
A new paper from the National Center for Medical Home Implementation and the American Academy of Pediatrics offers resources and tools designed to help clinicians put the family at the center of health care.  The paper covers topics such as access, care management, communication, cultural sensitivity and collaboration among practices. Find the tools (PDF).

KEEP IN TOUCH
Let us know what's happening with your organization or family. E-mail Network Manager Janis Connallon at Janis.Connallon@lpfch.org with your news or updates. Newsletter Editor: Eileen Walsh