DCFS & HFS Managed Care Transition Plan for DCFS Youth Member Assistance Requested
November 8, 2019
MEMORANDUM
DCFS & HFS Managed Care Transition Plan for DCFS Youth – Member Assistance Requested
In response to stakeholder concerns, the Department of Healthcare and Family Services (HFS) and Department of Children and Family Services (DCFS) have delayed full implementation of mandatory managed care for Youth in Care of DCFS (DCFS Youth), Former Youth in Care, and other Special Needs Children from November 1, 2019 to February 1, 2020. Former Youth in Care and other Special Needs Children will be enrolled, effective February 1, 2020, in a HealthChoice Illinois Managed Care Organization (MCO) as outlined in an October 29, 2019 HFS Provider Notice. For DCFS Youth, HFS has contracted with IlliniCare to administer a new health plan called YouthCare designed specifically for this population. The DCFS Youth transition will be implemented in two phases, with health care coordination outreach scheduled to begin on November 1 and coverage effective February 1. Details on the phased-in approach are outlined in IlliniCare’s Youth Care overview.
Please note that claims for covered services provided to DCFS Youth, Former Youth in Care, and other Special Needs Children should continue to be billed directly to HFS until February 1, 2020.
DCFS/HFS Request for Hospital Assistance
HFS and DCFS have asked for IHA’s assistance in informing freestanding psychiatric hospitals and psychiatric distinct part units within General Acute Care hospitals that YouthCare’s health care coordinators will be reaching out to facilities beginning November 1 to assess patient needs and assist with post-acute placement. [Please note that IlliniCare uses the term “health care coordinator” to distinguish its YouthCare team from other care coordinators, such as DCFS and Purchase of Service (POS) staff].
YouthCare’s health care coordinators must obtain consent from the youth’s DCFS case worker prior to speaking to directly with hospital staff about a specific youth. While DCFS has a list of facilities currently treating DCFS Youth, it does not have information on the youth’s clinicians or hospital care coordination/discharge planning staff. Therefore, if your facility is contacted by a YouthCare health care coordinator, please work with them and the DCFS case workers to obtain the appropriate consents.
Questions/Additional Information
Questions regarding the program and/or the informed consent process may be directed to one of the following YouthCare contacts (do not include any PHI or other identifiable personal information in your email to YouthCare):
|
Tracy Eilers Johnson |
Brenita Johnson |
|
YouthCare & SNC Product |
Senior Director, YouthCare Operations |
|
IlliniCare Health |
IlliniCare Health |
Additional information, including the draft transition plan (September 25, 2019), draft FAQ (October 24, 2019), and agendas and minutes of the Illinois Child Welfare Medicaid Managed Care Reform Implementation Workgroup, of which IHA is a member, are available on the HFS website and DCFS website. Public comments and questions regarding the transition may be submitted to HFS.DCFSMCOComments@illinois.gov.