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MetroPlusHealth to provide health insurance coverage and comprehensive care management to NYC youth in foster care and VFCAs

Dr. Talya Schwartz, President & CEO, MetroPlusHealth

MetroPlusHealth, New York City’s five-star rated health plan, announced today that children and youth placed in foster care under Voluntary Foster Care Agencies (VFCAs) with 29-I licenses will now receive access to quality health care through MetroPlusHealth and other Medicaid Managed Care Plans. VFCAs are licensed to provide critical supports to youth in foster care, including but not limited to nursing support, medication management, skill-building, and discharge planning, consultation and supervision, as well as home and community-based services—MetroPlusHealth will now cover those services.

“Today, over 1,000 youth in foster care— who will be best served by a holistic approach to their care, ensuring timely access to high-quality providers —will be enrolled with our plan, and we are ready to meet their needs,” said Dr. Sanjiv Shah, Chief Medical Officer, MetroPlusHealth. “We will leverage our vast network to fill necessary access issues and our Children’s Special Service team will work closely with VFCAs and its provider partners, including NYC Health + Hospitals, to ensure these children and youths get the coordinated care they deserve.”

Each year over 400,000 children experience foster care, almost half of whom (47%) are under the age of 6. There are roughly 7,800 foster children in NYC – a historic low – but there are significant inequities that disproportionally impact families of color. Black youth make up 15% of NYS population but 57% of the foster care population. Moreover, children in foster care are disproportionately impacted by unmet medical and behavioral needs.

This new collaboration between VFCAs and health plans such as MetroPlusHealth is an initiative of the New York State Department of Health (NYSDOH) to provide VFCAs with additional supports to better meet the health care needs of foster children. VFCAs are often required to function independently and coordinate care, as needed, for kids placed in care.

“We applaud this new arrangement authored by NYSDOH which will allow MetroPlusHealth to assist VFCAs, and those they serve, to better navigate the complex health care system,” said MetroPlusHealth President & CEO, Dr. Talya Schwartz. “We can now meet the needs of this community in ways that will be most impactful and provide skilled care managers to partner in managing their overall care, identify unmet needs, connect members to care, and even schedule health appointments when necessary.”

NYSDOH anticipates that the transition from Medicaid fee-for-service, where the health care delivery system that exists for children can sometimes be fragmented, to Managed Care Plans will provide opportunities for closing gaps in care and improving continuity of care. Health Plans have a longitudinal view of the care experienced over time, via claims processing, alignment of services through utilization management, and care coordination. Ultimately, the goal is to evolve into a comprehensive integrated approach that emphasizes coordination, health outcomes, and the quality of care which defines the Managed Care Plan approach.

MetroPlusHealth has added staff to support this initiative and brought a child psychiatrist on board to help oversee this new effort, as well as assess the mental wellbeing of its new foster care members.

“We know these youth are the most vulnerable among us and are best served by a holistic approach to their care, ensuring timely access to first-rate providers such as the NYC Health + Hospitals Centers of Excellence for foster care youth, which offer comprehensive trauma-informed care to children placed in foster care. We seek to provide robust and comprehensive care management support for these children and the foster care agencies caring for them,” said Dr. Shah.

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