Lawmakers skeptical about DCFS managed health care

Feb. 5--Illinois lawmakers continued to express skepticism Tuesday about a state plan to move thousands of children under the care of the Department of Children and Family Services into managed health care.

While state officials insisted the move would result in better health care for those children, some legislators said the transition has been a mess and they are concerned children will be harmed as a result.

"We've gone into a system I don't think is really going to work," said Sen. Dave Koehler, D-Peoria. "Why are we putting all of our eggs in the basket of (managed care organizations). I think it's a flawed policy and I think we're going to see this time and time again until we finally realize this doesn't work."

At the start of a joint hearing of the Senate Human Services Committee and Special Committee on Oversight of Medicaid Managed Care, lawmakers learned of the latest problem with the rollout of the program. Danielle Gomez of the Cook County Public Guardian's office said that at least 2,500 children were supposed to be signed up for managed care over the weekend but were kicked out of the health system because of a "glitch." For a while, they had no insurance.

"These are not glitches. These are major flaws," Gomez said.

State officials said the issue was resolved during an emergency meeting Sunday in which managed care organizations promised to provide coverage even though the youth were not actually enrolled in a plan.

This isn't the first time problems have surfaced with switching DCFS wards to managed care health insurance. The change was supposed to happen last fall, but the switch was delayed until this month because of concerns raised last year.

On Saturday, the state switched 19,000 adopted and former foster children to Medicaid managed care for their health coverage. In April, another 17,000 current foster children will make the switch.

Officials with DCFS and the Department of Healthcare and Family Services said the change is not about saving the state money, but providing better healthcare for children.

"The goal is better clinical outcomes," said Kristine Herman with DHFS. "There is not expectation of cost savings. If better care means we are being more efficient, then that is great. But it is not a goal of cost savings for this program."

Earlier, Jamie Dornfeld, a DCFS administrator overseeing the transition, said that "DCFS is committed to supporting our families and ensuring that when managed care is fully implemented our children will receive a level of care and access to crucial services that do not exist today."

Manar, though, wasn't convinced, especially about claims that managed care is more accountable and produces better results.

"The accountability is completely absent in my opinion," Manar said. "There's no accountability here. We have to look at that. I think we should have this discussion about where this managed care movement in Illinois is headed. In my opinion, it is headed in the wrong direction."

Contact Doug Finke: doug.finke@sj-r, 788-1527, twitter.com/dougfinkesjr

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