Families of children with special health care needs in Rhode Island got some good news this holiday season. A recent article in the Providence Journal announced that CMS has approved two health home State Plan Amendments for Rhode Island. One will focus on improving care coordination, reducing hospital admissions, and emergency room visits for children with special health needs that are younger than 21 and enrolled in the Comprehensive Evaluation Diagnosis Assessment Referral Re-Evaluation (CEDARR) program.
Health care that is comprehensive, coordinated, accessible, and takes into account not only acute concerns but also those related to chronic illness sounds like a great idea, with benefits for patients, families, providers and payers. But it’s not easy to do and ways to fund it aren’t as plentiful as they could be. Thanks to the Affordable Care Act (ACA), help is on the way in the form of a health home.
Section 2703 of the ACA describes a state plan option to provide health homes for Medicaid-enrolled individuals with at least two chronic conditions, one chronic condition and the risk of developing a second, or one serious and persistent mental health condition. States that want to pursue this option must draft State Plan Amendments (SPAs) for health homes and apply to the Centers for Medicare and Medicaid Services (CMS). States with CMS approval for their SPAs will receive an enhanced federal matching rate of 90% for the first eight quarters that the health home option is in effect. While states have some flexibility to design health home programs that best fit the needs of their residents with chronic illnesses, every state’s plan must include:
- Care management and coordination
- Health promotion
- Transitional care from inpatient to other settings
- Individual and family support
- Relevant referrals to community and social support services
- The use of health information technology (HIT) to link services
Want to learn more about Section 2703 of the ACA and the Rhode Islandhealth home project? The Association of Maternal and Child Health Programs (AMCHP) and The Catalyst Center are hosting a national webinar called Children and the Medicaid Health Home State Plan Option (Section 2703) of the Affordable Care Act on December 7, 2011, from 12 noon – 1:30 p.m. ET.
Read more about the speakers, and register.
The Spark 