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Tackling systems change to improve access to incontinence supplies for children with special health care needs: Orange County Care Coordination Collaborative for Kids
Tackling systems change to improve access to incontinence supplies for children with special health care needs: Orange County Care Coordination Collaborative for Kids
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Case study (Lucile Packard Foundation for Children's Health)
- Author(s):
- Linton, Leslie S., author
- Contributor(s):
- Lucile Packard Foundation for Children's Health, issuing body.
- Publication:
- Palo Alto, CA : Lucile Packard Foundation for Children's Health, September 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Child Health Services
Children with Disabilities
Health Care Coalitions
Health Services Needs and Demand
Absorbent Pads
Insurance, Health
California
United States - Genre(s):
- Technical Report
- Abstract:
- During the summer of 2017, the coalition applied for and was selected to receive a grant of $12,000 from LPFCH as part of LPFCH's "Phase 3" funding for the program known as 5Cs, the California Community Care Coordination Collaborative. Part of the grant's scope of work was to identify a specific system-level issue for the group to address during the one-year grant period from August 1, 2017 to August 31, 2018, in addition to their ongoing networking and education meetings of the coalition. The group initially articulated their chosen issue fairly broadly: (1) Explore opportunities for increased coordination among CalOptima (managed Medi-Cal), California Children's Services and Regional Center, for the purpose of reducing children's wait times for services, referral or products and reducing the burden on parents to access/secure these services/products. (2) Develop a cooperative approach for gaining understanding of initial authorization and payment of services among CalOptima, California Children's Services and Regional Center, and increased coordination of payment for those services that do not fall "cleanly" under one agency's purview. (3) Pilot implementation of cooperative approach. OCC3 for Kids had several specific situations/models in mind as the group sought to further refine the specific system change/coordination challenge they wished to pursue. With at least three family representatives actively participating in the coalition, they had developed an ongoing interest in the problems that parents of CSHCN experience in securing durable medical equipment and supplies for their children. In the past, the group had invited consultant Maryann O'Sullivan to meet with the collaborative on this issue to consider possible advocacy strategies to pursue in support of CSHCN. The collaborative had also been introduced to a model practice followed in Kern County, whereby, in situations wherein the responsible payer was unclear, one of the parties (e.g. California Children's Services or the Medi-Cal plan) would agree to pay upfront for needed supplies/equipment with an agreement between care providers/insurers to provide reimbursement between the parties later on if the party that paid upfront was not ultimately determined to be the responsible party. The concept was to ensure that families did not wait while the issue of responsibility was bounced around between payers. With this background, collaborative partners decided to narrow the type of equipment/supplies. They chose diapers and other incontinence supplies needed on an ongoing basis by children as a consequence of a medical condition. Partners made this decision following a meeting with the collaborative's three family representatives, all of whom were intimately acquainted with the types of problems faced by parents, either because they worked as family mentors, they were parents of a child with special health care needs, or both. Diapers became the focus. Working with stakeholders, OCC3 for Kids leadership determined that the best process, having chosen a narrowed issue and type of supply, was to meet separately with each key stakeholder (family representatives, CalOptima, CCS, and Regional Center), for the purpose of learning about their administrative processes, listening to any concerns and exploring possible solutions before bringing the entire group together again.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (16 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918366887306676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918366887306676