1. Electronic Information Exchange:
Elements that Matter for Children in Foster Care "
Beth Morrow
Director, Health IT Initiatives
The Children’s Partnership
SPARC Webinar,
January 31, 2013

2. Children in foster care face unique
challenges that require additional care
coordination."
n Childhood trauma."
n Frequent movement among placements, caregivers,
and schools."
n Higher rates of special education needs, psychotropic
medications, and chronic health conditions."
n Enter adulthood without family support system."
www.childrenspartnership.org

3. Unique challenges face states/localities too"
n The average cost of Medicaid per child in foster care is over 3 times
the average cost for nondisabled children."
n Children in foster care account for 28% of all Medicaid expenditures
on inpatient psychiatric services (or, 46% of such expenditures on
nondisabled children)."
n During their early adult years, these youth are much more likely
than their peers to forego higher education, describe their general
health as fair or poor, become homeless, and rely on public
supports. "
www.childrenspartnership.org

4. What can be done? "
n Children in foster care need cross-sector, coordinated,
continuous behavioral and medical care."
n Key to this coordination: Communication and
information sharing by the adults caring for these
children."
Ø Electronic information exchange and electronic
records can help."
www.childrenspartnership.org

5. Better Outcomes at Lower Cost"
n Early efforts are making a difference:"
• Wraparound Milwaukee (WI) – Improved coordination has resulted
in reduced inpatient psychiatric care, residential treatment, and
juvenile corrections placements."
• UPMC For You (PA) – Improved coordination has increased the
proportion of foster children receiving annual well-child and dental
visits."
n We will hear from Texas and San Diego next about
how electronic information exchange has made a
difference for foster children in those communities. "
www.childrenspartnership.org

6. What needs to happen:"
n Bring stakeholders together "
-- develop champions "
-- work together to address key hurdles (information
sharing agreements, back-end IT capabilities, and
funding)"
-- leverage existing efforts that can help (initiatives,
systems projects, etc.)"
n Use Health Education Passport as starting point"
www.childrenspartnership.org

7. Contact"
Beth Morrow!
Director, Health IT Initiatives"
(718) 832-6061!
bmorrow@childrenspartnership.org!
http://www.childrenspartnership.org/our-work/foster-care-coordination"
"
"

8. Texas STAR Health Program
Rebecca Alejandro, Texas HHSC Health Plan
Specialist
January 28, 2013

9. Star Health Program Background
• In 2005, the Texas Legislature required the Texas Health and Human
Services Commission (HHSC) to design a comprehensive medical
services delivery model to meet the healthcare needs of children in
foster care.
• In April of 2008, the STAR Health program was implemented.
• Eligible clients include:
• Children and young adults in conservatorship of the Texas
Department of Family and Protective Services (DFPS).
• Youth age 18-21 who voluntarily continue in a foster care
placement.
• Former foster care youth who continue to receive Medicaid
benefits through age 21.
• Former foster care youth enrolled in higher education.

10. Main Objectives
• Immediate eligibility
• A statewide network of providers
• An increased focus on behavioral health services
• Service management and coordination teams
• Psychotropic drug utilization review
• Health Passport

11. Health Passport
• Medical, behavioral health, vision, dental, and prescription
claims
• Lab results
• Immunization records
• Allergies and known reactions, vital signs, weight, height,
and other such details
• Forms including Healthcare Service Plans, Psychotropic
Utilization reviews, Texas Health Steps exams, and
psychological evaluations

12. Health Passport
• A DFPS caseworker can view all information in the
child’s record.
• A foster parent can view all information except for the
Behavioral Health tab.
• DFPS contracted residential providers have a few
designated staff who have the same viewing rights as
foster parents.
• A network provider can view all information as well as
interact with the system to enter data and upload forms.
• Access is restricted to comply with HIPAA privacy and
security rules.

16. Making it Happen
• Interagency and Public-Private Collaboration
• Extended Timeline
• Cost of Implementation
• Performance Metrics
• Availability of Data

17. Conclusion
A complete training video on the Health Passport can be accessed
on Superior HealthPlan’s website at:
http://www.superiorhealthplan.com/wp-content/training/
clinicalTX/default.html
For additional information, contact:
Rebecca Alejandro
Texas HHSC Health Plan Specialist
Rebecca.Alejandro@hhsc.state.tx.us
512-491-1864

18. Information Sharing to Increase
Education Outcomes for
Students in Foster Care
Michelle
Lustig,
Ed.D,
MSW,
PPS
San
Diego
County
Of<ice
of
Education
Student
Support
Services
Foster
Youth
and
Homeless
Education
Services

19. California: County Offices of
Education
County
Of*ices
of
Education
õ There
are
58
County
Of<ices
of
Education
(COEs)
which
provide
services
to
school
districts.
COEs:
ô Support
school
districts
by
performing
tasks
that
can
be
done
more
ef<iciently
and
economically
at
the
county
level
ô COEs
provide
a
wide
range
of
services
including
<iscal
oversight,
special
and
vocational
education,
programs
for
youths
at
risk
of
failure,
and
instruction
in
juvenile
detention
facilities

20. Foster Youth Services Programs
Foster
Youth
Services
(FYS)
Programs
õ Provide
support
services
to
foster
children
who
suffer
the
traumatic
effects
of
displacement
from
family
and
schools
and
multiple
placements
in
foster
care
ô Services
are
designed
to
improve
the
children's
educational
performance
and
personal
achievement,
directly
bene<iting
them
as
well
as
providing
long-­‐range
cost
savings
to
the
state
ô Mandates
are
incorporated
into
Education
Code

21. California Law Relating to the Education
of Students in Foster Care
California
Education
and
Welfare
an
Institutions
Code
ô School
of
Origin
rights/proximity
to
school
ô School
Stability
Provisions
ô Equal
access-­‐curricular
and
extra
curricular
(CIF)
ô Immediate
Enrollment
ô Stay
put
rule
ô Least
restrictive
ô Foster
Care
liaison
ô Best
Interest
determination
ô Noti<ication
to
schools
districts
ô Transfer
of
records
ô Partial
credit
protection
ô Graduation
requirements
ô Notice
of
manifestation,
suspension,
expulsion

22. Relationship Between Data Sharing and
Educational Outcomes
õ Increased
ô Awareness
ô Cooperation
ô Collaboration
ô Responsibility
ô Matriculation
ô Academic
performance
ô Graduation
rates
ô School
stability

23. Background and History
San
Diego
County
Of*ice
of
Education,
Foster
Youth
Services
(SDCOE,
FYS)
õ Court
Leadership
õ Collaborative
history
õ Court
Orders
(2002,
2003,
2005,
2008,
2011)
õ Database
Agreement
(2006-­‐2011,
2011-­‐2016)
õ Interagency
Agreement
(2006-­‐2011,
2011-­‐2016)

24. Foster Youth Student Information
System (FY-SIS©)
õ Shared
Governance-­‐FY-­‐SIS©
Advisory
Group
õ Data
Warehouse
õ SDCOE
is
responsible
for
ensuring
secure
and
<iltered
access:
unique
screen
sets
based
on
user
group
õ Restricted
access
to
certain
data
õ Security/Firewalls/FTP
process

25. Foster Youth Student Information
System (FY-SIS©)
õ Weekly
feeds
from
Child
Welfare
and
Probation
õ Daily
feeds
from
Juvenile
Court
and
(nearly
all)
42
school
districts
õ User
group
Administrator
role
õ User
group
permissions
de<ined

26. Foster Youth Student Information
System (FY-SIS©)
FY-­‐SIS©
Contains:
¡ Demographic
Information
¡ Health
Information
¡ Assigned
Social
Worker/Probation
÷ Medications
(restricted)
Of<icer
÷ Well
Child
history
¡ Assigned
Attorney
÷ Immunizations
¡ Education
Rights
Holder
¡ Placement
History
(Restricted)
¡ School
History
including
current
¡ Probation
Only:
Minute
orders,
school
conditions
of
Probation,
¡ Grades
and
Attendance
Waivers
and
hearing
dates
¡ Unof<icial
Transcript
¡ Ca
English
Language
Assessment

27. Foster Youth Student Information
System (FY-SIS©)
FY-­‐SIS©
Does
Not
Contain:
¡ Reason
for
removal
(300
¡ Special
Education
code)
Information
¡ Discipline
Information
¡ Family
of
origin
information
(planning
stages)
¡ STAR
and
CAHSEE
test
¡ Sibling
information
scores
(planned
for
¡ Psychiatric
Diagnosis
2013)
¡ Mental
Health
History

28. Considerations and Lessons Learned
Cross System Data Sharing
— Begin
with
the
end
in
mind.
— Engagement
of
all
stakeholder
groups
— youth
and
caregivers
— Determine
the
best
way
to
meet
competing
demands,
policies,
mandates
and
restrictions.
— Shared
understanding
and
interpretation
of
FERPA,
HIPPA
and
SACWIS:
intersections
and
hurdles.
— Consideration
of
— who
maintains
the
database
— who
owns
the
data
— who
owns
the
intellectual
property
that
is
the
physical
database

29. Thank you!
Michelle
Lustig,
Ed.D,
MSW,
PPS
mlustig@sdcoe.net
P-­‐858-­‐503-­‐2628
F-­‐858-­‐503-­‐2636
http://www.sdcoe.net/ssp/support/?
loc=fys&m=9

30. What needs to happen:!
n Bring stakeholders together !
-- develop champions !
-- work together to address key hurdles (information
sharing agreements, back-end IT capabilities, and
funding)!
-- leverage existing efforts that can help (initiatives,
systems projects, etc.)!
n Use Health Education Passport as starting point!
www.childrenspartnership.org