It’s been one year since state officials postponed a change to Nevada Medicaid funding amid fears it would shutter organizations serving Clark County’s most vulnerable foster children.
Officials pledged to find a way to fill the funding gap, but the change is scheduled to take effect next month, and no solution is in place.
David Doyle, operations director of Eagle Quest, said foster care agencies like his will no longer be able to afford helping families care for some 450 children with serious physical, mental or emotional issues. Without the aid, the children could be separated from their foster homes and placed into psychiatric hospitals, the county’s emergency shelter and elsewhere.
“We’re going to be adding hundreds of children to places like Child Haven and (juvenile) detention,” Doyle testified Wednesday during a meeting of the state Legislature’s Interim Finance Committee.
The Nevada Department of Health and Human Services on July 27 will change the state’s Medicaid policy, scaling back a funding stream that accounts for more than half the money received by local agencies specializing in therapeutic foster care.
The potential crisis is part of the state’s shift away from basic skills training for foster children. Doyle said agencies in Clark County began implementing a new statewide treatment model, called Together Facing the Challenge, last summer.
The program has been well-received by foster families and has resulted in children staying in the same homes longer, said Reesha Powell, the deputy administrator for the Nevada Division of Child and Family Services.
“The less the kids move around, the better it is for them,” she testified Wednesday. “We’re also finding they’re having increased access to psychiatric care as well as mental health services.”
However, Doyle and other foster care officials remain worried because Together Facing the Challenge does not come with the $72.70 agencies received from Medicaid every day for each child enrolled in basic skills training.
And in July the state will begin reducing the amount of basic skills training funding they provide foster care agencies. After 180 days the funding will only be doled out when deemed medically necessary by Nevada’s Medicaid fiscal agent, Hewlett Packard Enterprise.
Foster care agencies will still receive $62 per child each day from Clark County, and they can collect money for other Medicaid-billable services. Doyle said that likely won’t amount to enough for agencies like Eagle Quest to keep their doors open.
“We have to pay the case managers, and we have to pay the foster parents,” he said. “And that alone is more than we’d be receiving.”
Following outcry, state officials last year postponed making any changes to the Medicaid funding. Former Nevada Division of Child and Family Services administrator Kelly Wooldridge said then that the state would work to bundle Medicaid-billable services from Together Facing the Challenge to help foster care agencies make up lost funding.
Wooldridge has since been reassigned, and it appears the reduction in funding is moving forward without a new plan in place. That came as a surprise to both foster care agencies and Clark County.
“We had been under the impression that there would be no changes to the current funding model until the permanent, sustainable model was in place, and have recently learned that is not the plan and not the case,” county Family Services assistant director Jill Marano testified Wednesday. “So there is some concern about placement stability around our youth in specialized foster care in Clark County.”
Department of Child and Family Services spokeswoman Karla Delgado wrote in an email Friday that the state is working with Clark County to find funding alternatives. Meanwhile, therapeutic foster care providers are preparing to send the county and state 30-day notices that they should ready themselves to find new homes for the affected foster children.
“There’s a looming crisis that can be prevented, but we need immediate intervention from the (Nevada) Department of Health and Human Services,” Doyle said. “We need to identify alternative funding before the rug is pulled out beneath these kids.”