Questions raised as state program for medically fragile kids rescreens


  • June 11, 2015
  • /   Staff Reports
  • /   training-development
  TALLAHASSEE — The state last month removed about 2,000 children from a specialized program that provides services to medically fragile kids, finding that they were no longer "clinically eligible" under a new screening process. But the move by the Department of Health to re-evaluate children in the Children's Medical Services Network is drawing criticism from pediatricians and some children's advocates. Department spokeswoman Tiffany Cowie said in an email that 7,424 children enrolled in the Children's Medical Services Network under Medicaid were re-screened between May 4 and May 20. Of those, 2,065 were found to be "not clinically eligible," while 5,359 were found eligible and kept in the program. According to Cowie, in Escambia County, 35 children in the network were screened and four were found not eligible. Three children in the network in Santa Rosa County were rescreened and two were found not eligible. For June, the total enrollment in the plan in Escambia is 951 children; in Santa Rosa it is 257, Cowie says. Critics say they're troubled that the department has stopped enrolling new kids in the CMS Network — except for emergency cases — during a 90-day period while the state re-screens nearly 65,000 children using a new eligibility tool that went into effect last month. "The CMS Network has a stronger support network for the family of a child with special needs," said Karen Woodall, director of the Florida Center for Fiscal and Economic Policy and a member of the state's KidCare Coordinating Council. "There's likely to be more immediate attention than you would get with a regular health-care plan." During the three-month re-screening period, new applicants for coverage are being enrolled in Medicaid managed-care plans, as are the children who were re-screened and found to be ineligible for the CMS Network under the new criteria. Some say the CMS Network, which was designed for children with severe and chronic illnesses, does more to help families struggling with such challenges than Medicaid managed-care plans. "There are severe medical needs that require children to have feeding tubes and (tracheotomy) tubes, and cause their breathing to stop on a regular, intermittent basis," said Cindy Arenberg Seltzer, chief executive officer of the Children's Services Council of Broward County. "There are a lot of very scary issues with which parents of all socioeconomic conditions need support." The Department of Health "is committed to providing quality care to residents, and especially children, through a number of programs, including Children's Medical Services,” Cowie wrote in an email. The 90-day re-screening period will end July 31, and critics are concerned about the lack of children being enrolled during that period. News Service of Florida writer Margie Menzel and Pensacola Today Editor Shannon Nickinson contributed to this report.
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