As neglected or abused children are put into child protective services, foster parents often don’t know the full extent of that child’s medical or mental health needs. The children entering the system sometimes need immediate medical care, experts say, leading foster parents in Illinois to the state’s YouthCare program. But a recent investigation uncovered that the state’s top Medicaid contractor failed to fulfill its obligation to provide basic medical services, like dentist visits, immunizations and mental health support for kids in crisis.
The Illinois Answers Project reviewed state contracts and spoke with foster parents, Medicaid employees and medical providers, as well as state officials. The findings revealed that too often, the for-profit insurance company Centene Corp., which manages health care for roughly 37,000 current and former foster youth through YouthCare, “failed to deliver basic medical services to thousands of foster children.” The company has received nearly $370 million from the state to carry out these services since 2020, the report states.
Only 62% of current foster children had an annual dental visit last year, according to Centene’s data. Just 55% of foster children got standard immunizations, with about 67% of adolescents receiving a “well-care visit,” something required under Centene’s contract.
Former foster kids still enrolled in the state Medicaid program, who were reunified with family, adopted or placed into a new home, experienced worse care outcomes. Of those kids, only 43% had a dentist appointment in 2021, with 47% getting a well-being visit.
Some parents denounced the program that left foster kids in life-threatening health emergencies, saying they were forced to navigate outside of Centene’s network, and out of pocket.
Melissa Thomforde, a foster parent for 11 years, said she keeps her foster kids on her own private insurance to ensure they are receiving the services they deserve: “We pay to get them appropriate level care because, if you rely on YouthCare, you either get subpar providers or the wait list is so long, it’s just ridiculous,” Thomforde said.
Wait times were one major issue cited in the investigation. It found foster parents were forced to wait months, even up to a year, for an appointment to be made — these waits have caused many foster families to pay out-of-pocket for medications or other necessary medical services for foster youth.
A primary contract requirement of YouthCare is to assess children’s needs and assign them to one of four “risk levels,” but since 2020 the program has failed to assign over 17% of foster children to the top two categories.
Healthcare and Family Services (HFS) Director Theresa Eagleson admitted that the program is still in its early stages of impact.
“Progress is often slower than we’d all like it to be and progress is never linear, but these numbers are trending now in the way we want them to be trending,” Eagleson said in defense of YouthCare. “This plan — and the services being brought to the kids — is better than what these children had before, and we’re working on making it even better.”
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