Collaborative effort leads to early success for STAR Health

Every day, the State of Texas is responsible for roughly 28,000 children in the state’s foster care and kinship care systems, children who have been abused or neglected and removed from their homes for their own safety. That’s 28,000 children who are moving in and out of the foster care system or moving from one placement to another. Imagine how difficult it is to coordinate health care for them.

A year ago, HHSC and the Department of Family and Protective Services (DFPS) launched STAR Health, the first comprehensive health and statewide medical network for Texas’ foster children. The Medicaid managed care system was designed to improve health and behavioral health services for children in state care. STAR Health carried the promise of immediate access to a primary care doctor, a medical home for each child and a seamless system of accessible, coordinated, comprehensive and continuous health care.

Today, the vision has developed into reality. Since the launch of STAR Health, 28,826 children in foster and kinship care have been successfully enrolled in the program and each has received a health screening. As a result of those screenings, the needs of children with highly complex medical and behavioral health care needs are being managed by health care professionals.

“The bottom line,” says DFPS Deputy Commissioner Joyce James, “is that children are reaping the benefits from STAR Health because their behavioral and health care needs are being met. We are a model for the rest of the nation and are seen as leaders in this work.” 

Service management pays off

One of the keys that makes STAR Health work is coordinated service management. The teamwork and partnerships formed between DFPS staff and health care providers not only offers improved care for children but it takes some of the “leg work” burden that caseworkers and caregivers had before STAR Health.

Kathy Roberts, a Child Protective Services specialist, notices the improvement. “We have so many children using some type of durable medical equipment, and now staff and caregivers no longer have to struggle to find that equipment, especially for those kids whose needs or health status changes,” Roberts says. “It’s so much easier on everyone. You can get what you need with one call to service coordination.”

Child Protective Services Specialist Amy Cooper points out that service coordination extends to one of the most challenging aspects of health care for victims of abuse or neglect. 

“The behavioral health portion has been an enormous help. I had a situation where the case manager was available and provided information on medications that was beyond my knowledge. There was also a doctor who answered questions and who was willing to contact the child’s foster family about their concerns.”        

New controls on psychotropic medications

STAR Health also produced a new process for monitoring and reviewing psychotropic medications prescribed to children in DFPS care to make sure they’re within the parameters set out by the Department of State Health Services. 

“STAR Health service managers receive real time data that tracks the psychotropic medications our foster children are receiving,” says DFPS Medical Director James Rogers. “If the medications are outside of the norm, the information is automatically sent to the medical staff for a full review and, if needed, they can call the prescribing physician to find out what’s going on.”

Rogers says the cases are monitored over time to see that proper care is given. CPS caseworkers, supervisors, foster parents, judges or others involved with the placement can also ask for a review if they are concerned about a child’s medications.

“We are clearly seeing improving patterns and are receiving good cooperation from the prescribing physicians.”

Health Passports

The underlying foundation of STAR Health is the broad menu of medical and vision care, prescription drug, behavioral health and dental services.  

Every child has a primary doctor or provider to coordinate care and a web-based Health Passport, which captures information about each foster child’s medical and dental visits, prescription drugs the child has been prescribed, the child’s immunization record, allergy information, a record of Texas Health Steps checkups and behavioral health progress reports. The Health Passport travels with the child in each placement and even after leaving DFPS care. 

Despite the largely positive reviews, no one associated with STAR Health is resting on their laurels. “With all our accomplishments there is a lot of work still to be done,” DFPS’ Joyce James says. “We have to keep working to continually improve the system.”