MCHPRC: Publications

Children's Health Service Delivery

Reports:

Is the Health Care System Working for Adolescents? Perspectives from Providers in Boston, Denver, Houston, and San Francisco
by Margaret A. McManus, Kandi I. Shejavali, and Harriette B. Fox. Report, 40 pages, October 2003.
This report provides a comprehensive assessment of how well adolescents in four urban areas are being served by the current health care system. It contains provider perspectives on the extent to which preventive and primary care, reproductive care, and behavioral care adequately meet adolescents’ needs and the main organizational, health insurance, managed care, and other factors facilitating or impeding access to these services. The report also includes recommendations for organizing and financing an optimal health care system for adolescents. Information was obtained primarily from on-site interviews with health care providers.
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Many States Reporting Cost-Cutting Measures for Children´s Mental Health Services
by Harriette B. Fox, Margaret A. McManus, Harry Schmidt, and Mary Reichman, Fact Sheet No. 3, 4 pages, June 2002, $10.00.
This fact sheet examines state changes affecting children´s mental health services in fiscal years 2002 and 2003 resulting from state budget shortfalls. Administrative spending reductions and service delivery changes are summarized. These service changes include cuts in inpatient hospital care, residential treatment, and community-based services. The findings are based on a brief survey of each state´s mental health authority staff person responsible for children´s services conducted in March and April of 2002.
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Program Cuts Affecting Half of All State Title V Programs for Children with Special Health Care Needs
by Margaret A. McManus, Harriette B. Fox and Stephanie Etienne, Fact Sheet No. 2, 4 pages, March 2002, $10.00.
This fact sheet examines state Title V CSHCN program changes resulting from state budget shortfalls in fiscal year 2002. States reported on reductions in administrative spending, enrollment, eligible conditions and services, and planned program expansions. The findings are based on a brief survey of Title V CSHCN program directors conducted in December of 2001 and January of 2002.
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Pediatric Provider Capacity for Children with Special Health Care Needs: Results from a National Survey of State Title V Directors
by Stephanie J. Limb, Margaret A. McManus, and Harriette B. Fox. Report, 50 pages, March 2001, $30.00.
This report summarizes the results of a national survey of state Title V directors of programs for children with special health care needs on access to pediatric providers. It addresses Title V directors´ assessments of access to medical homes; pediatric medical and surgical subspecialty care; inpatient hospital care; home health care; occupational, physical, and speech therapies and audiology services; dental care; and mental health care. It also includes an analysis of the most significant causes of access difficulties. Innovative strategies and recommendations to address pediatric provider problems are highlighted. Included in the report are detailed tables documenting each state´s rating of access to the specified services and their assessment of the most important causes of access difficulties.
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Pediatric Provider Networks for Children with Special Needs in the Current Health Insurance Market: Report from an Expert Work Group
by Margaret A. McManus, Harriette B. Fox and Paul W. Newacheck. Report, 25 pages, November 2000, $35.00.
This report summarizes the major barriers experienced by pediatricians serving children with special health care needs in managed care arrangements. It includes a comprehensive literature review on pediatrician satisfaction with managed care. A set of recommendations to address these problems is also included.
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Summary of Interviews with Selected State Title V Agencies Regarding Developmental Support Services for Young Children and their Families
by Rochelle Bobroff, Margaret A. McManus, and Harriette B. Fox. Report, 23 pages, December 1998, $20.00.
This report describes the range of developmental support services furnished by state Title V agencies, including their provider arrangements and revenue support from Medicaid and other state sources. The six types of developmental support services addressed are: comprehensive risk assessments, telephone advice lines, parent education, parent counseling, home visiting, and case management. The report also includes a description of six state Title V programs offering extensive services in this area. Information was obtained through interviews conducted with state Title V directors in the fall of 1998.

Summary of Federally Funded Projects Related to the Financing and Delivery of Enhanced Preventive and Developmental Services for Young Children
by Rochelle Bobroff, Margaret A. McManus, and Harriette Fox. Report, 36 pages, September 1998, $20.00.
This summary of federally funded projects provides descriptions of more than 115 projects related to the financing and delivery of enhanced preventive and developmental services for young children. Included are projects funded by the Maternal and Child Health Bureau, the Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration, the Health Care Financing Administration, and the National Institute of Mental Health. The report provides information on national, training, and state and community-based service delivery projects.

Medicaid Managed Care for Children with Chronic or Disabling Conditions: Improved Strategies for States and Plans
by Harriette B. Fox and Margaret A. McManus. Report, 67 pages, July 1996, $40.00.
This report presents findings and recommendations from an extensive study of Medicaid managed care arrangements for children with developmental, emotional, behavioral, or complex physical conditions. The report describes the range of chronic conditions and disabilities among children, provides a snapshot of current Medicaid managed care policies and plan practices affecting children, and presents a discussion of alternative structural arrangements that states might use in serving these children through managed care. It also identifies essential components of state managed care contracting policies and plan practices. Information for the report was obtained through an extensive literature review and interviews with plans, state Medicaid agency staff, pediatric providers, and families. Expert advice was also obtained through an advisory group and key informant interviews.
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Strategies to Enhance Preventive And Primary Care Services For High-Risk Children In Health Maintenance Organizations
by Margaret A. McManus and Harriette B. Fox. Report, 52 pages, 1995, $25.00.
This report provides background information on children who are at high risk for biological, behavioral, or environmental problems and describes 15 recommended design elements to improve preventive and primary care. It addresses needs assessment, access initiatives, and enhanced preventive and primary care. For each of the design features, implementation issues and illustrative examples are presented.
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Using Medicaid to Finance Care Coordination Services for Children with Special Health Care Needs
by Harriette B. Fox and Lori B. Wicks. Technical Report, 73 pages, 1991, $25.00.
This report describes the opportunities that exist for Medicaid financing of care coordination services provided to children with special health care needs. It presents information on the Medicaid requirements relating to coverage of care coordination services, identifies six options for Medicaid financing of various care coordination activities, and assesses the pros and cons of using each option with regard to special-needs children. The report concludes with descriptions of five models of care coordination systems and assesses the extent to which Medicaid could be used to finance the elements of each system.
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Using Medicaid to Finance Care Coordination Services for Children and Adolescents with Severe Emotional Disorders
by Harriette B. Fox and Lori B. Wicks. Technical Report, 80 pages, 1991, $25.00.
This report identifies the ways in which Medicaid can be used to finance care coordination services furnished to children and adolescents with severe emotional disorders. It presents information about basic Medicaid program requirements that pertain to coverage of care coordination services, describes six options for Medicaid financing of various care coordination activities, and assesses the pros and cons of each option with regard to youth having severe emotional disorders. The report also describes five model care coordination systems and indicates the extent to which Medicaid could be used to finance each one.
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The Role of Medicaid and EPSDT in Financing Early Intervention and Preschool Special Education Services
by Harriette B. Fox and Lori Neiswander Wicks. Technical Report, 147 pages, April 1990, $30.00.
This report provides an assessment of the ways in which the Medicaid program, and Medicaid´s EPSDT benefit in particular, can be used to finance many components of states´ early intervention and preschool special education programs. The report includes a discussion of important implementation issues that states need to address in developing a strategy for maximizing Medicaid financing of health-related services.
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Articles:

Access to Health Care for Children with Special Health Care Needs.
by Paul W. Newacheck, Margaret A. McManus, Harriette B. Fox, Yun-Yi Hung, and Neal Halfon. Pediatrics. Vol. 105, No. 4 Pt 1, pp. 760-66, April 2000.
This article presents findings from the 1994-1995 National Health Interview Survey on Disability on the number of U.S. children who have an existing special health care need and their health insurance status. It also describes differences in access for children with and without health insurance coverage. Policy implications for the State Children´s Health Insurance Program are discussed.

An Examination of State Medicaid Financing Arrangements for Early Childhood Development Services
by Harriette B. Fox, Margaret A. McManus, and Stephanie J. Limb. Maternal and Child Health Journal. Vol. 4, No. 1, pp. 19-27, March 2000.
This article examines the extent to which state Medicaid agencies finance early childhood development services either through their capitated contracts or on a fee-for-service basis. It also looks at states´ interest in funding these services in the future. The services examined were parent counseling, home visiting, comprehensive assessments, telephone advice lines, parent education classes, and case management. Information was obtained through telephone surveys with state Medicaid managed care directors and through an analysis of Medicaid managed care contracts.

Managed Care´s Impact on Medicaid Financing for Early Intervention Services
by Harriette B. Fox, Margaret A. McManus, and Ruth A. Almeida. Health Care Financing Review. Vol. 20, No. 1, pp. 59-72, Fall 1998.
The article presents an analysis of Medicaid financing for seven types of early intervention services in 39 states before and after the introduction of managed care. It includes an assessment of the association between the level of Medicaid financing for these services and program characteristics, provider arrangements, managed care carve-out policies, and managed care contract requirements. Information was obtained through telephone surveys with state early intervention and Medicaid program staff and through an analysis of Medicaid managed care contracts.

		Publications

Medicaid SCHIP Private Health Insurance Managed Care Children with Special Health Care Needs Adolescents Children's Health Service Delivery Pediatric Provider Capacity Program Impact Series Join Our Email List