Texas Children’s Health Plan has been selected by the Texas Health and Human Services Commission as a health plan in the STAR Kids Program, a managed care program that provides health coverage to children and youth with special health care needs.
Beginning September 1, 2016, the STAR Kids program will be implemented to manage children with special health care needs. This move is expected to bring about 40,000 new members into the Health Plan. In anticipation, more than 400 new employees will be hired to manage these cases. The program will provide benefits such as prescription drugs, hospital care, primary and specialty care, preventive care, personal care services, private duty nursing and durable medical equipment and supplies.
“Texas Children’s Health Plan is very proud to be involved in the STAR Kids program and be able to provide children with special health care needs the care they deserve,” said Christopher Born, president of Texas Children’s Health Plan. “The introduction of STAR Kids speaks to our commitment of providing excellent care to the members of our community.”
Children age 20 or younger who receive Supplemental Security Income Medicaid, are enrolled in the Medically Dependent Children Program or receive services through 1915(c) waiver programs will receive a variety of services through the STAR Kids program. Children, youth and their families will have the choice of STAR Kids health plans and will have the option to pick one that best suits their needs.
“The case managers we are able to hire will help these members through the process and through the system, removing barriers,” said Kristen Cover with the Health Plan. “The families are going to have experienced care managers, who are often nurses, to assist them and be a support system for the whole family. The parents are no longer the only ones managing their children’s cases.”
Born said over the last few years, he has met the Texas Department of Health and Human Services about finding a new way to care for these children.
“It was a letter from Representative John Zerwas to Texas Children’s President and CEO Mark A. Wallace that was really a catalyst for this new way of caring for medically complex kids,” Born said. “Mark was adamant that we needed to be leaders in finding a more coordinated way to care for these kids on disability-related Medicaid and that’s really where the ball started rolling.”
“This is a tremendous tribute to Texas Children’s and our capacity, our ability and our passion to care for all children in Texas,” Wallace said. “Not only does this extend the care to this new patient population with a new and improved paradigm to care for these children, creating a better model of care.”
Texas Children’s Health Plan is currently the largest Children’s Health Insurance Program (CHIP) and Medicaid HMO in the Harris and Jefferson service areas and provides coverage in more than 20 counties in the Houston metropolitan area. By approving Texas Children’s Health Plan to offer coverage in the Health and Human Services Commission Northeast Expansion Area, which includes 34 counties, 64,000 STAR Kids eligible members in the Northeast, Harris and Jefferson service areas will be able to choose Texas Children’s Health Plan as their new health plan starting September 2016.
Take a moment to read the blog post (below) from President and CEO Mark A. Wallace about the journey that helped us reach this milestone and why it’s so important to so many children.