Wisconsin Creating Coordinated Medical Care Program for Children in Foster Care

The Department of Health Services (DHS) and the Department of Children and Families (DCF) have received federal approval to create a foster care “Medical Home” program in the southeastern region of the State, to begin this fall.

The initiative creates a virtual “medical home” for children in foster care and out-of-home care where a child will receive an individualized treatment plan that addresses their specific trauma-related needs. As a result, these children are expected to have improved physical and mental health, improved resiliency and shorter stays in out-of-home care. These positive health and mental health outcomes for children will also result in long-term savings in Medicaid costs.

Under the program, some 2,500 children in six counties (Milwaukee, Waukesha, Racine, Kenosha, Ozaukee, and Washington) will continue to have access to all covered Medicaid services but these will be coordinated to ensure services are appropriate to each child. Each child will have a primary care provider and team that will create a medical care plan focused on the specific needs of the child, including physical and mental health and dental care. A Care Coordinator will communicate with the child protection worker for each child, the child’s parent(s) or guardian, and other providers to ensure they receive needed services promptly.

DHS will certify one or more integrated health systems to participate in the new program. To be certified, qualified health care providers must be integrated health systems with demonstrated capacity in trauma-informed care and evidence-based treatment, and include qualified physicians, nurse practitioners, and other support staff and an adequate network of qualified providers for medical, dental, and behavioral health services. To provide continuity of care for each child, they must be able to contract with providers outside their network.