Insurance Coverage

How we address this outcome.

We are receiving technical assistance on insurance advocacy and health benefits counseling from ABC for Health in Wisconsin, and are conducting activities such as the development of community asset maps of health benefits training and advocacy resources.

We convened a stakeholders group, partnering with health plans, children's hospitals, families, advocacy groups and the Pediatric Society of Oregon to tackle the goal of providing adequate insurance for the funding of needed services.

We are striving to increase the availability of information on health benefits and access to health care for CYSHN in a variety of ways:

• Provided training on managed advocacy strategies benefits counseling/managed advocacy at the OCCYSHN Spring conference
• For important links to health care finance information and tools:
  • http://www.hdwg.org/catalyst/Financing_Toolkit.php (external link)
  • http://www.safetyweb.org/ (external link)
• Updated “Navigating the System” to health plans and families. This helpful booklet for Oregon families of CYSHN helps guide families in finding their way in managed care. The way that families get health care, how it is paid and the guidelines or rules needed to follow are changing. This guide helps consumers to understand some of the routes to take as they look for a managed care plan or provider and making choices about the health care services for their children.
• Conducted a review of services authorization services that were not approved to determine patterns of service denial.
• Working with local planning groups of the Community Health Improvement Partnership.
• Partnering with other groups to raise the awareness of health care access concerns of children and youth with special needs. For information on the measures of children’s physical and mental health, health care, and general well-being as it relates to their families, schools, and neighborhoods: http://www.mchb.hrsa.gov/thechild/index.htm (external link)

Key Systems Outcome: All families of children with special health care needs will have adequate private and/or public insurance to pay for the services they need.