A partnership of private organizations and public agencies launched a pilot project last week in Ventura County, Calif., aimed at improving social and health care coordination for children in foster care.
Spurred by federal initiatives supporting expanded use of health IT, the project — called Ventura County Foster Health Link — is designed to be used as a model for other communities in California and the nation. The program allows caregivers, social workers, guardians and the kids themselves the ability to communicate and share information over the Internet.
Eventually, the policies and practices being tested in Ventura County could be applied to all children, officials said.
“The use of an ‘electronic backpack’ that safely stores accurate, timely and complete information about a child and allows it to be shared with medical providers and others as appropriate is an approach that could benefit all children,” said Ginny Puddefoot, director of Health IT Initiatives for Vulnerable Youth at The Children’s Partnership, one of the private partners.
The Children’s Partnership has plans to expand the project to all parts of the state. A similar program is launching in Sacramento County.
Many Policy, Bureaucratic Hurdles To Overcome
“The concept of taking two separate functions — especially government functions — and coordinating them is challenging enough,” said Barry Zimmerman, director of Ventura County’s Human Services Agency. “But when you start dealing with the complexities and privacy issues of integrating health care and foster care for youth, there are a lot of policy issues that need to be overcome.”
“We think Ventura is a good place to start this kind of effort because we have a robust county hospital system that allows us to work basically with one entity on the health care side and that will make interoperability easier. At least we hope so,” Zimmerman said.
Children in foster care often don’t have built-in support systems and background knowledge of family medical histories so coordinating care becomes more important, officials said.
“This tool can improve care coordination and outcomes for children whose lives and care tend to be more fragmented and chaotic,” Puddefoot said.
“The reason we focus on children and youth in foster care is that this is a uniquely vulnerable population of children whose health care and health outcomes have been documented to be significantly below those of their non-foster care peers,” Puddefoot said.
Lessons learned in Ventura can be used elsewhere.
“Our vision is very much that this approach can be extended to other vulnerable populations, such as children with special health care needs, children in Medi-Cal, and homeless youth. In fact, this approach is being designed so it can be adapted and implemented across the state and nationally,” Puddefoot said. Medi-Cal is California’s Medicaid program.
Files Will Follow Children
The intention is that a child’s electronic file will follow the child as he or she moves in and out of various care settings. Each backpack will have different contents, depending on the individual’s circumstances, but the basics in each file will be clinical records as well as an accounting of the child’s history in the social welfare system. The information will be available to case workers, new caregivers, health care providers and others “to the extent authorized by existing privacy and confidentiality laws,” Puddefoot said. The project is designed to adhere to all provisions of the HealthInsurance Portability and Accountability Act.
“The electronic files are designed to allow specific information to be shared with specific individuals under specific circumstances. What information is shared will vary depending on the authorizations and circumstances,” Puddefoot said.
For example, foster parents may be authorized to see certain information about the medical conditions of a child in their care. That’s the case legally now, but because paper records are often lost, incomplete or out-of-date as children move from place to place, the hope is that electronic records will be more timely, accurate, complete and always readily available, officials said.
Eventually, records may be available all over the state and country, but for now, the pilot promises they’ll be available only within Ventura County.
“While our vision is that these electronic files should be available to outside-the-area social workers or health care providers … achieving this goal is some years in the future,” Puddefoot said. The Children’s Partnership “is working at both the county and state levels to lay the groundwork for this to become a reality for California,” Puddefoot said.
Project’s Roots Traced to Health Information Exchange
Health information exchange efforts funded by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act’s support of HIE networks laid the groundwork for the Ventura project, officials said.
“The goal of having uniformity of health information is what sparked the idea here,” Zimmerman said. “There was a lot of early momentum in California for health information exchange and that momentum I think is why we are able to get this project off the ground.”
Phase one of the Ventura project, expected to be completed in 2015, is funded with a variety of public funds and private philanthropic contributions.
Public partners — Ventura County Human Services Agency, Ventura County Health Care Agency and California HHS — are joined by The Children’s Partnership, Verizon Foundation, Sierra Health Foundation, Ventura County Medical Resource Foundation and KCN Consulting from the private sector.
“This project is a powerful example of how technical innovation, combined with knowledge of children’s needs, can lead to stronger support for kids and a more efficient use of taxpayer money. We are very pleased to see California taking the lead in this field,” said Wendy Lazarus, founder and co-president of The Children’s Partnership, a not-for-profit children’s advocacy organization.
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