Anne R. Markus, JD, PhD, Sara Rosenbaum, JD, and Soeurette Cyprien. Department of Health Policy, The George Washington University Medical Center, 2021 K St, NW, Suite 800, Washington, DC 20006, 202-530-2339, armarkus@gwu.edu

Objective: To explore the level of interaction and coordination between Title V programs and separately-administered SCHIP programs in the provision of services needed by CSHCNs.

Design: Qualitative methods combining a review of research findings on states’ early experience with SCHIP, an analysis of the coordination and benefit provisions of separate SCHIP plans, and a written survey of Title V agencies in states with separately-administered SCHIP programs regarding changes to their CSHCN program following SCHIP enactment.

Findings: A handful of states used their Title V programs to attempt to fill in the gaps in coverage created by scaled back SCHIP benefit packages. The majority of states, however, have not yet taken such steps. Additionally, even in states that have sought to improve coverage for CSHCNs, some children - particularly those with extensive behavioral health needs - are likely to find it difficult to navigate the system and to still face gaps in coverage.

Conclusions/Implications: Although SCHIP benefit packages work well for the majority of children who are healthy, they can result in CSHCNs facing gaps in needed services with nowhere else to turn for needed specialty care. As states re-design Medicaid and SCHIP, they may want to mobilize the multiple state agencies whose mission is to serve CSHCNs at the program design stage to create a formalized referral system and to coordinate service delivery once the program is implemented in order to ensure that fewer CSHCNs fall through the cracks and more receive gap-filling services.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the three main models of coordination between SCHIP and Title V, and
• Discuss the implications of these models for CSHCNs' access to care

Keywords: Children With Special Needs, Access to Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.