Managed Care for Children with Disabilities and the Interface of Legislative Policies. PREL Briefing Paper.

This paper addresses issues related to health care reform and the impact of managed care on health care services to children and youth with disabilities or special health care needs. Federal laws governing support for children with disabilities and their families are listed and briefly reviewed, noting a trend toward the dismantling of guarantees for children with disabilities. Major health care needs of disabled and chronically ill children are noted, including the finding that about 10 million children have no health insurance, that massive cuts in Medicaid could cause another 5 million to lose health coverage, and that one-third of children with chronic illness or disability have no source of care. Concerns of families are also listed, such as lack of sufficient family income, inability to locate necessary services, and difficulty in communicating with the health care provider. The current status of Medicaid-managed care for disabled children is summarized and model state programs are noted. Sixteen recommendations for advocates of children with disabilities are offered, such as to become informed about issues of public and private financing of health care, to insist on guaranteed access to medically necessary speciality care, to lobby legislative bodies at all levels, and to form coalitions with others concerned about children and health. (Contains 24 references.) (DB)