The Department of Children and Families (DCF) and MassHealth cosponsor a pilot program to enroll certain children in foster care who have special health-care needs into Neighborhood Health Plan (NHP), a health plan that contracts with MassHealth. Through its network of providers, NHP provides and/or arranges for a full range of medical services to be delivered in the child's foster home or other appropriate settings when medically necessary.

For children who participate in this pilot program, a nurse practitioner from NHP works with the DCF case manager, the DCF family resource worker, the foster family, and the primary-care physician to develop an individualized medical-care plan, arrange for the child to obtain the necessary care and services, and monitor the child's health care needs 24 hours a day. NHP also helps arrange and provide medically necessary home-health services, durable medical equipment, and medical supplies in the foster home.

A child who has been placed in the custody of DCF and is living in a foster home at the time of enrollment may be eligible to participate in the pilot program. Also, the child must need:

  • complex medical management on a regular basis over a prolonged period of time; and
  • direct administration of skilled-nursing care requiring complex nursing procedures on a regular basis over a prolonged period of time; or skilled assessment or monitoring related to an unstable medical condition on a regular basis over a prolonged period of time.

NHP manages the child's health care, and is the provider of most of the medical services the child needs, including private-duty nursing services. The nurse practitioner from NHP authorizes and coordinates the services needed by the child as outlined in the individualized medical-care plan. The nurse practitioner acts as liaison between the foster family and providers and remains in contact with the foster family and the DCF caseworker regarding the ongoing needs of the child.

For more information or to request an application for the Special Kids/Special Care Pilot Program, please contact:

Special Kids/Special Care Pilot Program
MassHealth Office of Acute and Ambulatory Care
Executive Office of Health and Human Services
600 Washington Street 6 th Floor
Boston, MA 02111
Telephone: 617-348-5517
Fax: 617-348-5596

or

Massachusetts Department of Children and Families
Health and Medical Services Team
Special Kids/Special Care Pilot Program
24 Farnsworth Street
Boston, MA 02210
Telephone: 617-748-2358
Fax: 617-261-7437



This information is provided by MassHealth