State presenters outline enrollment rules and coverage options for Native youth in foster care
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Summary
State agencies and Coordinated Care explained Apple Health enrollment paths for youth in foster care, highlighted exceptions for American Indian/Alaska Native (AIAN) youth and described the form-and-data steps required to change coverage or placements.
State health and child‑welfare staff summarized how Medicaid coverage works for American Indian and Alaska Native (AIAN) youth in foster care, stressing that tribal sovereignty and program rules affect whether a child is placed in managed care.
In a virtual session hosted by the Department of Children, Youth, and Families’ Office of Tribal Relations, presenters from the Washington State Health Care Authority (HCA), the Department of Social and Health Services (DSHS) and Coordinated Care described three Medicaid pathways for youth in out‑of‑home placement: full managed care (Apple Health Core Connections), behavioral‑health‑services‑only (BHSO) with medical fee‑for‑service, and fee‑for‑service Apple Health without managed care. "One thing we do want to start with is that there...are no standard criteria for determining who meets the definition of an Indian or American IndianAlaska Native person," said Jaren Heller of HCA’s Office of Tribal Affairs.
Why it matters: the choice of enrollment affects which provider networks and coordination services are available to youth and caregivers and whether tribes participate in decisions about care. Coordinated Care representatives said Apple Health Core Connections is the state’s specialized foster‑care plan and that most youth entering state foster care are automatically enrolled in it unless exceptions apply.
What the presenters said: Coordinated Care staff said the Health Care Authority generally enrolls foster youth in Apple Health Core Connections but AIAN youth are treated differently: youth identified as American Indian or Alaska Native (whether or not enrolled with a tribe) do not automatically enroll in the managed‑care foster plan and instead remain in fee‑for‑service unless proactively opted in. HCA staff also described ICWA‑related definitions used in dependency cases. "ICWA...applies to any unmarried person who is under age 18 and either a member or citizen of an Indian tribe or is eligible for membership," HCA staff said.
Administrative steps: presenters explained that placement and enrollment data typically flows from FamLink into ProviderOne and that the foster‑care form (linked in the session materials) is the document used to add or update a youth’s foster care medical enrollment. The presentation referenced the foster care form several times and displayed form numbers as both "19027" and "1927" in different slides; presenters emphasized using the form link provided in the materials and updating it whenever placement or coverage changes.
Exceptions: DSHS staff said tribal‑custody placements paid by tribal payment only require consent before managed‑care enrollment, dual‑eligible youth (Medicare primary) need special coordination, and noncitizen youth cannot enroll in managed care and remain on fee‑for‑service. Presenters encouraged tribal social workers and caseworkers to use the linked foster‑care form and to contact HCA or the plan’s care liaison when coverage changes are needed.
What’s next: presenters asked participants to use the session links, contact care management teams for enrollment questions and complete the session survey. The agencies said additional contact details and resources are available in the chat and linked materials.