system of care for rhode island's children, youth and families

CHAPTER 4: FINANCING THE SYSTEM OF CARE
Financing a comprehensive system of care for children, adolescents, and their families is one
of the most complex aspects of system reform. Funding for services for children and families
comes from a very broad range of federal, state, local, and private sector sources. In FY 2001
the DCYF budget exceeded $200 million and these funds were augmented from a number of
other sources including but not limited to public and private insurance, federal government
grants and contracts, federal entitlements, state general funds, trust funds or other set-asides,
and local revenues.
On a State level, funding and supports were available from DHS in the form of RIte Care
capitation, fee for service Medicaid claims, and a variety of supports available under TANF.
DHS funding for programs for Families and Children in Medicaid alone exceeded $300
million in FY 2001 and covered 120,000 family members of whom over 80,000 were
children. LEAs also were a resource available for this system, particularly in their growing
role as Medicaid providers.
In the Ideal System of Care, DHS and DCYF have a strong partnership. DCYF is
responsible for developing programs and services to meet the needs of its priority
populations. DHS is the designated single state agency with responsibility and accountability
for the Medicaid State Children’s Health Insurance (SCHIP) programs. The majority of
DCYF children, youth, and families are Medicaid/SCHIP eligible. Therefore, the
opportunity exists to strategically leverage DCYF’s and DHS’s authorities and resources to
expand services. DHS is a funder with a voice in program development. The responsibility
for funding programs is accompanied by participation in design, development, and
measurement of program effectiveness. Likewise, in the ideal system, DHS does not
establish programs that directly affect DCYF children and families without DCYF’s full and
equal participation. These two departments operate as a strategic alliance.
The DHS plays an important role in partnering with the DCYF and other state agencies to
maximize Medicaid support for eligible children and their families. They continue their
work with DCYF in developing opportunities for access to RiteCare coverage and their work
with DCYF and other state agencies developing opportunities for increased access to services
through programs like CEDARR 18 and the LCC’s. In the Ideal System, DHS ensures access
to the full range of medically necessary prevention and treatment services through
contractual language with RIteCare providers. DCYF funds provide non-Medicaid
reimbursable services. In the Ideal System design, the case rate supports the non-Medicaid
reimbursable costs while the Lead Agencies bill Medicaid for reimbursable services with the
DCYF providing the State Medicaid share.
18 CEDARR stands for Comprehensive Evaluation Diagnosis Assessment Referral and Reevaluation and is a
collaborative effort of the following state agencies: DHS, DCYF, RIDE, DOH, and MHRH. DHS administers
the CEDARR program.
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