NC Medicaid Managed Care Children, Families Specialty Plan

Raleigh -- August 15, 2024: Press Release:  The North Carolina Department of Health and Human Services today

announced Blue Cross Blue Shield NC was selected to operate the Children and Families Specialty Plan. A  first-of-its-kind initiative,the CFSP is a single, statewide NC Medicaid Managed Care plan that will wrap Medicaid-enrolled children, youth and their families in the child welfare system with seamless, integrated and coordinated health care.  medicaid.ncdhhs.gov/transformation

Supporting children served by the child welfare system requires close coordination across multiple systems and partners to ensure we support preserving families, reunification and securing permanency to ensure the best outcomes. Children and families in the child welfare system often find it difficult to navigate getting the health care, social services and mental health care they need. The CFSP is designed to support this population by providing health care and mental health care coverage that follows the person — regardless of their geographic location or situation — and works across all these multiple systems.  Children and Families Specialty Plan webpage

"This plan will ensure there is a unified system of care and clear accountability when it comes to improving the health and well-being of our kids living with the most complex challenges," said NC Health and Human Services Secretary Kody H. Kinsley. "We continue to improve how we serve people, so it's more efficient and promotes better outcomes."

The CFSP provides comprehensive coverage for all services provided by the Standard Plan in addition to most Tailored Plan services, such as 1915(i) Home and Community-Based Services and enhanced behavioral health and residential services. It also includes a broad range of behavioral health services such as outpatient therapy, inpatient treatment, and crisis and therapeutic residential options for children. Additionally, the CFSP is responsible for addressing unmet health-related resource needs, including housing, food, transportation, and interpersonal violence. The plan also covers pharmacy, long term services and supports (LTSS) and Intellectual/Developmental Disability (I/DD) services.

At launch, the CFSP will operate statewide, offering robust care management to approximately 31,000 current and former foster care children and youth who will be enrolled automatically. Children of these eligible populations will also be automatically enrolled at launch and maintain enrollment while their parents are enrolled. In line with the plan's goal to support and strengthen families, the plan will also be available to parents and family members of children and youth served by the child welfare system, including those receiving Child Protective Services (CPS) In-Home Services. NCDHHS is currently working on estimating this population size, and service to family members will be available no sooner than July 2026.  

"As we put this plan into action the department recognizes the importance of implementing a whole-person centered, well-coordinated system of care that will support Medicaid-enrolled children, youth and families served by the child welfare system," said Deputy Secretary of NC Medicaid Jay Ludlam.

Since 2021, NCDHHS has been leveraging the move to managed care for NC Medicaid to build an innovative health care delivery system that puts the health of beneficiaries at the forefront. Under Medicaid Managed Care, NC Medicaid Standard Plans and the Eastern Band of Cherokee Indians Tribal Option launched on July 1, 2021, followed by Behavioral Health I/DD Tailored Plans on July 1, 2024.

For information about the CFSP, please visit the  Children and Families Specialty Plan webpage .

More information about the transition to NC Medicaid Managed Care can be found on the Medicaid website at   medicaid.ncdhhs.gov/transformation

The first CFSP contract was awarded to Blue Cross Blue Shield NC after a competitive selection process, and the term will last four years. Only entities operating as NC Medicaid Standard Plans, NC Medicaid Behavioral Health I/DD Tailored Plans and any other entity that meets the definition of a Prepaid Health Plan under NCGS § 58-93-5 or the 2023 Appropriations Act were able to bid on the contract. 

The North Carolina Department of Health and Human Services announced today that Blue Cross Blue Shield NC has been selected to operate the Children and Families Specialty Plan (CFSP). A first-of-its-kind-initiative , CFSP is a unique statewide North Carolina Medicaid managed care plan that will include Medicaid-enrolled children, youth and their families served in the child welfare system with seamless, integrated and coordinated care.

Supporting children served by the child welfare system requires close coordination across multiple systems and partners to ensure our support in preserving families, reunification, and ensuring permanency to ensure the best outcomes. Often, children and families in the child welfare system struggle to get the medical care, social services, and mental health care they need. CFSP is designed to support this population by providing medical and mental health care coverage that follows the person, regardless of their geographic location or situation, and works across all of these multiple systems.

“This plan will ensure there is a unified system of care and clear accountability when it comes to improving the health and well-being of our children living with the most complex challenges,” said North Carolina Secretary of Health and Human Services Kody H. Kinsley. “We continue to improve the way we care for people, making it more efficient and promoting better outcomes.”

CFSP provides comprehensive coverage for all services provided by the Standard Plan, plus most Tailored Plan services, such as 1915(i) Home and Community-Based Services and Enhanced Behavioral Health and Residential Services. It also includes a broad range of behavioral health services, such as outpatient therapy, inpatient treatment, and therapeutic and crisis residential options for children. In addition, CSFP is responsible for addressing unmet health-related resource needs, including housing, food, transportation, and interpersonal violence. The plan also covers pharmacy services, long-term services and supports (LTSS), and intellectual/developmental disability (I/DD) services.

At launch, CFSP will operate statewide, offering robust care management to approximately 31,000 current and former foster children and youth who will be automatically enrolled. Children in these eligible populations will also be automatically enrolled at launch and will remain enrolled as long as their parents are enrolled. Consistent with the plan’s goal of supporting and strengthening families, the plan will also be available to parents and family members of children and youth served by the child welfare system, including those receiving in-home services from Child Protective Services (CPS). The North Carolina Department of Health and Human Services (NCDHHS) is currently working to estimate the size of this population, and service to family members will be available no earlier than July 2026.  

"In implementing this plan, the department recognizes the importance of implementing a comprehensive, well-coordinated system of care that supports Medicaid-enrolled children, youth and families served by the child welfare system," said North Carolina Medicaid Deputy Secretary Jay Ludlam.

Since 2021, NCDHHS has been leveraging the shift to managed care for NC Medicaid to build an innovative health care delivery system that puts beneficiaries’ health at the forefront. Under Medicaid Managed Care, NC Medicaid Standard Plans and Eastern Band of Cherokee Indians Tribal Option (NC Medicaid Standard Plans and Eastern Band of Cherokee Indians Tribal Option) launched on July 1, 2021, followed by Behavioral Health I/DD Tailored Plans on July 1, 2024.

For information about CFSP, visit the Child and Family Specialized Plan webpage  .

More information about the transition to NC Medicaid Managed Care can be found on the Medicaid website at  medicaid.ncdhhs.gov/transformation .

The first CFSP contract was awarded to Blue Cross Blue Shield NC following a competitive selection process and will be valid for four years. Only entities operating as NC Medicaid Standard Plans, NC Medicaid Behavioral Health I/DD Tailored Plans, and any other entity that meets the definition of a Prepaid Health Plan under NCGS § 58-93-5 or the 2023 Appropriations Act were eligible to bid on the contract.