New DOH Hire Signals New Approach To Children’s Health

Apr 21, 2016

In tapping a distinguished pediatrician as head of its children's medical programs, the Florida Department of Health on Wednesday signaled a new approach to caring for the state's sickest kids.

The appointment of John Curran --- senior administrator and faculty member at the University of South Florida's College of Medicine --- to be a deputy secretary of the agency was announced at the start of a rule-making workshop on the Children's Medical Services Network, which Curran will now oversee.

A former president of the Florida Chapter of the American Academy of Pediatrics, Curran has worked with Children's Medical Services since 1974. Curran has been CMS medical director for the Tampa Bay Region since 1986.

"He's really considered the dean of the Children's Medical Services medical directors around the state," said pediatric cardiologist Louis St. Petery, a frequent DOH critic. "And it really couldn't have happened at a better time, after all the negative events at CMS over the last year or two."

The CMS Network has been mired in controversy since a new eligibility-screening tool, introduced last May, eliminated one-fifth of roughly 65,000 enrollees. More than 13,000 children with "chronic and serious" medical conditions were found to be ineligible for Children's Medical Services by late September.

That's when an administrative law judge ruled that the Department of Health hadn't properly established the new screening tool through a rule-making process. As a result, the department stopped the screenings and made a rule expanding the eligibility criteria, which went into effect Jan. 11.

According to DOH data presented Wednesday, between Jan. 11 and April 10, 19,758 children were screened for Children's Medical Services under the new rule. Of those, 15,778 were found to be eligible for the program, while 3,980 --- just over 20 percent --- were not.

And following Wednesday's announcement of his new role, Curran led the first public discussion of the new rule since it took effect. The updated screening tool allows physicians as well as parents to "attest" that a child's condition warrants CMS specialty care.

Curran reviewed the latest draft of the physician attestation form. It includes new categories, such as cleft palates, for which children can qualify for CMS. It also has what Curran called a "write-in ballot," permitting doctors to document a child's disability even if it doesn't fit one of the categories.

"We're trying to make it good, make it easy," Curran said. "It's so important for kids who have disabilities that we be friendly and supportive to them."

Those who participated in the public comment portion of the workshop agreed.

"Clearly, y'all listened last time," said Karen Woodall of Kidswell Florida, an advocacy group for children's health care.

But Woodall and others also asked Curran to take action on the 13,074 children who lost their CMS eligibility last year. While the Department of Health has posted on its website that those children can be rescreened and perhaps re-enrolled, Woodall said, not many people read the website.

The department thus far has declined to notify the children and their families directly.

"I understand that there's a concern about the cost of doing a mailing," Woodall said. "But the reality is that a lot of families didn't know that they have the opportunity. ... We think that would be important."

She also said that since the children who had been dropped from CMS were now in regular Medicaid managed-care plans, the plans should report to DOH on their conditions and the services they have received.

"I am committed to trying to see what alternatives there are," replied Curran, who doesn't actually start work until May 2. "It's hard sometimes to walk backwards, but maybe there are ideas that can work."

He said his role would include helping the Department of Health plan for the future of children's health, "particularly in the managed-care environment."

"It's going to take a lot of communication and collaboration and people working together," Curran told The News Service of Florida. Curran said he hopes he can help bridge differences between the agency and its critics, "because the environment has changed recently, and I think it gives the opportunity."

He was referring to a settlement agreement earlier this month between the state and groups representing pediatricians and dentists, who had waged a class-action lawsuit about care provided to children in Florida's Medicaid program for more than a decade.

Now state agencies and the medical professionals who opposed them in the lawsuit "are at least agreeing to talk together," Curran said.