A year after the Legislature mandated that the Oregon Health Authority and commercial insurers adequately compensate child abuse centers for medical assessments, very few health plans and coordinated care organizations have complied.
“There seems to be a lack of knowledge in the medical community of the change in law,” complained Doug Riggs, the lobbyist for the Oregon Network of Child Abuse Centers.
Riggs said the majority of CCOs from around the state will not even return phone calls from the network to discuss the need to re-negotiate contracts to include more than a basic health examination, or conduct a forensic interview after a possible abuse situation.
In the Portland metro area, the group has mixed success. FamilyCare has made the decision to cover the examinations and interviews after alleged abuse with a global budget package, a model that CareOregon also has followed.
“We want to make sure that our members have these services,” said Heather Raeburn of FamilyCare. “For us, it was an easy decision.”
But Riggs said that other players have yet to come on board. “[They] have been unwilling to negotiate a billing rate as required in the bill. We’re hoping that it’s a misunderstanding of the law.”
Oregon has 21 child abuse centers that were created by a 2009 law to professionally and methodically assess suspected victims of child abuse, matching the children with people capable of taking on their psychological and medical needs while providing the legal system with better evidence to prosecute their cases when abuse does occur. The centers serve about 6,500 children across Oregon each year.
But a poor funding stream compelled a bipartisan group of legislators to push for House Bill 2234, including co-sponsors Rep. Gene Whisnant, R-Sunriver and Sen. Sara Gelser, D-Corvallis.
Patty Terzian, the statewide manager for the child abuse network, said she’d spent countless hours trying to get CCOs and the Health Authority to cooperate and get contracts for the centers that are commensurate with the work that they do.
“Center leaders need to put their energy into serving the children in their communities, not trying to navigate a complex system of medical billing,” Terzian told the Senate Health Committee.
The centers are the kind of upstream investment that CCOs were meant to make with their holistic emphasis. Riggs said that if children in a child abuse situation are restored to a healthy environment, the system could save $250,000 per child as abuse is a critical “adverse childhood experience.”
