Title V has an agreement in place with the Georgia Department of Community Health (DCH) who is responsible for administering the Medicaid program and the Children’s Health Insurance Program (SCHIP), PeachCare for Kids®. The most recent Title V MCH- Title XIX Medicaid Inter-Agency Agreement (IAA) executed in 2016 outlines the formal partnership. Georgia’s Title XIX Medicaid program provides support to pregnant women, children, retirees aged 65 and older, and individuals who are legally blind or disabled. The MCH Director and the DCH Deputy Executive Director meet quarterly to discuss issues related to MCH services delivery and coverage, particularly for CYSHCN.

Since 2006, Georgia Medicaid has contracted with managed care organizations to manage more than 1.3 million Medicaid and SCHIP low-income adults and children. Georgia ranks 42nd in the nation for state health care system performance which is measured through factors like number of adults who are uninsured. Thirty-two percent of Georgia’s population is low-income with 17 percent of the population covered by Medicaid. Children, youth, and young adults in foster care, those receiving Adoption Assistance, and a select group of children with Department of Juvenile Justice involvement are covered for their medical, dental, and behavioral health needs through a single managed care organization. A small carve-out of the Aged, Blind, and Disabled (ABD) population is served through a fee-for-service arrangement. Approximately 8,000 ABD are served by Title V CYSHCN’s program for care coordination services, health care transition preparation and planning, and access to pediatric sub-specialists who partner with the program to serve families through on-site and telemedicine clinics in rural areas of Georgia.

Georgia uses the federally run health insurance exchange and is divided into 16 geographic insurance markets. For 2021, six insurers offer coverage in Georgia’s exchange. There are approximately 517,113 people enrolled in coverage through the Georgia exchange.

Assistance with navigating the state’s complex health care system and social supports is provided by the Family to Family Health Information Center and Healthy Mothers Healthy Babies Coalition (HMHB) of Georgia. Georgia’s Family to Family Health Information Center, named Parent to Parent of Georgia (P2P), provides support to more than 20,000 families with children with special needs each year.  HMHB partners with the Georgia Association for Primary Health Care to provide education to families on health insurance, Affordable Care Act (ACA) plans, eligibility and directly enroll families in ACA plans through the Federal Healthcare Marketplace and the Planning for Healthy Babies Program (P4HB).

More than half of births in Georgia are paid for by Medicaid. Medicaid pays for medical care for pregnant women, including labor and delivery, postpartum care and a full-range of Medicaid covered services including physician’s’ visits, prescription medicines, and inpatient and outpatient hospital services for six months post-delivery. To improve healthy pregnancies and preventative care for women, as well as reduce the number of low-birth-weight babies, Title V administers the Perinatal Case Management (PCM) program and promotes the enrollment of women in Medicaid’s P4HB demonstration waiver program. P4HB covers family planning services for low-income women ages 18 to 44, as well as limited primary care and dental services to those who have given birth to a very low birth weight (VLBW) baby.

DPH and Medicaid also partner with supplemental funding to provide six Regional Perinatal Care Centers (RPCs) for access to maternal and neonatal specialty care. In 2018, the legislature provided funding to implement coverage of group prenatal care. The Centers for Medicare & Medicaid Services (CMS) recently signed off on a plan to extend Medicaid coverage for women in Georgia, increasing coverage from the current 60-day postpartum period to six months, making Georgia one of three states to extend the coverage.

Medicaid for children under 19 pays for medical care for children ages zero through the month of the 19th birthday. Children may qualify at various income levels depending on age, family size, and income. Those who qualify are entitled to the full range of Medicaid covered services including doctors’ visits, health checkups, immunizations, dental and vision care.

Improving access to adequate health insurance coverage for Georgia’s CYSHCN is a priority for the MCH program. The CMS program’s care coordination services ensure that families that meet eligibility criteria for Medicaid programs are enrolled; including the Health Insurance Premium Payment program, Children’s Health Insurance Program Reauthorization Act, Katie Beckett and Home and Community Based Waivers. Georgia has five home and community-based services waiver programs. Waiver program services include assistance with daily living activities, facilitating the arrangement of medical or support services, and services to relieve family caregivers. Waiver programs serve people who are elderly, physically disabled, have developmental or intellectual disability, or are medically fragile children.

Close partnership between Medicaid and Title V also assists with providing timely access to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits for children and adolescents in areas where there are shortages in pediatricians. Local health departments, including rural areas, provide EPSDT services to low-income children and adolescents. Many children birth to five with identified developmental delay and risk factors are connected to the C1st program for assessment, monitoring and linkages to the early intervention services.

Georgia’s early intervention services program, Babies Can’t Wait (BCW), expanded its scope of services in 2018 to include the provision of autism related services. This expansion was due to Medicaid’s expansion of covered services to include adaptive behavioral services (ABS) for individuals under the age of 21 with Autism Spectrum Disorder (ASD). ASD coverage is provided for assessment and treatment services according to severity and is based on medical necessity. To ensure adequately trained professionals to provide quality diagnostic assessments, the Georgia Autism Assessment Collaborative (GAAC) was formed. GAAC is funded by Title V and implemented by the Emory Autism Center (EAC) with cooperation from the Georgia Psychological Association. BCW is enrolling board-certified behavioral analysts to provide ABS to eligible children and working with the C1st program to expand access to MCHAT screenings for infants and toddlers. Georgia became the 41st state to pass legislation (HB 429) providing coverage for ASD treatments. The law requires state-regulated private insurance companies operating in Georgia to provide coverage under group health insurance policies for habilitative and rehabilitative care, including ASD, counseling services, and therapeutic services to children diagnosed with ASD.

The Title V MCH program and Medicaid collaborate to ensure an understanding of MCH programs and ensuring DPH representation with CMOs. Together MCH and Medicaid have the capacity to reduce morbidity and mortality among women, infants, children, and adolescents, and to improve the health status of women and children in Georgia.