December 11, 2024 • 37 mins
Explore the challenges and barriers for transition-age youth and the power of digital technology in transforming care for these vulnerable populations. Bob and Shelley are joined by Amerigroup experts as they discuss the complexities of foster care systems and shine a light on the barriers many families face both physically and emotionally.
Listen and Learn:
- How mobile engagement solutions like GoMo Health assist youth in foster care and their families and caregivers by providing personalized support, bolstering self-confidence, and helping participants make informed decisions
- The importance of preventative care and ways to educate members on their healthcare services and benefits
- The critical barriers many transition-age youth face as they leave the foster system and ways we can help them navigate through their journey
From personal anecdotes to expert strategies, this episode underscores the essence of self-advocacy and education in the foster care system.
Hosts
- Bob Gold, Chief Behavioral Technologist, GoMo Health
- Shelley Schoenfeld, Chief Strategist, GoMo Health
Featured Guests
- Bhavini Solanki, Director, Georgia Families 360°
- Danielle Nabinger, MSW, Child Welfare Consultant
- Angela Smith, Care Coordinator, Amerigroup
Experts:
Thanks for tuning in. Subscribe today to receive alerts of new weekly episodes and follow @GoMoHealth on social for the latest in healthcare engagement.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:05):
Digital technology is the future and I love that it's
the kind of the private orconfidentiality of having it on
my phone.
Speaker 1 (00:14):
The major reason why kids come into care is not for
abuse.
It's for neglect, and most ofthe neglect is due to poverty
and or substance abuse.
Opioid use.
Speaker 3 (00:26):
What I'd like to teach my young people is to
advocate for themselves and takecharge of their own health care
.
Speaker 4 (00:37):
There are times in the world and in life when a
discovery changes how we dothings.
Hi, I'm Shelly Schoenfeld.
Join me and my podcast partner,behavioral technologist Bob
Gold, on this journey ofdiscovery as we unfold a whole
person health delivery sciencefor people in need.
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
(00:58):
Partnership between Amerigroupin Georgia and GOMO Health.
We'll learn at a very granularlevel how the care and service
partnership really comestogether for transition age
youth and the other personsserved before, during and after
child welfare foster careservices are provided.
We'll hear from three dynamicexperts, all sharing their
(01:21):
experiences from the front linesChild welfare consultant for
more than 25 years.
Danielle Nebinger, careCoordinator.
Angela Smith and first upDirector of Georgia Families 360
, bhavini Solanki.
Speaker 2 (01:40):
Care Group is a Medicaid managed care
organization.
We're part of a much largerorganization that has several
Medicaid plans across thecountry, as well as Medicare and
commercial products.
But for Georgia, for Medicaidspecifically, we manage, I think
, a little over 500,000 members,mostly moms and babies over
(02:07):
500,000 members, mostly moms andbabies.
And then we have a separatecontract that we've had the sole
source holder of for kids andchild welfare.
So kids that are part of thefoster care system, as well as
those that have chosen toreceive adoption assistance, so
they've been adopted and chooseto keep Medicaid versus moving
to commercial, and then ahandful of justice-involved
youth as well.
(02:28):
You know, I think themisconception sometimes is that
insurance companies are out tomake money.
The reality is we are the payerfor a certain product or
membership type.
We get a per-member, per-monthpayment and our job for that
payment is to keep them healthy,whether that's making sure
(02:50):
they're going to appointments,they're getting treatments
conducted, they're involved incertain therapies, whatever the
case might be.
So, yes, it benefits us if theyare healthier.
But there's a lot of thingsthat go into that.
There's misconceptions that wedon't want people to go to the
hospital or to the emergencyroom because it's expensive.
(03:11):
Yes, it's expensive and yes,they are not always getting the
care they need at those levelsof facilities.
For example, let's say you'rehaving an asthma attack but it's
controlled enough that youcould go see your primary doctor
or go to an urgent care.
That's a better place for youto go and get treated versus
(03:32):
going to an emergency room andwaiting and not their priority
is going to be gunshot victimsor car accident victims and
things like that, which ends upyou having to wait for a long
time, versus building arelationship with your primary
(03:54):
care doctor and gettingtreatment conducted at that
level.
And they're not set up for thefollow-up Right up.
Those emergency room doctorsare not set up to be your
ongoing doctor and to check onyou and to get to know you and
maybe be even able to spend thetime with you that your primary
care doctor would or an urgentcare doctor would if you were
(04:16):
following up with them.
So we do a lot of education on.
When you're dealing with X,this is where you should go to
get that treated.
Or if you're feeling like Y,here are some options of things
that you could do.
You know, really encouragingpreventative care.
You know, getting those annualcheckups, not just for the
children but for adults as well.
(04:36):
You're going to the eye doctorgetting your eyes checked, make
sure you have the rightprescription glasses, because
that impacts your ability todrive or walk or prevent
accidents as you're walking orfalling or any of those things
that can happen.
And then even you know let'ssay, you have a cancer diagnosis
and you've got medications.
We have case managementprograms that can then help make
(04:58):
sure you're tracking on all thethings that you need to do.
Did you get this home healthperson to come in?
Let me help you connect withthat.
Do you need crutches or awheelchair or whatever it might
be?
Let me help get you set up withthat DME provider to get that
taken care of for you.
Think about if you've ever goneto the hospital for I mean even
for a delivery or for removalof.
(05:19):
I had my gallbladder removed.
At the moment when they giveyou all the follow-up
instructions, I don't know thatI remember any of it.
Thankfully, they give you apiece of paper that I might look
at later on, but the beauty ofthe case manager is that they
also get a copy of that and thenthey can tell you did you go
get your prescription filled?
Did you schedule your follow-upappointment?
Do you need to go to physicaltherapy?
(05:41):
Do you know where to go forthat?
Let me help you with that sothat you almost kind of have a
like an assistant, like anavigator, that helps you
through it, because insurance iscomplicated.
It's complicated.
Maybe they had a great fosterparent who taught them a lot of
life skills.
Maybe they were in a group homewhere they got some of that.
But how much they may have paidattention to that or have
(06:04):
retained it, you know, we knoweverybody's level of attention
is shorter and shorter andshorter, even for adults, not
just kids.
We're all on our phones, we'reall doing all those things and
so simple thing or what we thinkare simple things like how do
you open a checking account?
How do you even write a check?
How do you do bill pay ifyou're not going to get a
(06:26):
checkbook?
What should you look for in arental agreement?
How do I make sure that what Iget in my paycheck is enough to
pay for all the things that Iwant without now starting to
accrue debt at a young age?
How can I plan for a vacation?
You know simple budgetingthings that I know we all wish
that they would teach more of inhigh school and things like
(06:47):
that.
We try to do that for youngpeople, really starting at that
age 14 timeline and allowingthem times to exercise it and
grow that skill set so that whenit's time and they want to be
on their own, they know how todo that with some level of
confidence.
So you know, I think we had arealization that everybody's on
(07:10):
their phones, whether we want toadmit it or not, especially
young people, and so the bestway to engage with them and get
them involved is through theirphone, which makes sense now
that we're talking about it.
And the beauty of the GOMOprogram is that it really is so
(07:31):
specialized to that individual.
It's at the rate that you wantit, it's the information that
you choose to have, theinformation that you choose to
engage in when you want it.
And for anybody learninganything, it is about repetition
and consistency, and I think,specifically for the transition
age youth, that's how they buildtrust.
(07:53):
Is consistency right?
Their engagement with people ispushing buttons to see where is
your breaking point, and onlywhen you can't reach it, then
we've now developed trust, andso it's great because this
program never has a breakingpoint.
We can just keep going withwhere they're going and along
the way they're learning, andmaybe they don't even realize it
(08:14):
and at the end they've builtconfidence and now have a skill
and now are more excited aboutlearning the next thing, because
now they've got one under theirbelt.
So digital technology is thefuture and I think it's great
that they can engage inexercises that help them across
all of their life, whether it'sat work or at school or with
(08:36):
their family, and they'regetting it at the pace that they
want and I love that.
And I love that it's the kindof the private or
confidentiality of having it onmy phone.
We don't have to go to atherapist's office and everybody
knows that I'm in therapy, eventhough there's nothing wrong
with that but I think it allowsthem to have some sense of
(08:59):
control about what they'relearning and what they're
engaging in that nobody elseknows about.
So when a child comes intofoster care, there's a plan
established for them, areunification plan or it's a
permanency plan, and sopermanency is defined by
whatever the judge and otherinvolved people feel is the next
(09:20):
step for that child If theywere removed from biological
parents and the biologicalparents are gonna work a care
plan or treatment plan andthat's where that child is gonna
go back, then they have areunification plan.
If that's not the plan, thenthey have to create a separate
plan for maybe independentliving for that child or
adoption or other options thatmight be available.
(09:41):
So if it's a reunification plan, then that's our opportunity to
engage with that biologicalfamily and give them an
opportunity to address whateverthe issues were that brought
that child into care so thatthey're ready for that child to
be able to return.
That could be parenting skills.
It could be pest problem thatthey have in their home.
(10:05):
It could be that they losttheir job and they're unemployed
and couldn't pay for things.
All of those things can beaddressed in a way that meets
their needs and prepares them toget that child back in their
home, if they're able to.
You know, if that's thesituation that they're available
to do and sometimes it takeslonger, sometimes it doesn't
have to take long that they'reavailable to do and sometimes it
takes longer, sometimes itdoesn't have to take long I
(10:26):
think it really does come downto what resources are available
for them and just bringing themto awareness about those
resources which can bechallenging.
If you don't have a job and youcan't pay for things, then you
may not have internet service tobe able to research things, and
maybe I'm too embarrassed to goto the local crisis center to
(10:47):
ask for help, or whatever thecase might be.
This allows them a way to beable to address what's going on
in their home without thatembarrassment, without judgment,
and gets them to a positiveplace with their child.
I think the biggest realizationI've had is that, at least in
the state of Georgia, our systemof care is huge.
(11:11):
There are a lot of componentsand pieces and parts and because
of that it can get veryconfusing, but also because of
that there's a lot going on, alot of great synergy and work
and people trying to helpfamilies.
Speaker 5 (11:34):
For youth and young adults in and coming out of the
child welfare and foster caresystem.
There's nothing more traumaticthan losing your parents at a
young age and going throughvarious foster homes or foster
parents, adoptive parents,guardians.
So what GOMO does is we provide,in simple one thought at a time
(11:57):
, messaging, various content tohelp them understand how their
voice can matter, that they canmake decisions on their behalf
about school, about where theylive, and help them with basic
needs that they've never beentaught before, that they may be
(12:17):
embarrassed to discuss or talkwith others, how to open up a
bank account, how to cook, whereto go for needed services and,
very important, how they couldadjust and cope, based on the
trauma and stress of whatthey're doing, and tips and
ideas when you go into a newfoster home, foster parents, of
(12:41):
how to mitigate that yourself,and then with your peers who may
not understand what a youth inchild welfare and foster care.
So GOMO asks questions, theyrespond, we personalize the
information to them based ontheir age, gender, circumstances
, situation and if they tell ussomething, it immediately
(13:04):
adjusts to what they're sayingthey need in the moment, because
if you're not helping someonein the moment, they'll have 10
other issues by next week by thetime you can get to them, and
that's where there's costlyhuman adverse events and tolls
all around.
So GOMO's there for them as abuddy and as a nonjudgmental,
(13:28):
transparent way for them tolearn, listen, act and build
their own self-trust andconfidence to make decisions
that have their voice matter.
Speaker 1 (13:44):
My name is Danielle Navinger and I've been at
Amerigroup for a little over 10years.
Nabinger and I've been atAmerigroup for a little over 10
years and for the last 10 yearsI've really helped support the
organization in serving thefoster care, adoption assistance
and juvenile justicepopulations, advising them on
policies and approaches,innovations.
(14:06):
I grew up in New Jersey andlived my whole life there until
in my early 30s I moved toGeorgia and I went to school for
psychology and politicalscience.
Didn't know what I wanted to doand my first job out of college
was I was a case manager fortransitional age youth who were
aging out of foster care.
(14:26):
I ran a group home as well forthat same population for a
couple of years in New Jerseyand since then, last 30, oh my
God, five years, I have been inall sorts of roles in child
welfare, both direct service aswell as administration, a lot of
planning and strategy andinnovation.
(14:49):
My first job out of school wasbeing a case manager for youth
who were transitioning out offoster care and there was
absolutely nothing in schoolthat prepared me for working
with that population.
It was heartbreaking,overwhelming.
It was heartbreaking,overwhelming and an immense
(15:11):
sense of satisfaction andgratitude working with them.
They were encounteringchallenges and issues that, as a
young 20-something person, Icould never have imagined,
having grown up in middle-classfamily in New Jersey.
Day to day, it was definitelyemotionally draining.
(15:33):
You would give so much ofyourself all day long trying to
negotiate the systems that weretrying to help the kids, and
this was in the beginning oftransitional age services.
This is when, in the early 90s,late 80s, when these types of
programs were just becoming areality and so there wasn't a
(15:57):
big blueprint for what to do orhow to do it, there were some
really good ideas about what todo and how to do it, but beyond
that there really wasn't muchout there.
So you know we didn't usecomputers then.
Everything was face to face andyou know, working individually
(16:17):
with young people who had, inmost cases, a lifetime of very
difficult relationships andexperiences.
So trying to both maintain thework that needed to be done,
trying to get them into jobs,develop job skills, finish their
education, support theirrelationships with their natural
(16:42):
family or other family memberswho were involved with them was
very draining, and then to turnaround at the end of the day and
be able to come back refreshthe next day to do it all over
again.
There was a lot of heartbreakand a lot of challenges and a
lot of sadness, but then also alot of victories and happiness
(17:04):
that came along with it.
It definitely took a while forthe different youth to open up
to a new person and you knowit's not any great mystery.
You know it's developed ontrust and you behave the way you
do what you say you're going todo.
You behave the way that you sayyou're going to behave and
(17:26):
that's how trust builds andthat's what I think is essential
.
I think a lot of it has to dowith relationships we were
talking about, like what I usedto do to kind of relax and kind
of be with my family.
I mean, and it makes youdefinitely appreciate more what
you have with your family.
(17:46):
You know, even, as we can sayit may be dysfunctional at times
, it's, you know, a lot betterthan a lot of other people have.
And to understand thoserelationships a lot of these
young people hadn't.
Their families have been inincredible situations that no
one would be envious of and yetthey still want to be with them,
(18:08):
you know.
So understanding that andhelping them to better
understand how to manage that asa young adult who's going to be
on their own and how they canwork through those relationships
to be successful, you know,throughout the rest of their
lives, is really important andyet difficult.
The group home I worked in itwas one of the first ones for
(18:31):
transitional age youth in NewJersey.
It was in Elizabeth, new Jersey.
It was a two apartment home,upstairs, downstairs, and
capacity for six people in eachapartment and there were staff
24-7 who eight hour shifts, whowould be at the home and would
(18:51):
help the people, and it was allgirls Help them learn daily
living skills, cooking, groceryshopping, get them to school,
help them learn how to take thetrains and get to where they
needed to be, go to work, learnbanking and finance and all of
(19:11):
those kinds of things.
It's been 35 years and I stillremember almost all of them and
their names and their situations.
One young woman had cerebralpalsy and her mother had passed
away and she was living with herfather and brothers in
deplorable conditions and shewas brought into foster care, I
(19:34):
think at like the age of sevenor eight or something like that,
and she had pretty significanthealth needs and had a lot of
depression, anxiety thatprevented her from really
managing her own care.
That prevented her from reallymanaging her own care.
And you know, like I said,working with her and working
(19:57):
with the other staff and seeinga therapist, and you know,
trying to carve out some skillbuilding and some dreams, you
know, having a dream or havingsome hope for what her life
could be was just reallyimportant for her.
Another young woman had beeninstitutionalized.
This was during a time when weused to keep kids in
(20:19):
institutions for long periods oftime.
She was developmental anddelayed to the point that she
thought you bought toast at thegrocery store.
I'll never forget that.
That had a huge impact on me.
We went grocery shopping oneday and she asked if she could
(20:42):
get toast, not realizing thatyou just put bread in a toaster
to get toast.
Because she had never doneanything like that for herself.
She had never made herselfbreakfast, she had never made
her own bed, anything like thatfor herself.
She had never made herselfbreakfast, she had never made
her own bed, anything like that.
So you know, how does a person,how do you get a young person
like that to the point where youknow they can live at least
somewhat independently?
You know, and she had no familythat she had been visiting with
(21:06):
that we knew of at the time.
So you know, how do you createa life, or help them create
their lives you know forthemselves, their future for
themselves.
I think the biggest challengethat we have is that many people
don't understand that a systemof care really requires two
different levels.
And we get the one level prettysomewhat okay, and that's the
(21:29):
operational level, like theday-to-day you know, check this
box, do this, do this step.
But there is a second level ofthe vision for the system and
how policy is supposed toreflect values and how the work
should be structured andresourced that I don't think a
(21:51):
lot of people have a vision ofor a frame from which to
understand that and, as a result, I don't think we invest enough
.
We barely have enough to keepthe system going.
We don't invest in people toplan out the strategy or think
through what's the big strategyLike.
(22:13):
For example, if we really didwant no child to leave foster
care without a family, we coulddo it, but there's no one whose
job it is to make sure that thathappens.
You know, we're too worriedabout where they're going to
sleep tonight.
We've talked about before withyou know, kids sleeping nights
in hotels and in child welfareoffices, and not that we
(22:36):
shouldn't be worried about that,because we should be, but
there's no one.
We're worried about that everyday and we're never getting to
think about what is it going totake to make sure no kid leaves
care without a family.
About half of the populationcurrently just in foster care
(22:57):
not on adoption assistance areunder the age of six and about
20% of them will be under theage of one.
The major reason why kids comeinto care is not for abuse, it's
for neglect, and most of theneglect is due to poverty and or
substance abuse, opioid use.
(23:18):
It's a court process, so therehas to be like a warrant from
the courts to remove a childfrom their home, and so then the
Child Welfare Agency has aChild Protective Service team
that will go out, and then thechild welfare agency has a child
protective service team thatwill go out and remove the child
from the home and place them intheir first placement.
(23:39):
Typically there'll be a courthearing within 72 hours to
review the claims and to make adetermination about whether they
stay in care or not.
They develop a visitation plan.
So, again, it's one of thosethings where, as a mother and as
(24:00):
a human, it is justheart-wrenching to imagine a
child of any age being takenfrom you and then being told
that you can only see them oncea week, twice a week, you know,
every other week because they'replacing them somewhere.
(24:21):
You know that's 20 miles, 30miles, 100 miles from where you
currently live, 30 miles, 100miles from where you currently
live.
You may have other children, sothe children may be placed in
separate homes.
So you would have to createvisitation arrangements, you
(24:45):
know, for multiple children,which also is another difficulty
.
It is really difficult becausesome of those things that they
could do it really depends onwhat the real issues were and we
like to, as a system, assignsolutions regardless of what the
real conditions were thatprevented them from being able
to keep their children or notbeing able to keep their
children safe.
(25:05):
Of course, parenting educationis a big.
You'll see it probably onalmost every parent's case plan
that they have to completeparenting education, even though
that may not have anything todo with the reason why the kid
is in care.
They may have raised kids, theymay have successfully raised
(25:26):
kids, it may be because they'reunemployed or they lost their
job or they got evicted orthey're dealing with domestic
violence in the situation.
But a lot of it tends to comeback to concrete resources that
they need in place consistentlyover time.
You know to take care of theirfamily and that becomes really,
(25:52):
really difficult.
It's really difficult whenyou're expected you may have
three children.
You're expected to visit allthree of them every week, keep a
full-time job and, you know,take care of a house and maybe
take care of your ailing motherall at once.
So just imagine having to walkin their shoes for a week a
month a year until they can gettheir kids back.
(26:14):
Oh, and then all the courtdates too.
Well, first off, most kids arenot given up.
Most kids are taken from theirparents and very few will.
It's called voluntary.
It's a voluntary removal, sothey sign that for temporary
reasons.
So it's about 60 to 65 percentof children will go back to
(26:35):
their parents over a period oftime.
The standard largely is under12 months.
There will be kids who will gohome in that 12 to 24 months,
and then the longer a child's incare, the less likely it is
that they will go home.
That's why it's reallyimportant to understand those
(26:56):
cohorts of kids and who the kidsare who are approaching or have
been in care six months so thatyou can, you know, work really
hard to get them back homebefore that 12-month marker.
Children who are in foster careare categorically eligible for
Medicaid.
In Georgia Every kid in fostercare could potentially be
(27:17):
receiving Medicaid.
Potentially.
There are some few exceptionsIf their parents have insurance
other private insurance thatcovers them, then they'll stay
on that as well.
But not every child on Medicaidis in child welfare.
It doesn't work the other way.
We talked earlier about trustand if they do not trust you,
(27:37):
they are not going to.
You know it's bad enough thatyou know my own kids.
You know what I mean Talking tome, let alone someone who's been
through what they've beenthrough, and the people they've
been through who've told themthings that they haven't
followed through on, who don'ttell them things.
That's another big issue is theworld is very unpredictable for
(28:03):
youth in foster care.
There is no definitive answerplan.
You know you may be here today,but that doesn't guarantee that
you're going to be in thatplacement tomorrow for reasons
that have nothing to do withanything that you can control.
So I think that that's a bigpart of it is trying to keep
(28:26):
focused on the long-term goalsand vision and dreams that
you're trying to accomplish forthe youth and the families,
while taking care of theday-to-day to make it actually a
reality, like keeping them instable placements, having
consistency in treatment and inproviders, so they don't have to
(28:51):
retell their story every singletime they change a provider.
You know they can see someprogress in treatment because
they're in it for, you know, onemonth, two months, three months
, rather than after two weekstheir therapist leaves and
they've got to start all overagain they've got to start all
(29:20):
over again.
Speaker 5 (29:20):
So the child welfare and foster care system we need
to get more parents to be fosterparents and adoptive parents
and then we need to retain themin the system and here's how
GOMO is helping on both ends.
We provide, in a simple, easyway, information, resources that
are personalized to questionsthat someone considering being a
(29:42):
foster or adoptive parent, or,once they are a foster or
adoptive parent what to expect,how to deal with youth who's
been through traumaticexperiences, how to talk to your
other children if you have them, activities to build
relationships between all ofthose, what to expect in school
and peer situations.
(30:04):
And they have the ability inthe program to tell us about
their own mental health.
You know, are they havingtrouble sleeping, various mental
stress issues, and we give themtechniques and tools to be able
to deal with that in a private,confidential way which bolsters
(30:24):
their self-perceived ability tomanage their family, live
happier lives and focus on funand engaging activities and
events and having a good,enjoyable time as a foster and
adoptive parent.
Speaker 3 (30:44):
Well, my name is Angela Smith.
I am actually born and raisedhere in Atlanta, georgia.
I'm like a unicorn.
I was raised on the west sideof Atlanta.
I went to school in AtlantaPublic School System.
I'm a mother of four.
I have worked at Amerigroup for10 years now.
So I have been at Amerigroupsince the inception of the
Georgia Families 360 program.
(31:05):
We manage all of the members infoster care, some select members
of juvenile justice and we alsomanage adoption assistance.
I specifically work with ourtransitional age youth.
Those are our members betweenthe ages of 19 to 26.
Some of those members havesigned themselves out of care
and some of those members arestill in care.
In addition to that, I alsomanage several programs within
(31:27):
our department.
I manage our LifeSET program,which is a program that we're
partnered with Youth Villages on.
It's kind of an independentliving skills program, so it
teaches them how to manage theirfinances, their education, and
they're paired with a specialistto help them achieve their
goals stable employment orhousing.
(31:50):
I also manage our flex fundhere at Amerigroup, which is a
fund that we have that helps tosecure housing stability for our
members.
You know a lot of our membersend up homeless, you know, once
they age out of care, a lot ofthe young people, when they're
transitioning out of foster care, a lot of them have no idea
they even have the benefitsavailable.
(32:11):
You know, a lot of our youngpeople become.
They have such a distrust inthe system so when they turn 18,
they decide to sign themselvesout of care so they think they
have no benefits available.
But if they were in foster careon their 18th birthday, they
are eligible for health carebenefits regardless of if they
decided to stay in care or not.
And so that's the biggestbarrier, just the lack of
(32:34):
knowledge.
Well, we do have our LifeSETprogram.
So that is the program thatwe're partnered with Youth
Villages on.
So if we have a young personthat desires to go to college,
they will be paired with theLifeSET specialist that will
help them if they needassistance taking the SAT,
prepping for that, filling outcollege applications, submitting
the FAFSA, prepping for that,filling out college applications
you know submitting the FAFSAand you know preparing for
(32:56):
college, so they're able toassist them all steps, you know,
along the way with that process.
And we also at Amerigroup haveemployment specialists that
specifically do those types ofthings.
They connect with differentpartners, so they have partners
in the community.
They have resume writing, theydo mock interviews with our
youth to prepare them for that,because, as we see, a lot of
(33:18):
young people don't want to go tocollege.
A lot of young people aredeciding to go directly into the
workforce or go to trade school.
So we do have an employmentspecialist that also works with
our members to help them meetthose needs as well or those
goals.
First thing I would say I'm here.
You know I would give them alittle space, but I would just
stay consistent every week,reaching out, letting them know
(33:41):
over and over again the benefitsthat are available to them.
Like, hey, first of all, it'svery important to make sure that
you're getting yourpreventative care.
You know a lot of illnesses canbe cured if they're detected
early.
Just letting them know theimportance of that and the
benefits associated with that.
We do offer monetary rewardsfor going to get your annual
exam, your dental exams, yourvision exam, mammograms.
(34:04):
There are benefits associatedwith that.
You know a lot of times what Inotice with young people if you
give them something, you have tohave something to kind of rule
them in.
So like, hey, we have thisbenefit to offer you, you know,
and it's helpful for you, youknow.
So I have to have that.
And, but most importantly, justsaying I'm here, I'm here for
(34:26):
you, and just constantly makingthat connection, reaching out to
them and eventually, with mostof the young people I have
experienced, they eventuallywill call back when they're in
need.
They will call back and that'show you build that connection
with them.
And so now they know who tocall.
I'm like, hey, I'm having apharmacy issue, or I got a bill
and I don't know what to do withthis, or I do want to go to the
dentist.
Can you help me find one, youknow?
So I do that.
But ultimately, what I like toteach my young people is to
(34:49):
advocate for themselves.
I don't want to do everythingfor them.
I want them to learn to be anadvocate for themselves and take
charge of their own health care.
Speaker 4 (35:02):
Bob.
What an amazing group of people.
I have to salute theircommitment and their awareness
of the challenges and theircontinued perseverance to help
some of our most underservedyouth.
These real-life stories arejust so inspiring and really
give me pause.
What are your takeaways?
Speaker 5 (35:24):
Professionals who go into the child welfare and
foster care system are peoplewho love to help other humans
and who care and you heard thatcome through from Danielle,
vivini and Angela.
But for folks like them andcase managers in the child
welfare system, you're onlyspending limited time actually
with the youth, with the familyand, as we all know, for those
(35:46):
of us who have families andfriends, it takes sometimes a
village, so to speak, to helpand move people.
So what we do to support theprofessionals is GOMO, is their
virtual assistant.
We call GOMO the virtual childwelfare assistant and we're with
(36:06):
their cases and the youth andthe parents who are trying to
get through life 24 by 7.
We're with them in the ups anddowns.
They tell us things and we reactthat they probably wouldn't
necessarily think of to tell achild welfare worker or
professional in the half an hourthey have, because they have 50
(36:27):
things they want to say.
They can't say them all.
But then what GOMO does is weescalate when a person a youth
or an adult in the system tellsus something that could lead to
an adverse event or hasquestions that they need
answered immediately, has issuesaround school or needing a
provider.
So we actually give to theprofessionals impactful
(36:53):
situations in real time thatthey can deal with, because how
do they know who of their manycases are having an issue at any
given time and they love it.
They go into the profession tohelp and we are their virtual
voices that are helping theircases, practice what they're
trying to get them to do andescalating to them, so they
(37:16):
could be very helpful when theyneed to, and that's how change
happens at scale.
Speaker 4 (37:23):
Thanks, bob, and thanks so much Bhavini, Danielle
and Angela for giving us yourinsider's view on this very
important issue.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
engines, including Apple Music,spotify and iHeart Radio.
On behalf of my podcast partner, bob Gold, and myself, thank
(37:47):
you all for listening to thisepisode of Human Resilience
Changing the Way Healthcare isDelivered.
Digital technology is the future and I love that it's
the kind of the private orconfidentiality of having it on
my phone.
Speaker 1 (00:14):
The major reason why kids come into care is not for
abuse.
It's for neglect, and most ofthe neglect is due to poverty
and or substance abuse.
Opioid use.
Speaker 3 (00:26):
What I'd like to teach my young people is to
advocate for themselves and takecharge of their own health care
.
Speaker 4 (00:37):
There are times in the world and in life when a
discovery changes how we dothings.
Hi, I'm Shelly Schoenfeld.
Join me and my podcast partner,behavioral technologist Bob
Gold, on this journey ofdiscovery as we unfold a whole
person health delivery sciencefor people in need.
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
(00:58):
Partnership between Amerigroupin Georgia and GOMO Health.
We'll learn at a very granularlevel how the care and service
partnership really comestogether for transition age
youth and the other personsserved before, during and after
child welfare foster careservices are provided.
We'll hear from three dynamicexperts, all sharing their
(01:21):
experiences from the front linesChild welfare consultant for
more than 25 years.
Danielle Nebinger, careCoordinator.
Angela Smith and first upDirector of Georgia Families 360
, bhavini Solanki.
Speaker 2 (01:40):
Care Group is a Medicaid managed care
organization.
We're part of a much largerorganization that has several
Medicaid plans across thecountry, as well as Medicare and
commercial products.
But for Georgia, for Medicaidspecifically, we manage, I think
, a little over 500,000 members,mostly moms and babies over
(02:07):
500,000 members, mostly moms andbabies.
And then we have a separatecontract that we've had the sole
source holder of for kids andchild welfare.
So kids that are part of thefoster care system, as well as
those that have chosen toreceive adoption assistance, so
they've been adopted and chooseto keep Medicaid versus moving
to commercial, and then ahandful of justice-involved
youth as well.
(02:28):
You know, I think themisconception sometimes is that
insurance companies are out tomake money.
The reality is we are the payerfor a certain product or
membership type.
We get a per-member, per-monthpayment and our job for that
payment is to keep them healthy,whether that's making sure
(02:50):
they're going to appointments,they're getting treatments
conducted, they're involved incertain therapies, whatever the
case might be.
So, yes, it benefits us if theyare healthier.
But there's a lot of thingsthat go into that.
There's misconceptions that wedon't want people to go to the
hospital or to the emergencyroom because it's expensive.
(03:11):
Yes, it's expensive and yes,they are not always getting the
care they need at those levelsof facilities.
For example, let's say you'rehaving an asthma attack but it's
controlled enough that youcould go see your primary doctor
or go to an urgent care.
That's a better place for youto go and get treated versus
(03:32):
going to an emergency room andwaiting and not their priority
is going to be gunshot victimsor car accident victims and
things like that, which ends upyou having to wait for a long
time, versus building arelationship with your primary
(03:54):
care doctor and gettingtreatment conducted at that
level.
And they're not set up for thefollow-up Right up.
Those emergency room doctorsare not set up to be your
ongoing doctor and to check onyou and to get to know you and
maybe be even able to spend thetime with you that your primary
care doctor would or an urgentcare doctor would if you were
(04:16):
following up with them.
So we do a lot of education on.
When you're dealing with X,this is where you should go to
get that treated.
Or if you're feeling like Y,here are some options of things
that you could do.
You know, really encouragingpreventative care.
You know, getting those annualcheckups, not just for the
children but for adults as well.
(04:36):
You're going to the eye doctorgetting your eyes checked, make
sure you have the rightprescription glasses, because
that impacts your ability todrive or walk or prevent
accidents as you're walking orfalling or any of those things
that can happen.
And then even you know let'ssay, you have a cancer diagnosis
and you've got medications.
We have case managementprograms that can then help make
(04:58):
sure you're tracking on all thethings that you need to do.
Did you get this home healthperson to come in?
Let me help you connect withthat.
Do you need crutches or awheelchair or whatever it might
be?
Let me help get you set up withthat DME provider to get that
taken care of for you.
Think about if you've ever goneto the hospital for I mean even
for a delivery or for removalof.
(05:19):
I had my gallbladder removed.
At the moment when they giveyou all the follow-up
instructions, I don't know thatI remember any of it.
Thankfully, they give you apiece of paper that I might look
at later on, but the beauty ofthe case manager is that they
also get a copy of that and thenthey can tell you did you go
get your prescription filled?
Did you schedule your follow-upappointment?
Do you need to go to physicaltherapy?
(05:41):
Do you know where to go forthat?
Let me help you with that sothat you almost kind of have a
like an assistant, like anavigator, that helps you
through it, because insurance iscomplicated.
It's complicated.
Maybe they had a great fosterparent who taught them a lot of
life skills.
Maybe they were in a group homewhere they got some of that.
But how much they may have paidattention to that or have
(06:04):
retained it, you know, we knoweverybody's level of attention
is shorter and shorter andshorter, even for adults, not
just kids.
We're all on our phones, we'reall doing all those things and
so simple thing or what we thinkare simple things like how do
you open a checking account?
How do you even write a check?
How do you do bill pay ifyou're not going to get a
(06:26):
checkbook?
What should you look for in arental agreement?
How do I make sure that what Iget in my paycheck is enough to
pay for all the things that Iwant without now starting to
accrue debt at a young age?
How can I plan for a vacation?
You know simple budgetingthings that I know we all wish
that they would teach more of inhigh school and things like
(06:47):
that.
We try to do that for youngpeople, really starting at that
age 14 timeline and allowingthem times to exercise it and
grow that skill set so that whenit's time and they want to be
on their own, they know how todo that with some level of
confidence.
So you know, I think we had arealization that everybody's on
(07:10):
their phones, whether we want toadmit it or not, especially
young people, and so the bestway to engage with them and get
them involved is through theirphone, which makes sense now
that we're talking about it.
And the beauty of the GOMOprogram is that it really is so
(07:31):
specialized to that individual.
It's at the rate that you wantit, it's the information that
you choose to have, theinformation that you choose to
engage in when you want it.
And for anybody learninganything, it is about repetition
and consistency, and I think,specifically for the transition
age youth, that's how they buildtrust.
(07:53):
Is consistency right?
Their engagement with people ispushing buttons to see where is
your breaking point, and onlywhen you can't reach it, then
we've now developed trust, andso it's great because this
program never has a breakingpoint.
We can just keep going withwhere they're going and along
the way they're learning, andmaybe they don't even realize it
(08:14):
and at the end they've builtconfidence and now have a skill
and now are more excited aboutlearning the next thing, because
now they've got one under theirbelt.
So digital technology is thefuture and I think it's great
that they can engage inexercises that help them across
all of their life, whether it'sat work or at school or with
(08:36):
their family, and they'regetting it at the pace that they
want and I love that.
And I love that it's the kindof the private or
confidentiality of having it onmy phone.
We don't have to go to atherapist's office and everybody
knows that I'm in therapy, eventhough there's nothing wrong
with that but I think it allowsthem to have some sense of
(08:59):
control about what they'relearning and what they're
engaging in that nobody elseknows about.
So when a child comes intofoster care, there's a plan
established for them, areunification plan or it's a
permanency plan, and sopermanency is defined by
whatever the judge and otherinvolved people feel is the next
(09:20):
step for that child If theywere removed from biological
parents and the biologicalparents are gonna work a care
plan or treatment plan andthat's where that child is gonna
go back, then they have areunification plan.
If that's not the plan, thenthey have to create a separate
plan for maybe independentliving for that child or
adoption or other options thatmight be available.
(09:41):
So if it's a reunification plan, then that's our opportunity to
engage with that biologicalfamily and give them an
opportunity to address whateverthe issues were that brought
that child into care so thatthey're ready for that child to
be able to return.
That could be parenting skills.
It could be pest problem thatthey have in their home.
(10:05):
It could be that they losttheir job and they're unemployed
and couldn't pay for things.
All of those things can beaddressed in a way that meets
their needs and prepares them toget that child back in their
home, if they're able to.
You know, if that's thesituation that they're available
to do and sometimes it takeslonger, sometimes it doesn't
have to take long that they'reavailable to do and sometimes it
takes longer, sometimes itdoesn't have to take long I
(10:26):
think it really does come downto what resources are available
for them and just bringing themto awareness about those
resources which can bechallenging.
If you don't have a job and youcan't pay for things, then you
may not have internet service tobe able to research things, and
maybe I'm too embarrassed to goto the local crisis center to
(10:47):
ask for help, or whatever thecase might be.
This allows them a way to beable to address what's going on
in their home without thatembarrassment, without judgment,
and gets them to a positiveplace with their child.
I think the biggest realizationI've had is that, at least in
the state of Georgia, our systemof care is huge.
(11:11):
There are a lot of componentsand pieces and parts and because
of that it can get veryconfusing, but also because of
that there's a lot going on, alot of great synergy and work
and people trying to helpfamilies.
Speaker 5 (11:34):
For youth and young adults in and coming out of the
child welfare and foster caresystem.
There's nothing more traumaticthan losing your parents at a
young age and going throughvarious foster homes or foster
parents, adoptive parents,guardians.
So what GOMO does is we provide,in simple one thought at a time
(11:57):
, messaging, various content tohelp them understand how their
voice can matter, that they canmake decisions on their behalf
about school, about where theylive, and help them with basic
needs that they've never beentaught before, that they may be
(12:17):
embarrassed to discuss or talkwith others, how to open up a
bank account, how to cook, whereto go for needed services and,
very important, how they couldadjust and cope, based on the
trauma and stress of whatthey're doing, and tips and
ideas when you go into a newfoster home, foster parents, of
(12:41):
how to mitigate that yourself,and then with your peers who may
not understand what a youth inchild welfare and foster care.
So GOMO asks questions, theyrespond, we personalize the
information to them based ontheir age, gender, circumstances
, situation and if they tell ussomething, it immediately
(13:04):
adjusts to what they're sayingthey need in the moment, because
if you're not helping someonein the moment, they'll have 10
other issues by next week by thetime you can get to them, and
that's where there's costlyhuman adverse events and tolls
all around.
So GOMO's there for them as abuddy and as a nonjudgmental,
(13:28):
transparent way for them tolearn, listen, act and build
their own self-trust andconfidence to make decisions
that have their voice matter.
Speaker 1 (13:44):
My name is Danielle Navinger and I've been at
Amerigroup for a little over 10years.
Nabinger and I've been atAmerigroup for a little over 10
years and for the last 10 yearsI've really helped support the
organization in serving thefoster care, adoption assistance
and juvenile justicepopulations, advising them on
policies and approaches,innovations.
(14:06):
I grew up in New Jersey andlived my whole life there until
in my early 30s I moved toGeorgia and I went to school for
psychology and politicalscience.
Didn't know what I wanted to doand my first job out of college
was I was a case manager fortransitional age youth who were
aging out of foster care.
(14:26):
I ran a group home as well forthat same population for a
couple of years in New Jerseyand since then, last 30, oh my
God, five years, I have been inall sorts of roles in child
welfare, both direct service aswell as administration, a lot of
planning and strategy andinnovation.
(14:49):
My first job out of school wasbeing a case manager for youth
who were transitioning out offoster care and there was
absolutely nothing in schoolthat prepared me for working
with that population.
It was heartbreaking,overwhelming.
It was heartbreaking,overwhelming and an immense
(15:11):
sense of satisfaction andgratitude working with them.
They were encounteringchallenges and issues that, as a
young 20-something person, Icould never have imagined,
having grown up in middle-classfamily in New Jersey.
Day to day, it was definitelyemotionally draining.
(15:33):
You would give so much ofyourself all day long trying to
negotiate the systems that weretrying to help the kids, and
this was in the beginning oftransitional age services.
This is when, in the early 90s,late 80s, when these types of
programs were just becoming areality and so there wasn't a
(15:57):
big blueprint for what to do orhow to do it, there were some
really good ideas about what todo and how to do it, but beyond
that there really wasn't muchout there.
So you know we didn't usecomputers then.
Everything was face to face andyou know, working individually
(16:17):
with young people who had, inmost cases, a lifetime of very
difficult relationships andexperiences.
So trying to both maintain thework that needed to be done,
trying to get them into jobs,develop job skills, finish their
education, support theirrelationships with their natural
(16:42):
family or other family memberswho were involved with them was
very draining, and then to turnaround at the end of the day and
be able to come back refreshthe next day to do it all over
again.
There was a lot of heartbreakand a lot of challenges and a
lot of sadness, but then also alot of victories and happiness
(17:04):
that came along with it.
It definitely took a while forthe different youth to open up
to a new person and you knowit's not any great mystery.
You know it's developed ontrust and you behave the way you
do what you say you're going todo.
You behave the way that you sayyou're going to behave and
(17:26):
that's how trust builds andthat's what I think is essential
.
I think a lot of it has to dowith relationships we were
talking about, like what I usedto do to kind of relax and kind
of be with my family.
I mean, and it makes youdefinitely appreciate more what
you have with your family.
(17:46):
You know, even, as we can sayit may be dysfunctional at times
, it's, you know, a lot betterthan a lot of other people have.
And to understand thoserelationships a lot of these
young people hadn't.
Their families have been inincredible situations that no
one would be envious of and yetthey still want to be with them,
(18:08):
you know.
So understanding that andhelping them to better
understand how to manage that asa young adult who's going to be
on their own and how they canwork through those relationships
to be successful, you know,throughout the rest of their
lives, is really important andyet difficult.
The group home I worked in itwas one of the first ones for
(18:31):
transitional age youth in NewJersey.
It was in Elizabeth, new Jersey.
It was a two apartment home,upstairs, downstairs, and
capacity for six people in eachapartment and there were staff
24-7 who eight hour shifts, whowould be at the home and would
(18:51):
help the people, and it was allgirls Help them learn daily
living skills, cooking, groceryshopping, get them to school,
help them learn how to take thetrains and get to where they
needed to be, go to work, learnbanking and finance and all of
(19:11):
those kinds of things.
It's been 35 years and I stillremember almost all of them and
their names and their situations.
One young woman had cerebralpalsy and her mother had passed
away and she was living with herfather and brothers in
deplorable conditions and shewas brought into foster care, I
(19:34):
think at like the age of sevenor eight or something like that,
and she had pretty significanthealth needs and had a lot of
depression, anxiety thatprevented her from really
managing her own care.
That prevented her from reallymanaging her own care.
And you know, like I said,working with her and working
(19:57):
with the other staff and seeinga therapist, and you know,
trying to carve out some skillbuilding and some dreams, you
know, having a dream or havingsome hope for what her life
could be was just reallyimportant for her.
Another young woman had beeninstitutionalized.
This was during a time when weused to keep kids in
(20:19):
institutions for long periods oftime.
She was developmental anddelayed to the point that she
thought you bought toast at thegrocery store.
I'll never forget that.
That had a huge impact on me.
We went grocery shopping oneday and she asked if she could
(20:42):
get toast, not realizing thatyou just put bread in a toaster
to get toast.
Because she had never doneanything like that for herself.
She had never made herselfbreakfast, she had never made
her own bed, anything like thatfor herself.
She had never made herselfbreakfast, she had never made
her own bed, anything like that.
So you know, how does a person,how do you get a young person
like that to the point where youknow they can live at least
somewhat independently?
You know, and she had no familythat she had been visiting with
(21:06):
that we knew of at the time.
So you know, how do you createa life, or help them create
their lives you know forthemselves, their future for
themselves.
I think the biggest challengethat we have is that many people
don't understand that a systemof care really requires two
different levels.
And we get the one level prettysomewhat okay, and that's the
(21:29):
operational level, like theday-to-day you know, check this
box, do this, do this step.
But there is a second level ofthe vision for the system and
how policy is supposed toreflect values and how the work
should be structured andresourced that I don't think a
(21:51):
lot of people have a vision ofor a frame from which to
understand that and, as a result, I don't think we invest enough
.
We barely have enough to keepthe system going.
We don't invest in people toplan out the strategy or think
through what's the big strategyLike.
(22:13):
For example, if we really didwant no child to leave foster
care without a family, we coulddo it, but there's no one whose
job it is to make sure that thathappens.
You know, we're too worriedabout where they're going to
sleep tonight.
We've talked about before withyou know, kids sleeping nights
in hotels and in child welfareoffices, and not that we
(22:36):
shouldn't be worried about that,because we should be, but
there's no one.
We're worried about that everyday and we're never getting to
think about what is it going totake to make sure no kid leaves
care without a family.
About half of the populationcurrently just in foster care
(22:57):
not on adoption assistance areunder the age of six and about
20% of them will be under theage of one.
The major reason why kids comeinto care is not for abuse, it's
for neglect, and most of theneglect is due to poverty and or
substance abuse, opioid use.
(23:18):
It's a court process, so therehas to be like a warrant from
the courts to remove a childfrom their home, and so then the
Child Welfare Agency has aChild Protective Service team
that will go out, and then thechild welfare agency has a child
protective service team thatwill go out and remove the child
from the home and place them intheir first placement.
(23:39):
Typically there'll be a courthearing within 72 hours to
review the claims and to make adetermination about whether they
stay in care or not.
They develop a visitation plan.
So, again, it's one of thosethings where, as a mother and as
(24:00):
a human, it is justheart-wrenching to imagine a
child of any age being takenfrom you and then being told
that you can only see them oncea week, twice a week, you know,
every other week because they'replacing them somewhere.
(24:21):
You know that's 20 miles, 30miles, 100 miles from where you
currently live, 30 miles, 100miles from where you currently
live.
You may have other children, sothe children may be placed in
separate homes.
So you would have to createvisitation arrangements, you
(24:45):
know, for multiple children,which also is another difficulty
.
It is really difficult becausesome of those things that they
could do it really depends onwhat the real issues were and we
like to, as a system, assignsolutions regardless of what the
real conditions were thatprevented them from being able
to keep their children or notbeing able to keep their
children safe.
(25:05):
Of course, parenting educationis a big.
You'll see it probably onalmost every parent's case plan
that they have to completeparenting education, even though
that may not have anything todo with the reason why the kid
is in care.
They may have raised kids, theymay have successfully raised
(25:26):
kids, it may be because they'reunemployed or they lost their
job or they got evicted orthey're dealing with domestic
violence in the situation.
But a lot of it tends to comeback to concrete resources that
they need in place consistentlyover time.
You know to take care of theirfamily and that becomes really,
(25:52):
really difficult.
It's really difficult whenyou're expected you may have
three children.
You're expected to visit allthree of them every week, keep a
full-time job and, you know,take care of a house and maybe
take care of your ailing motherall at once.
So just imagine having to walkin their shoes for a week a
month a year until they can gettheir kids back.
(26:14):
Oh, and then all the courtdates too.
Well, first off, most kids arenot given up.
Most kids are taken from theirparents and very few will.
It's called voluntary.
It's a voluntary removal, sothey sign that for temporary
reasons.
So it's about 60 to 65 percentof children will go back to
(26:35):
their parents over a period oftime.
The standard largely is under12 months.
There will be kids who will gohome in that 12 to 24 months,
and then the longer a child's incare, the less likely it is
that they will go home.
That's why it's reallyimportant to understand those
(26:56):
cohorts of kids and who the kidsare who are approaching or have
been in care six months so thatyou can, you know, work really
hard to get them back homebefore that 12-month marker.
Children who are in foster careare categorically eligible for
Medicaid.
In Georgia Every kid in fostercare could potentially be
(27:17):
receiving Medicaid.
Potentially.
There are some few exceptionsIf their parents have insurance
other private insurance thatcovers them, then they'll stay
on that as well.
But not every child on Medicaidis in child welfare.
It doesn't work the other way.
We talked earlier about trustand if they do not trust you,
(27:37):
they are not going to.
You know it's bad enough thatyou know my own kids.
You know what I mean Talking tome, let alone someone who's been
through what they've beenthrough, and the people they've
been through who've told themthings that they haven't
followed through on, who don'ttell them things.
That's another big issue is theworld is very unpredictable for
(28:03):
youth in foster care.
There is no definitive answerplan.
You know you may be here today,but that doesn't guarantee that
you're going to be in thatplacement tomorrow for reasons
that have nothing to do withanything that you can control.
So I think that that's a bigpart of it is trying to keep
(28:26):
focused on the long-term goalsand vision and dreams that
you're trying to accomplish forthe youth and the families,
while taking care of theday-to-day to make it actually a
reality, like keeping them instable placements, having
consistency in treatment and inproviders, so they don't have to
(28:51):
retell their story every singletime they change a provider.
You know they can see someprogress in treatment because
they're in it for, you know, onemonth, two months, three months
, rather than after two weekstheir therapist leaves and
they've got to start all overagain they've got to start all
(29:20):
over again.
Speaker 5 (29:20):
So the child welfare and foster care system we need
to get more parents to be fosterparents and adoptive parents
and then we need to retain themin the system and here's how
GOMO is helping on both ends.
We provide, in a simple, easyway, information, resources that
are personalized to questionsthat someone considering being a
(29:42):
foster or adoptive parent, or,once they are a foster or
adoptive parent what to expect,how to deal with youth who's
been through traumaticexperiences, how to talk to your
other children if you have them, activities to build
relationships between all ofthose, what to expect in school
and peer situations.
(30:04):
And they have the ability inthe program to tell us about
their own mental health.
You know, are they havingtrouble sleeping, various mental
stress issues, and we give themtechniques and tools to be able
to deal with that in a private,confidential way which bolsters
(30:24):
their self-perceived ability tomanage their family, live
happier lives and focus on funand engaging activities and
events and having a good,enjoyable time as a foster and
adoptive parent.
Speaker 3 (30:44):
Well, my name is Angela Smith.
I am actually born and raisedhere in Atlanta, georgia.
I'm like a unicorn.
I was raised on the west sideof Atlanta.
I went to school in AtlantaPublic School System.
I'm a mother of four.
I have worked at Amerigroup for10 years now.
So I have been at Amerigroupsince the inception of the
Georgia Families 360 program.
(31:05):
We manage all of the members infoster care, some select members
of juvenile justice and we alsomanage adoption assistance.
I specifically work with ourtransitional age youth.
Those are our members betweenthe ages of 19 to 26.
Some of those members havesigned themselves out of care
and some of those members arestill in care.
In addition to that, I alsomanage several programs within
(31:27):
our department.
I manage our LifeSET program,which is a program that we're
partnered with Youth Villages on.
It's kind of an independentliving skills program, so it
teaches them how to manage theirfinances, their education, and
they're paired with a specialistto help them achieve their
goals stable employment orhousing.
(31:50):
I also manage our flex fundhere at Amerigroup, which is a
fund that we have that helps tosecure housing stability for our
members.
You know a lot of our membersend up homeless, you know, once
they age out of care, a lot ofthe young people, when they're
transitioning out of foster care, a lot of them have no idea
they even have the benefitsavailable.
(32:11):
You know, a lot of our youngpeople become.
They have such a distrust inthe system so when they turn 18,
they decide to sign themselvesout of care so they think they
have no benefits available.
But if they were in foster careon their 18th birthday, they
are eligible for health carebenefits regardless of if they
decided to stay in care or not.
And so that's the biggestbarrier, just the lack of
(32:34):
knowledge.
Well, we do have our LifeSETprogram.
So that is the program thatwe're partnered with Youth
Villages on.
So if we have a young personthat desires to go to college,
they will be paired with theLifeSET specialist that will
help them if they needassistance taking the SAT,
prepping for that, filling outcollege applications, submitting
the FAFSA, prepping for that,filling out college applications
you know submitting the FAFSAand you know preparing for
(32:56):
college, so they're able toassist them all steps, you know,
along the way with that process.
And we also at Amerigroup haveemployment specialists that
specifically do those types ofthings.
They connect with differentpartners, so they have partners
in the community.
They have resume writing, theydo mock interviews with our
youth to prepare them for that,because, as we see, a lot of
(33:18):
young people don't want to go tocollege.
A lot of young people aredeciding to go directly into the
workforce or go to trade school.
So we do have an employmentspecialist that also works with
our members to help them meetthose needs as well or those
goals.
First thing I would say I'm here.
You know I would give them alittle space, but I would just
stay consistent every week,reaching out, letting them know
(33:41):
over and over again the benefitsthat are available to them.
Like, hey, first of all, it'svery important to make sure that
you're getting yourpreventative care.
You know a lot of illnesses canbe cured if they're detected
early.
Just letting them know theimportance of that and the
benefits associated with that.
We do offer monetary rewardsfor going to get your annual
exam, your dental exams, yourvision exam, mammograms.
(34:04):
There are benefits associatedwith that.
You know a lot of times what Inotice with young people if you
give them something, you have tohave something to kind of rule
them in.
So like, hey, we have thisbenefit to offer you, you know,
and it's helpful for you, youknow.
So I have to have that.
And, but most importantly, justsaying I'm here, I'm here for
(34:26):
you, and just constantly makingthat connection, reaching out to
them and eventually, with mostof the young people I have
experienced, they eventuallywill call back when they're in
need.
They will call back and that'show you build that connection
with them.
And so now they know who tocall.
I'm like, hey, I'm having apharmacy issue, or I got a bill
and I don't know what to do withthis, or I do want to go to the
dentist.
Can you help me find one, youknow?
So I do that.
But ultimately, what I like toteach my young people is to
(34:49):
advocate for themselves.
I don't want to do everythingfor them.
I want them to learn to be anadvocate for themselves and take
charge of their own health care.
Speaker 4 (35:02):
Bob.
What an amazing group of people.
I have to salute theircommitment and their awareness
of the challenges and theircontinued perseverance to help
some of our most underservedyouth.
These real-life stories arejust so inspiring and really
give me pause.
What are your takeaways?
Speaker 5 (35:24):
Professionals who go into the child welfare and
foster care system are peoplewho love to help other humans
and who care and you heard thatcome through from Danielle,
vivini and Angela.
But for folks like them andcase managers in the child
welfare system, you're onlyspending limited time actually
with the youth, with the familyand, as we all know, for those
(35:46):
of us who have families andfriends, it takes sometimes a
village, so to speak, to helpand move people.
So what we do to support theprofessionals is GOMO, is their
virtual assistant.
We call GOMO the virtual childwelfare assistant and we're with
(36:06):
their cases and the youth andthe parents who are trying to
get through life 24 by 7.
We're with them in the ups anddowns.
They tell us things and we reactthat they probably wouldn't
necessarily think of to tell achild welfare worker or
professional in the half an hourthey have, because they have 50
(36:27):
things they want to say.
They can't say them all.
But then what GOMO does is weescalate when a person a youth
or an adult in the system tellsus something that could lead to
an adverse event or hasquestions that they need
answered immediately, has issuesaround school or needing a
provider.
So we actually give to theprofessionals impactful
(36:53):
situations in real time thatthey can deal with, because how
do they know who of their manycases are having an issue at any
given time and they love it.
They go into the profession tohelp and we are their virtual
voices that are helping theircases, practice what they're
trying to get them to do andescalating to them, so they
(37:16):
could be very helpful when theyneed to, and that's how change
happens at scale.
Speaker 4 (37:23):
Thanks, bob, and thanks so much Bhavini, Danielle
and Angela for giving us yourinsider's view on this very
important issue.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
engines, including Apple Music,spotify and iHeart Radio.
On behalf of my podcast partner, bob Gold, and myself, thank
(37:47):
you all for listening to thisepisode of Human Resilience
Changing the Way Healthcare isDelivered.
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