Orthodontic Grants Now Available through Sunshine Health/CBCIH My Healthy Child Reinvestment Fund
Date: 02/03/23
Orlando, Florida
This February, in honor of National Children’s Dental Health Month, Sunshine Health and Community Based Care Integrated Health (CBCIH) are pleased to announce that the My Healthy Child Reinvestment Fund has allocated an additional $50,000 to address gaps in healthcare services available to youth in foster care.
Sunshine Health and CBCIH are partners in the Sunshine Health Child Welfare Specialty Plan, which serves youth in, or adopted from, the state’s child welfare system.
Since 2017, more than 100 Florida children and teens in foster care have benefitted from the fund, which covers costs associated with orthodontic care deemed not medically necessary. Recognizing the immense benefit of this program for the children enrolled in the Child Welfare Specialty Plan (CWSP), additional funds are now available for 2023.
As in prior years, funds will be distributed via a grant application process managed by the CBC Nurse Care Coordinators affiliated with each of the state’s child welfare lead agencies.
Who is eligible?
To qualify for a grant:
- Child or youth requiring orthodontic services must be currently enrolled in the Sunshine Health Child Welfare Specialty Plan (CWSP).
- Orthodontic services must have been recommended by the enrollee’s treating provider.
- Request for orthodontic services must have been submitted to a Medicaid dental plan with all the required documentation (as outlined in the 2018 Florida Medicaid Dental Services Coverage Policy) within the last twelve months and denied based on medical necessity criteria.
- A Medicaid Dental provider must have provided a written cost estimate for orthodontic services.
How to Apply
All My Healthy Child grant requests must be submitted by a CBC Nurse Care Coordinator on behalf of an eligible child or teen. Requests will not be considered unless all the required documents are submitted with the application. Incomplete applications will not be considered or held for future review.
To complete the grant application, go to: www.cbcih.net/funding
The following information and documentation is required to be submitted with the grant application:
- Enrollee’s Medicaid ID number*
- Copy of Adverse Benefit Determination (denial)stating that requested services are not medically necessary and the date of denial for orthodontia services*
- Copy of signed Orthodontia Provider Attestation*
- Copy of cost estimate and payment terms from Medicaid orthodontia provider*
*Required Document
Questions? grants@cbcih.com
Please note: Complete requests, with all required documents, will be reviewed in order received. Up to $50,000 is available through the My Healthy Child Grant Fund in the current distribution cycle. Once the funds have been allocated, no additional grants will be available until, and if, the fund is replenished.
Please note: With this release, priority will be given to areas of the state previously underserved by this fund, including those served by these lead agencies: Brevard Family Partnership, Children’s Network Hillsborough, Children’s Network of SW Florida, FSS North Florida, FSS Suncoast, Kids Central Inc., Kids First of Florida, NW Florida Health Network, and Partnership for Strong Families.
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About Sunshine Health
Headquartered in Broward County and with offices across the state, Sunshine Health is among the largest healthcare plans in Florida. Offering coordinated care and a network of support for our members, Sunshine Health is transforming the health of the community, one person at a time. Sunshine Health is a wholly owned subsidiary of Centene Corporation, a diversified, multi-national healthcare enterprise. We offer government- sponsored managed care through Medicaid, Long Term Care, the Health Insurance Marketplace (Ambetter), and Medicare Advantage and Prescription Drug Plans (Wellcare). Our specialty plans include the Child Welfare Specialty Plan serving children in or adopted from the state's Child Welfare system; the Serious Mental Illness Specialty Plan for people living with serious mental illness; and the Children's Medical Services Health Plan, operated by Sunshine Health on behalf of the Florida Department of Health for children and adolescents with special healthcare needs.
For more information, visit SunshineHealth.com or follow us on Facebook and Twitter @SunHealthFL.
About Community Based Care Integrated Healthcare (CBC Integrated Health) LLC
Headquartered in Orlando, CBC Integrated Health is a venture operated in partnership with Embrace Families Inc. and 15 additional community-based care lead agencies in Florida. CBC Integrated Health delivers critical coordination between the Florida Medicaid Sunshine Health Child Welfare Specialty Plan, service providers, and the child welfare clients directly served by the lead agencies throughout the state of Florida.
About the Child Welfare Specialty Plan Reinvestment Fund
The Child Welfare Specialty Plan Reinvestment Fund was created in 2017 by the partners of the Sunshine Health Child Welfare Specialty Plan, Sunshine Health and Community Based Care Integrated Health (CBC Integrated Health). The specialty health plan is a Florida Medicaid Managed Medical Assistance Program designed to provide services to Florida Medicaid-eligible children under the age of 21 years who have an open case in the Florida Safe Families Network (FSFN) and Florida Medicaid-eligible children who have been adopted through the state's child welfare system and are receiving a state adoption subsidy. The Child Welfare Specialty Plan is administered by the Florida Agency for Health Care Administration (AHCA), which contracts with Sunshine Health to serve this specialty population. Sunshine Health sub-contracts with Community Based Care Integrated Health (CBCIH) to perform critical functions of the Child Welfare Specialty Plan.
The Fund is designed to proactively address the need to increase system capacity, bolster the provider network and fill needs not covered by Medicaid. To date, the Fund has invested over $1.7 million to strengthen the state's child welfare system, including $300,000 dedicated to providing orthodontic services for youth in foster care. The Fund is managed on behalf of the partners by Embrace Families Foundation, Inc.