When the President signed the Patient Protection and Affordable Care Act (P.L. 111-148) on March 23, 2010 to force major overhauls of the healthcare system, the law also amended three sections of Titles IV-B and IV-E of the Social Security Act.  Administration for Children and Families (ACF) released on June 7 a Program Instruction (ACYF-CB-PI-10-10) outlining how the amended sections now ensure that children receiving independent living services and/or education and training vouchers and those youth aging out of foster care have sufficient information about the importance of having a health care power of attorney or health care proxy and the option to execute such a document if desired.

The Fostering Connections to Success and Increasing Adoptions Act of 2008 amended sections related to health care coordination for foster children and the case review system for developing a personalized transition plan for youth aging out of care.   The new legislation requires that the Health Care Oversight and Coordination Plan (specified in Fostering Connections) incorporate in the aging out youth’s transition plan the new requirements, including an option for health insurance, information about health care power of attorney or health care proxy required under state law.  In addition, a new certification is required from the Chief Executive Officer of the State or Leader of the Tribe that affirms that education is provided to the aging out or emancipated youth on the importance of designating an individual to participate in health care decisions when the youth might be incapable of making decisions.

The effective date for these revisions is October 1, 2010.  An amendment to the State or Tribe’s Title IV-E State Plan is required no later than December 31, 2010.  As states are preparing the Annual Progress and Services Report (APSR) for the June 30, 2010 deadline, incorporated changes and modifications to current policies are required and may be part of the update.