Expanded Access
Coalition Meeting
December 2,
2003, 9:30-12:30 a.m., OHP Central Processing
MINUTES
Attending:
Sandy Wood (OMAP)
Linda Herman (Clackamas County Health Dept)
Marcy Sugarman (Multnomah County Health Dept)
Matt Reed (Our Oregon Coalition)
Laura Brennan (DHS)
Robert Gassner (National Psoriasis Foundation)
Sheila Kirk (NARA)
Beth Kapsch (Children First for Oregon)
Lela Buser (NARA)
Shari Ehara (OHSU)
Robert Judge (Wellpartner)
Debbie Lamberger (OHSU)
Rhonda Walker (OHAP/LC-CKF Coalition)
Kaaren Driscoll (OHSU)
Katie Gautnier (Oregonians for Health Security)
Joy Soares (CareOregon)
LoriAnn Sheridan (OHAP)
Jere High (VGMHC)
Ellen Pinney (OHAP)
Yuleni Rodriguez (OHAC)
Jennie Hamilton (OPCA)
Ileana Henriguez (YVFWC)
Elena Gainy (YVFWC)
Melinda Barboza (Salud Medical Center)
Tim Miller (OHAP)
Ernestina Martinez (Salud Medical Center)
Michele Wallace (OHP Processing Center)
Nancy
Rudolf (OMAP)
Carol Simila (Oregon Insurance Div.)
Kelly Harms (IPGB)
Karen Normandin (OAHHS)
Kevin McAndrews (PeaceHealth)
Liz Baxter (OHPR)
Alma Hernandez (Tuality Healthcare)
Virginia Andraile (Tuality Healthcare)
Vickie Trevino (TCH)
Kristi Jamison (Central City Concern)
I. Call To
Order & Introductions: Jennie
called the meeting to order at 9:45 a.m. Following
introductions, Jennie reviewed the handouts.
I.
OHP waiver, CMS, & Revenue Referral Update: Kelly Harms explained the waiver continues to be under review
by CMS, and she has no idea when it will be approved. Jennie explained the referendum, which will be taken to the
voters for a February 3rd vote.
She stressed the importance of engaging people, getting people registered
to vote, and distributing flyers in the clinics to educate consumers.
Ellen Pinney reviewed components of the temporary tax increase, which
piggybacking off a bill that continued the 10cent cigarette tax.
She pointed out if ballot measure 30 fails, the longstanding 10cent
cigarette tax which supports OHP would be eliminated along with
proposed new tax increases and elimination of tax exemptions / deductions
I.
Matt
Reed, from Our Oregon Coalition, the coalition taking the lead on organizing
support of BM30, explained that the campaign
will highlight local impacts and putting a face on the people who are
impacted. He added school districts
are a key focus audience. Joy
Soares added that in addition to local emphasis, another message which rings
well with voters is the unpredictability and instability that would be created
by a no vote and focusing on seniors, with less focus on OHP. Matt explained DHS stopped sending out voter registration
forms due to the added expense. He
handed out the new guidelines for voter registration and briefly explained the
Help America Vote Act (HAVA). He
pointed out the last day to get voter registrations in for the February vote is
January 13, and ballots will be mailed out January 16-20.
He stressed the importance of grassroots efforts to get people to vote in
February since the tax opponents were successful in securing 147,000 signatures,
ensuring measure 30 will be on the ballot.
Ellen explained that if clinics, hospitals or other social service
agencies send in voter registration forms on behalf of
clients who turn them in on site, people newly registering to vote do not
have to provide identification, whereas if the registration is mailed in, they
are required to include proof of their name and address.
Tim Miller suggested hosting community forums to educate people.
Concerns were expressed relative to policy prohibiting expression of
opinions on ballot measures. It was
suggested that education on impacts need not violate that provision. Education
could merely focus on the results of a YES vote and the results of a NO vote
without specifying which way to vote. Jennie
is looking into how best to protect clinics that wish to be proactive.
Joy suggested that if the media contacts anyone, they should connect with
Our Oregon Coalition to ensure a consistent message. They would also appreciate contacts of people who would be
impacted by the failure of the measure to use for the campaign.
Kelly suggested putting together a fact sheet
with the basic message from the coalition for use in letters to the
editor.
PLEASE LOG ONTO THE FOLLOWING
WEBSITES FOR MORE INFORMATION, FLYERS AND FACT SHEETS ABOUT BM30 AND ITS IMPACTS
ON OREGONIANS:
§
OurOregonCoalition.com
§
oregoniansforhealthsecurity.org
III. Committee
on Outreach, Enrollment & Retention (COER) Update–
Laura Brennan explained COER is comprised of ˝ community stakeholders
and state stakeholders, meeting
quarterly to address Covering Kids & Families issues.
a.
Sponsorship Organizations – Laura explained they are working on developing
the concept of sponsorship organizations at the community level to pay premiums
on behalf of consumers. Liz Baxter
explained OMAP is adamant about ending this practice by January, however, will
be flexible if there’s a community-based model in place to provide for
sponsorship organizations. Nancy
Rudolf said OMAP is working on criteria in an effort to avoid jeopardizing the
process and agency. Liz explained
one of the concerns is where the money is coming from.
Jennie added that someone contacted the Oregon Attorney General’s
office with concerns about provider sponsored premium support being in violation
of federal anti-kickback rules.
b.
Simplication – Michele Wallace said an Application Work Group is working to
streamline the application at this time, and the policy people at CAF are
working on the application. Ellen
added they are also trying to have the watermark removed from the OHP
application on OMAP’s website. Jenny
suggested simplifying access to the OHP applications on the website in other
languages.
Rhonda
Walker expressed concern about the cumbersome 17-page application a client was
required to complete to move from OHP Standard to OHP Plus.
It was explained that if an individual is disabled, there is additional
information needed to ensure they receive all services available to them.
Michele explained that field offices seek to get as much information as
they can, while OHP Central only deals with the financial eligibility issues.
There are also a significant amount of questions that are federally
required to determine disability. She
added they receive 700-800 applications for OHP Standard each month and have 90
days to process them. At this time,
they are backlogged with applications. She
pointed out the main reason of pends is lack of the green form, asking about
disabilities and commented that this problem will be resolved with the new
application. In response to a
question on reciprocity, Michele explained the programs are so different,
requiring different information so it’s not possible without an extensive
application covering all questions needed.
c.
Date Stamps – Ellen told the EAC that only limited number of date stamps are
available throughout the state and
two trained people must be at each site certified for datestamps.
Two Covering Kids and Families projects are attempting to become
certified as date stamp sites – Lincoln County Covering Kids and Families and
and Community Health Center in Medford.
d.
Premium checks by phone – Nancy R. explained that William Earhart is
willing to accept checks by phone if there is no fee involved.
§ Governor’s Priority-Children – Laura told the EAC that the Governor has publicly committed to making children a priority including the enrollment and retention of Oregon children in SCHIP / OHP. That he created the Children’s Charter, which is a great opportunity to get children insured. Ellen pointed out that between September 2002 and September 2003, SCHIP enrollment remained stagnant despite the need and larger pool of eligible children. Liz addressed the 2002 Uninsured Report, focusing on the 50,000 uninsured children, most of whom qualify for coverage. Tim questioned if undocumented children are included in the statistics. Liz explained figures are based on Census information.
Rhonda pointed out one barrier to increasing enrollment in SCHIP is the language that is used. A parent who has heard about the SCHIP program calls the OHP phone number (which is in answered by a prison inmate) and is told about OHP, not SCHIP. While Oregon’s SCHIP program in in fact an expansion of OHP, other states that have similar expansions have made greater headway in enrolling children by using language that draws out the difference (and increased income eligibility) for children. Laura explained the Office of Health Policy & Research is working with the Governor’s office to simplify the enrollment process and there are opportunities to change eligibility.
Jennie gave a few examples of what other communities are doing. In Klamath Falls, large ads are placed in the local newspaper. Clinics are screening for both OHP and SCHIP. In Medford, the school districts have a referral system. She suggested targeting ESL teachers and school nurses through individual outreach efforts. Marcy Sugarman told the EAC about the brochure Multnomah County Health Department created since the state publications get out-of-date. They also include updated information on their website.
Kelly suggested having clinic directors invite local legislators to their clinics to show them the faces of OHP clients and the services they receive. Jennie said the OPCA is working on getting policy liaisons in the clinics at this time.
Liz explained the Governor has created an opportunity, and is looking to do something not done before. She added we do not talk about children’s health care well and need to describe health care without the welfare model. Jennie told the EAC the OPCA did a televised video two years ago and had a 350% increase in calls. She stressed the need for repetition of a consistent message. Joy suggested the focus be on the family, not just the kids, since uninsured parents are unlikely to take their children to the doctor. Ellen pointed out there is a 72˘ on the dollar from the feds for SCHIP and 60˘ for OHP. Also, one of the federal requirements for SCHIP is screening for other programs.
§ Problems & Solutions – Ellen shared a list of problems and solutions, which EAC had previously identified, soliciting additional suggestions from the EAC in attendance – listed below:
a. Problem – Lack of Awareness
Solutions:
1. Call SCHIP
2. Link outreach, education & information distribution to school lunch program and food stamps.
3. Hosting an Outreach and Enrollment Application Day twice a year
4. Social marketing – be the norm to have health coverage
5. Simple information on OHP & SCHIP in clinics.
6. Create list of CBO’s who need information (update regularly)
7. Applications easily accessible.
b. Problem – Complexity of Application
Solutions:
1. Simplify applications.
2. Enhance and enforce date stamps.
3. Provide $$ to support eligibility workers & providers.
4. Develop Internet application.
5. One-year continuous enrollment.
6. Simple 6-month application
7. Create simple children’s application.
c. Coordination
1. Cross-fertilization of information about/across programs.
2. People on FHIAP wait list should receive information of SCHIP.
3. Premium bills should indicate children don’t pay premiums.
4. Uniform assets test for kids @ $10,000
5. Elimination of six-month wait period
6. Governor’s support of universal health care for kids.
The following items were listed on the white board, illustrating suggestions from EAC attendees:
Next Steps – Jennie pointed out the list is too long to
effectively be addressed. She asked
that attendees list their three top priorities once they receive the list via
email and Ellen will work with Liz to determine what can realistically happen.
§ Update on Medically Needy Program – Sandy Wood told the EAC the new discount cards start in April, and the new Medicare program begins January 2006 without meds. She pointed out they cannot implement the new MEDS program until the waiver is approved by CMS, and it will be on a first come, first serve basis, with a cap of 6,000 enrollees.
§ FHIAP Enrollment – Kelly addressed the current numbers of FHIAP enrollment: 2,526 approved & enrolled in group coverage; 3,313 enrolled in individual coverage; 800 approved and in the process of enrollment; 1,978 kids are enrolled; and 3,861 adults enrolled; and there are 13,000 on the reservation list with a one-year wait period. She added they are currently doing an employer survey through the Lewin Group, which will survey employer attitude toward health coverage, what their benefits are, and qualifying employment hours, etc.
§ Videos – EAC viewed two videos from FHIAP and OPCA.
§ Lunch & OHP Central Processing Tours
§ Announcements & Adjournment – 12:30 p.m.
a. Next meeting: January
27, 9:30-11:30 a.m., DHS Parkway Bldg., Upstairs, Room 6
Note:
Limited parking; overflow at Fred Meyer across the street
b. Adjournment: 12:30 a.m.
Handouts:
OMAP Medically Eligibles Data (October 2003) COER Request List to Lynn Read
OMAP Medically Eligibles Data Sheet (Sept. 2002-Sept. 2003) OHP Standard Medically Eligibles Data
Washington State’s Financial Sponsor Program Multnomah County Managed Care Stats
Remarks by Governor Ted Kulongoski OPCA Call for Mobilization on Referendum
Oregonians for Health Security budget alert flyers October EAC Minutes
Voter Registration in Oregon flyer Original 1994 OHP application
EAC
Minutes 120203-EPc
Recorded by LoriAnn Sheridan, OHAP