Expanded Access
Coalition Meeting
January 27,
2004, 9:30-11:30 a.m., OHP Central Processing
MINUTES
Attending:
Sandy Wood (OMAP)
Linda Herman (Clackamas County Health Dept)
Marcy Sugarman (Multnomah County Health Dept)
Mary Ann Holser (Lane County Democrats)
Laura Brennan (DHS)
Tom Holser (Lane County Democrats)
Tina Kotek (Children First for Oregon)
Kristen Saxton (Outside In)
Rhonda Walker (OHAP/LC-CKF Coalition)
Wendy VanElverdinghe (CADO)
Katie Gautier (Oregonians for Health Security)
Joy Soares (CareOregon)
LoriAnn Sheridan (OHAP)
Jere High (VGMHC)
Ellen Pinney (OHAP)
Jennie Hamilton (OPCA)
Tim Miller (OHAP)
Michele Wallace (OHP Processing Center)
Kelly Harms (IPGB)
Liz Baxter (OHPR)
Nicola Pinson
I. Call To
Order & Introductions: Jennie
called the meeting to order at 9:49 a.m. Following
introductions, Ellen reviewed the handouts.
Jennie asked the EAC if they would be receptive to meeting 10:00-12:00 at
future meetings. With the exception
of the February meeting, all EAC meetings will begin at 10:00 a.m.
II. Oregon Health Plan
& Ballot Measure 30 Update/Advocacy Response:
Jennie asked for advocates to share their experiences with BM 30.
Mary Ann told the EAC members the Lane County Democrats were running a
phone bank. Katie informed the
group that 19,000 people received a mailing from Oregonians for Health Security,
and they’re also running a phone bank. She
stressed the need for increased activity before February 3rd,
especially towards the low-income population.
Jennie indicated people in Multnomah County are concerned with how the
measure affects the approved county tax. Tina
explained the county is looking at issuing a partial refund if the measure
passes. She stressed the need to write opinion/editorial pieces for
the newspapers. LoriAnn said she
received a guest opinion column in The News Guard in Lincoln City, addressing
the impact of BM 30.
Jennie
said the Oregon Primary Care Association is involved with voter registration
drives and engaging the OEW’s in this effort.
Ellen told the group OHAC had sent out a large mailing to all the clients
who have utilized the Health Helpline. She
explained that people who have moved within Oregon, and have voted in the last
six years, could still register to vote up to election day.
She addressed the MB30 Alert flyer, which is being distributed.
Laura said the hospital association was on NPR this morning, saying if
the measure fails, premiums will increase.
Ellen
suggested that there should be a meeting a week after the election with state
administrators to discuss next steps. She asked if there were any groups already
planning to do this in an effort to coordinate efforts.
Tina expressed interest in participating in the meetings, suggesting we
try to reinstate the cigarette tax in support of OHP.
Marcy, Linda and Wendy indicated they would be interested in
participating in the meetings.
Presented
later in meeting due to late arrival – Joy gave an update on what CareOregon
was doing to address BM30. They
sent information to 85,000 current and former CareOregon members as well as to
3,000 providers. Focus has been on
the impact of the uninsured. They
have calculated that dropping 88,0000 individuals from OHP will cost the insured
approximately $100/year. They have
been doing phone banking, addressing the unintended consequences and did a graph
for the Oregonian, illustrating the $300 million in lost Federal match.
III. Report on the progress of the
Committee on Outreach, Enrollment and Retention agreements
- Laura briefly explained the makeup of COER, adding their next meeting
is February 24 following EAC.
A. Development of concept of Sponsoring Organizations to
facilitate premium payments. Laura
explained they are currently trying to create a legal and viable framework so
entities may evolve to pay premiums on behalf of OHP clients.
They have received OMAP’s criteria and the Attorney General’s legal
issues, and are currently fleshing out premium sponsorship organizations.
Ellen pointed out that there is nothing
illegal about paying premiums for clients on an individual basis.
She added that the premium
sponsorship committee is asking the state for information, by county, on
disenrollments due to failure to pay premiums.
Rhonda pointed out they are still
having problems with the billing office, even when payments are sent in 10 days
early. Tom said he had to drive up
from Eugene to Portland to pay his premium.
He added he was told on the phone when he called Earhart, he was told not
to waste his time if he could not get his premium payment in by 5:00 p.m. on the
deadline date. He tried for weeks
to get through over the phone, and they explained they are only allowed so many
phone lines. Marcie addressed
various ways to raise funds to support premium payments.
For example, Multnomah County sold cookbooks to raise funds.
B.
Simplification and availability of OHP application
– Sandy informed the EAC that the watermark on the OHP application on-line has
been removed. Unfortunately, the
addendum is not on-line and is required to accompany the application when sent
in. She will look into getting it
posted online. She indicated the committee, which is working on the new
application, would be meeting the first or second week in February to discuss
the recommended changes, and the new application will be available in April
regardless of what happens with BM30. Ellen
asked if there will be links on the website for advice on completing the
application. Sandy said she would
have staff work on that. Sandy
explained the composition of the committee, including state staff, Marcy
Sugarman, Tim Miller, LoriAnn Sheridan, Ellen Pinney and OEW’s.
Tina shared her concern about forms being buried on the OMAP website, asking if the link could be on the front page. Sandy explained that OMAP is the only department of DHS, which has two form sites on the web. Jennie addressed the question on the application pertaining to TANF, suggesting that if OHP goes away, TANF is a way to keep people covered. Sandy explained they are required to screen for TANF and other programs, and if someone qualifies for TANF, they are referred to that department.
C.
Date Stamps for project sites and new FQHC’s
– Jennie told the EAC this is in the works.
IV. Medical ID Cards -
Sandy said OMAP is looking at changing the medical identification card to
make it more readable. A student
intern is working on it, and they may remove the requirement for social security
numbers. They will also be looking
into the prospect of a swipe card in the future when they have the technology to
support it.
V. Supporting Families Collaborative – LoriAnn told the EAC she is working closely with Michele Wallace at OHP Central Processing and the pilot site, Community Health Center in Medford, on the pending issue with the goal to reduce pends by 15%. She indicated the primary reasons for pends is lack of signature, insufficient income verification and lack of the addendum. They will be utilized an application checklist to facilitate their efforts and Michele is tracking the pends. She added they had a site visit by the Robert Wood Johnson Foundation last week in Medford, and they were pleased with the activities pursued to address the pend issue.
Ellen added that when an applicant puts down zero revenue, that’s a red flag for pending. She and Linda explained that although there is a small space to address revenue, the applicant needs to write a separate statement to attach to application explaining how they live (e.g., how may cans they collect). Tim asked if there is only one signature, but two parents in the household, does the application get pended. The answer is yes – all parents must sign the application.
VI. Governor’s Priority (Children) & Survey Results – Ellen addressed the survey she had sent out to EAC members, of which 17 were returned with responses. Liz said she will be putting together a steering committee to address the priorities, and will research what other states are doing in these areas. She pointed out that the top four items chosen as priorities included the following:
Outreach
– Item #4 - Every community based organization, every medical office, and
every state office that provides any kind
of service to the working poor and / or other low income Oregonians needs
to informed about and have
easy access to simple information about the availability of Oregon Health
Plan (CHIP) program, income guidelines, and how to get applications and
application assistance.
Coordination – Item #19
- Parents who owe past dues premiums should receive clear, accessible
information in their bills that their children owe no premiums and remain
enrolled even when parents cannot pay their premiums. - Sandy pointed out this
has already taken place and she will bring a copy of the letter to the next EAC
meeting.
Policy – Item #25 - One-year continuous enrollment
Policy – Item # 28 - Reduce or eliminate the six-month
uninsurance waiting requirement for children.
Joy Soares pointed out parents without insurance are
less likely to take their children to the doctor, so focus on getting parents
insured is important. Marcie shared
Multnomah County’s experience with doing referrals from school nurses.
The EAC briefly discussed school outreach, and Ellen suggested this
effort could be simplified if the Governor would talk with the Superintendent of
Education on the importance of insuring kids.
Marcie said Multnomah County asked the school district to send
information out with school materials. Ellen
shared what Washington was doing by including a box at the bottom of the free
lunch letter, asking that it be checked if the parents do not want to be called
about health insurance. She pointed
out it requires a strong collaboration between Medicaid, OEWs and the schools.
Kristen questioned why adults cannot get the six-moth uninsurance eliminated. Kelly explained it’s not in the waiver. Jennie elaborated on this issue – when CHIP was rolled out, each state did their own thing and some chose the waiting period because they feared the woodwork effect. Laura added the Federal government is concerned with employers dropping dependent coverage, resulting in crowd out. Ellen said they will be looking at other states with three-month uninsurance and one year enrollment to learn from them.
Tina suggested looking at remarketing OHP, removing the stigma attached to it. She suggested looking at the opportunities and costs of doing that. In regards to the OHP application on the website, which is accessible to anyone, Marcie shared her concern that community outreach is critical since many people do not have access to a computer. Ellen suggested eliminating item #14 (on-line application) from the priorities at this time.
Individuals expressing an interest in serving on the steering committee included Ellen Pinney, Jennie Hamilton, Tina Kotek, and Linda Herman. They will work with Liz Baxter on the top priorities.
VII. OHP/SCHIP/FHIAP Enrollment Numbers – Michele told the EAC they are 49 days out at processing applications at this time. She explained that lack of staff during December contributed to this delay in processing. She explained they are looking for temporary staff, but it takes 90 days before they’re ready to process applications efficiently. They spent January in training to ensure pends are happening for the right reasons. She pointed out at the pilot site for the Supporting Families Collaborative, 83% of the pends were for insufficient proof of income and 20% for lack of signatures. She stressed as long as the applications are signed, they won’t get pended. At this time, OHP Central Processing is working Saturdays and attempting to process 1,000 each Saturday. Priorities are pregnant women, emergencies and reapplications.
Kelly told the EAC FHIAP has 6,000 approved and enrolled to date. 47% are insured through employers. There is no wait for group coverage, however, there are 12,000 people on the wait list for individual coverage.
VIII. Surveys & Research – Ellen referred attendees to visit the Oregon Health Policy & Research website for the latest information from surveys they have done. The website is at www.ohppr.state.or.us.
IX. Announcements & Adjournment
A. Next
meeting: February 24,
9:45-11:30 a.m., DHS Parkway Bldg., Upstairs, Room 6
Note:
Limited parking; overflow at Fred Meyer across the street
B. Adjournment:
11:30 a.m.
Handouts:
OMAP Medically Eligibles Data (Nov & Dec 2003) BM 30 Action Alert
OMAP Medically Eligibles Data Sheet (Dec. 2002-Dec. 2003) OHP Standard Medically Eligibles Data
Legislative Interim Committee Information Memo from Jean Thorne – Potential Budget Cuts
OHP Quarterly Report (July-Sept. 2003) EAS Survey
Key Principles & Facts on DHS Proposed Disappropriation Plan
EAC
Minutes 012704-Draft.doc
Recorded by LoriAnn Sheridan, OHAP