OREGON HEALTH ACCESS PROJECT
Expanded Access
Coalition Meeting
July 27, 2004,
10:05-12:00 p.m., OHP Central Processing
MINUTES
Attending:
Linda Herman (Clackamas County Health Dept)
Kaaren Driscoll (OHSU)
Rhonda Walker (OHAP/LC-CKF Coalition)
Peggy LaCombe (Native American Rehab)
Katie Gauthier (Oregonians for Health Security)
Ellen Pinney (OHAP)
LoriAnn Sheridan (OHAP-CKF)
Carolyn Ross (DHS-CAF)
Stacy Hall (Outside In)
Celia Maysles (Outside In)
Tom Holser (OHAC-CHALC)
Maryann Holser (OHAC-CHALC)
Kevin McAndrews (PeaceHealth)
Allana McDonald (Rep. Mitch Greenleck)
Terra Chapek (Oregon Health News)
Isabel Cardenas (NWHS West Salem Clinic)
Jeanne Campos (CHC-Riverstone)
Eewyn R. Orledi (CHC-Safe & Sound)
Kelly Harms (IPGB)
Karen House (OHP Central)
I. Call To
Order & Introductions – Stacy Hall called the meeting to order at
10:05 a.m. Ellen Pinney gave a
brief background on Covering Kids & Families (CKF).
Introductions followed.
II. Governor’s
Kids Proposals: - Ellen
addressed the Governor’s Children’s Charter and the three-part initiative he
recently released: (1) raising the
assets test for CHIP to $10,000, in alignment with FHIAP; (2) creation of two
pilot sites (Lincoln & Hood River counties) to promote kids outreach; and
(3) a kids insurance product by IPGB. Carolyn
Ross added they wish to get the pilot programs rolling by September 1 and the
assets test increase will go into effect October 1.
She explained they did extensive analysis on the counties before
determining which to pursue as pilots. Michele
Wallace and Carolyn will serve as the CAF representatives for the project.
She addressed the stakeholders meeting they had last Thursday, stressing
the need to work with schools to reach kids.
Through their analyses, they found there are 250 kids in Hood River
County and 1200 kids in Lincoln County on food stamps, however, do not receive
Medicaid. They will be doing
further studies on eligibilities.
Carolyn explained DHS must get the first reports into the governor by
December 1. They will be doing data
match with the school lunch programs as well as checking into linking the
program to Medicaid. A committee
will create publications for distribution, and they’re working closely with
the Department of Education. She
added they will be pulling together stakeholders to design tools to facilitate
SCHIP enrollment. Ellen asked if
forms will be created to reach parents. Carolyn
explained each county will come up with their own outreach strategies.
She added they want all applications from the pilots processed at OHP
Central.
Ellen asked about the interim versus new application. Carolyn explained they are almost ready to send out to
committee, and the application will be posted on-line as well as printed.
She added they are training 60 people/day and will continue using the
4157 food stamp application as well as the old OHP application.
Linda Herman asked if there will be trainings on the new application. Carolyn said she would look into when trainings will take
place. She explained the new
application is much simpler, and will be in Spanish and Russian.
They have opened a hotline to answer questions. She added they have lost
60 staff since last year at OHP Central, and last night, transferred 30,000
cases to branches.
Linda
suggested they have contact people at the branches.
Ellen shared her concern that there is the potential for disenrollments
due to the transfer of cases to field offices.
Carolyn suggested people call OHP Central for assistance.
Karen House gave the phone numbers for contacting them:
1-800-699-9075. Their
internal phone number, not for clients is 503-378-2701 and the number for
clients to call is 503-378-2666. Carolyn
gave her phone number, 503-945-6074, for anyone to call with questions.
Carolyn said OHP Central received loads of applications datestamped June
30 with no signatures, and they have 30 days to process these. Ellen requested receiving branch office contacts.
Kelly
Harms addressed the new insurance plans under IPGB.
She explained the legislature directed IPGB to come up with a
public-private insurance plan, a no mandate plan, to include a children’s plan
for small businesses. They had
focus groups and the plan was well accepted.
She will send LoriAnn the summary sheet to distribute.
They are matching the kids program with a new low-wage workers product.
The kids program will not be tied to federal poverty level (FPL).
If the business does not have health insurance, there is no income level
limit. They are hoping to roll out
the programs the first of the year 2005. She
explained the adults program is similar to catastrophic plans, and they added
back women’s health care to the plan. The cost to employers is low, and premium levels are 30-50%
lower than market rates. Premiums
for kids range from $80-100. Those
who participate in the new adult plan are not eligible for FHIAP subsidies.
She stressed that FHIAP cannot implement the 200% FPL until CHIP is able
to. She further explained FHIAP
must meet maintenance of effort by the feds, and it’s a good option to put OHP
Standard people into FHIAP.
Kelly
told the EAC FHIAP no longer has a waiting list for the individual market and
marketing staff will be doing outreach to partners and issuing PSAs soon. To receive an application, the number to call is
1-888-564-9669. She addressed the
conditions: six-month uninsurance
unless coming off OHP Standard, $10,000 assets test, 185% FPL, and applicants
must reapply annually. She
explained FHIAP covers a large population under 100% FPL.
Rhonda
Walker questioned when the FPL will be reduced for OHP Standard clients.
Ellen said OMAP has pulled this idea off the table temporarily.
Karen said they are currently in a “wait and see” mode.
She added that Jim Edge has said the hospital provider tax has not been
approved by CMS yet. Ellen asked
Kelly to ensure the FHIAP marketing staff address SCHIP in their outreach
efforts. Kelly said they are
working with OHP to ensure they have updated information.
Ellen shared her concern there is little incentive for agents to promote
SCHIP. Kelly said they will offer
SCHIP as an opt out. Ellen asked
about the employer survey. Kelly
explained they have not worked on that yet.
III. Enrollment Numbers -
A. FHIAP – Kelly said they currently have 6,611 individuals enrolled in FHIAP, 3,652 in group and 2,959 in the
individual market. There are currently 1,391 individual applications under review and there are some not enrolling once accepted. 13,099 applications are outstanding and a total of 2,110 applications under review. She further explained almost half of the group enrollment are kids.
B. OHP – Karen said they are currently enrolling 51,000 OHP Standard enrollees into the dental plan. According to the OMAP Medically Eligibles data, there are currently 53,503 enrollees in OHP Standard, 19,871 in SCHIP, and a total of 361,736 Medicaid enrollees.
IV. Updates -
A. Coverage Concerns – Kaaren Driscoll expressed concerns about limitations to coverage on heart and liver
complications. There was a brief discussion on this issue. Linda questioned the definition of emergency. Ellen questioned the significant dip in CHIP enrollments. LoriAnn suggested it was due to public perceptions when Measure 30 failed.
B. Premium Sponsorships – Ellen told the EAC the Oregon Association of Hospitals & Health Systems
(OAHHS) was successful in covering the $6 premiums for OHP clients this month. Kaaren said it cost approximately $60,000 and the priority is to cover the most vulnerable clients with 0-10% FPL. They are hoping the Emergency Board drops the $6 premium for these clients. She added the goal is to continue this coverage through December, however, the problem is if they are going to cover the $6 premiums, they must pay for everyone’s $6 premium in the state. She, then, addressed the various strategies the premium sponsorship committee is currently working on. Ellen added the Union Gospel Mission in Salem is interested in helping as a sponsor. She pointed out the end product needs to be clients proactively applying for coverage.
C. OHP Workgroup – Ellen said Bruce Goldberg is serving on this workgroup. Katie Gauthier added there is a small group from the Health Policy Committee as well as stakeholders involved.
D. Health Policy Commission – Katie explained this started this year to look at long and short-term goals, broken down into workgroups: access - to primary care, cost – cost drivers, quality – technology and electronics, and health status – tobacco & obesity.
E. Local Pilots – Rhonda addressed the Lincoln County CKF coalition efforts. They are currently strategizing how to outreach to kids not in the school system. 1,200 flyers were distributed with lunch boxes at the local food pantry. They will also be participating in an enrollment week for the back-to-school efforts. Ellen pointed out date stamps are not permitted to be taken out of the office, and hopefully, this rule can be removed from the outreach contracts. Stacy addressed activities at Outside In, serving homeless youth. Celia expressed concern that OHP Central will only allow them to deal with three clients at a time. Karen said she would check into that. Celia added the reapplications every six months is a barrier for homeless youth. A brief discussion ensued on the proof of income requirements relative to homeless people. Linda said her office has created a “self-employment” form for them to use to address monies clients raise through various effoirts (e.g., pan handling, cans).
V. Announcements & Adjournment
A. Next
meeting: August 24, 10:00-12:00
p.m., DHS Parkway Bldg., Upstairs, Room 6
Note: Limited
parking; overflow at Fred Meyer across the street
B. Adjournment:
12:00 p.m.
Handouts:
OMAP Medically Eligibles Data (June 2004) OHP Standard Medically Eligibles Data (May 2004)
June 22, 2004 EAC minutes OHP SCHIP Enrollment graph May 2004
IPGB Certified Plan Implementation Update OHP Standard Eligibles graph May 2004
EAC
Minutes-072704.doc
Recorded by LoriAnn Sheridan, OHAP