OREGON HEALTH ACCESS PROJECT
Expanded Access
Coalition Meeting
September 28,
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)
Sandy Wood (OMAP)
Ellen Pinney (OHAP)
Marcy Sugarman (MCHD)
LoriAnn Sheridan (OHAP-CKF)
Carolyn Ross (DHS-CAF)
Stacy Hall (Outside In)
Karen Berkowitz (OLC)
Eewyn R. Orleck (CHC-Safe & Sound)
Yutonah Bowes (Silverton Hospital)
Kathy McGriff (NARA)
Elsi Elkins (Outreach Clackamas)
Carol Simila (OR Insurance Division)
Michele Wallace (DHS-CAF)
Heather Simmons (MWVCAA Head Start)
I. Call To
Order & Introductions – Ellen Pinney called the meeting to order at
10:05 a.m., giving a brief background on Covering Kids & Families (CKF).
Introductions followed.
II. Governor’s
Kids Proposals -
A. SCHIP Assets Test Increase – Ellen informed everyone the assets test for SCHIP will be increased to $10,000 from the current $5,000 on October 1, bring it into alignment with FHIAP assets limitation.
B. Kid
Care Initiative - Sandy Wood addressed the Kid Care initiative taking place
in two pilot counties, Hood River County and Lincoln County with the primary
focus on outreach to kids. She
explained Lincoln County was chosen because CKF was active there and Hood River
County was chosen due to the high population of Hispanics and people facing
barriers to health care. Beyond
outreach, Kid Care will also be looking at retention efforts.
She pointed out they did not get information into the school packets due
to the timing of Kid Care beginning September 1, however, they have sent
brochures to the schools and letters to parents.
She added OMAP was surprised at how active the communities already are
relative to outreach activities. They
provided Hood River County rack cards for distribution to reach people.
She stressed the importance of working with the schools, and is pleased
the clinics are going into the schools. She
added Rene DuBois, of DHS in Hood River, stated they are very excited about the
initiative.
Eowyn Orleck asked about taking applications out to the people.
Sandy explained the outreach policy was taken to the OMAP executive
staff, and they were receptive to allowing the date stamp to be taken off site
for the two counties during this initiative.
She also explained outreach workers can bring applications back to their
offices to date stamp on the same day. Marcie
Sugarman addressed what Multnomah County ESD did in mailing 17,000 flyers that
the health department provided them and it was a successful effort.
She will send LoriAnn the results.
Rhonda Walker addressed the back-to-school enrollment efforts in Lincoln
County, with the health department helping staff the schools during the
enrollment week. CKF engaged the
parents by providing slips the parents could fill out, requesting information on
health insurance, and CKF staff and volunteers followed up, contacting them –
45 people were unable to be reached, 45 were interested in FHIAP, and 90 were
interested in OHP/SCHIP. She added
one of the challenges was that the state worker that was assisting with calls
would not address FHIAP because she claimed the information was already included
in the OHP application packet.
Ellen asked if the revenue can be found, if the state will use best
practices to go statewide with the Kid Care effort.
Sandy stated the Kid Care goal is to get the word out to see what works
best and use pilots to look at retention and barriers to reapplications.
Rhonda stated the biggest barrier in Lincoln County has been the school
district. Ellen asked Marcie about
Multnomah County’s effort to include a box on the free and reduced lunch
application, indicating where or not the parent is interested in learning about
public health insurance programs. Marcie
said they did this,as well as distributed flyers to that regard.
LoriAnn Sheridan stated the school lunch program in Lincoln County sends
out 6,000 menus monthly, and the coordinator is willing to include information
on public health insurance programs for kids.
Linda Herman said, in Clackamas County, they use state brochures stamped
with local contact information.
Sandy pointed out the Kid Care initiative is unfounded. She added they chose not to include the Federal Poverty Level
information in the brochures because they do not want to screen out anyone who
may qualify for a state assistance program.
One of the challenges in Hood River is the significant amount of
undocumented children, who do qualify for emergency care under CAWEM.
C. IPGB Children’s Product – Ellen stated the kid’s private insurance package will be rolling out in January. This program will only cover dependent children.
III. Updates:
A. New
OHP Applications - Ellen addressed the downloadable applications and asked
about the status of the new application, which she understands will not be
available until November1. Sandy
stated the new application is at the printers.
Ellen reminded everyone there will be an OPCA/EAC application assistance
and best practices meeting on October 20 at SEIU, 26th and Powell in
Portland. She added Kelly Harms is
no longer with FHIAP and is now a DHS legislative liaison.
Sandy indicated Nancy Horn will be doing an application training the
afternoon of October 20, 1:30-3:30 p.m. on the new application.
Carolyn Ross pointed out the field offices are using the 415F application
for TANF, food stamps and Medicaid, while OHP Central is using the 7210 Medicaid
only application. 60% of cases are
in the field offices and 40% are at OHP Central.
She explained that with workload shifting, the field offices want one
application, preferably the 415F. They
are also looking at using the 7210 to reduce pends. As food stamp manager, she is responsible for the 415F and is
looking at redoing it, but it may be longer.
She will be forming a new workgroup to look at it.
She added there is money for the state exchange program, and is looking
into what Kansas, Utah, Minnesota and Pennsylvania are doing with their
applications. She will be trying to make application interactive online with
signature inclusion.
Stacy Hall said many of the homeless they work with have access to
computers at the libraries and also have their own email addresses. Sandy said before January, they will be looking at the
instructions to the application. Carolyn
added they will be looking a systems as well.
Ellen said the OCPP Alignment survey will be coming in November.
B. OHP Standard Update – Michele Wallace explained DHS must give CMS 60 days notice if they wish to change the FPL coverage limits for OHP Standard. She guestimates they will have an idea by the caseload on October 10-12 on what they may need to do. Carolyn stated they have not been seeing a drop by attrition, and may have to look at lowering the FPL if things don’t change in the next week. She added the CAF policy group will be looking at lowering the FPL, will take recommendations to Lynn Read, the DHS Cabinet, the Governor’s policy group, then to CMS. She pointed out it was legislatively mandated that OHP Standard enrollment be reduced to 24,000, not how to get there. Once FPL has been reduced, they will be dropping people during the redetermination period, so this will happen through a period of transition. Sandy added OMAP will be sending out a client notice once a decision is made.
C. E-Board & Premiums - Ellen stated Dr. Jeanine Smith from Oregon Health Policy and Research, gave a good presentation to the E-Board on premiums, and she understands OMAP will be addressing the November E-Board.
D. Premium Sponsorship - Carol Simila asked why people were dropping off. Ellen addressed the premium issue and the workgroup involved with ensuring premiums are paid on time. Carol added it is too bad the legislature is at cross purposes with the premium group. Carolyn added a lot of clients not qualified for OHP Standard are going to TANF. Ellen said she hopes they can continue paying premiums through January, expressing her concerns that William Earhart receives $3.11 for each premium paid. She encouraged everyone to write letters to Gary Weeks and Lynn Read, encouraging them to drop premiums for people at 0-10% FPL. Michele pointed out the tremendous outreach efforts in June increased the forecasting numbers significantly. Carolyn added 5,000 people were dropped September 1.
E. General Assistance – Karen Berkowitz addressed General Assistance (GA) and pre-SSI programs, pointing out they are not filling 1,100 slots and she’s concerned GA may be cut again. Sandy said Nancy Talbot deals with presumptive Medicaid and GA, suggesting they invite her to attend the next meeting.
F. Lawsuits – Ellen stated the Oregon Law Center won the lawsuit on co-pays, however the state and feds are appealing at this time. Karen added OLC is filing a counter-suit on premiums and the medically needy suit is sitting on council now. Marcie brought up her concerns about William Earhart and their accountability. She said she has seen people pay premiums six months in advance and be kicked off for failure to pay.
G. OHP Workgroup – Ellen stated the OHP Workgroup has completed their work and the results should be out soon. She added she was invited to a meeting for advocates on October 13, 1:00-3:00 p.m. in Hearing Room 343 at the Capital to participate on a panel. Results will go to the Health Policy Commission. She added there are some legislators on the workgroup.
H. Health Policy Commission – LoriAnn said she and Rhonda Walker attended the meeting in Newport, and the one issue that was of primary concern to all attending was health care access. Rhonda added there were over 20 people attending, representing advocates, community members, media and health organizations. The four key areas discussed with solutions recommended include cost, access, quality and improving health.
I. SCHIP Status – Ellen gave an urgent appeal to encourage Senators Wyden and Smith to support the SCHIP reauthorization bill. Federal match for every state dollar is $2.74 for SCHIP. She pointed out in 2001, there was $7.7 million left over and in 2003, there was $37.6 million unused.
J. Health Value Survey – Ellen stated Dr. Jeanine Smith, OHPPR, is doing a children’s access survey along with the Health Value Survey. Sandy stated this is a good tool for Kid Care and the article is posted on the OHPPR website.
K. Families USA Report – Ellen stated Families USA just released a new report today on the costs of health care. She added the Health Helpline has been getting a lot of calls from reporters seeking information on charity care. The Legislature will be encouraged to put charity care in statute.
L. Medicare Modernization Act – Sandy addressed the prescription card, which has not been saving consumers money. She added there are currently 181 seniors on the senior drug program. In January 2006, Part D of the act will roll out. DHS comments are that with dual eligibles no longer getting FFP for drugs, the feds need regulations for transition. They want to make sure regulations provide good access for people in institutions. Unfortunately, the definition of institution is limited.
IV. Announcements & Adjournment
A. Next
meeting: October
26, 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 (July 2004)
OHP Standard Medically Eligibles Data (August 2004)
July 27, 2004 EAC minutes
FHIAP Snapshot of Program Activity (9/20/04)
EAC
Minutes-092804.doc
Recorded by LoriAnn Sheridan, OHAP