Tuesday, 1 April 2003 Conference Planning Next Meeting: March 2004 Present: Sue Uyehara, Angie Tam Sing, Mary Rydell, Ruth Ota, Dee Helber, Barbara Luksch, Linda Colburn, and Jacqueline Rose 1. Prior to our meeting, the Planning Committee agreed to host Malama i na Keiki 4 on June 6. This date does not conflict with any major event targeting the same audience (outreach workers, outstationed eligibility workers, and Med-QUEST supervisors). 2. Barbara distributed a draft schedule and we reviewed the details. Due to interisland travel difficulties using Hawaiian Airline G coupons, we will start the conference earlier and end earlier. Some Y coupons will be available for those who cannot get G flights. For Molokai and Lanai participants, Barbara will research Island Air coupons. 3. Our goal: Working together we will find, enroll, and retain all eligible children and youth in public health insurance. 4. Highlights will include: * Lillian Koller, new DHS director, will give the welcome address and May Akamine, Executive Director, Kalihi-Palama Health Center, will be the featured speaker on "Hawaii's Health Disparities and the Uninsured." * Workshops on completing Med-QUEST's new application and reapplication forms led by Med-QUEST supervisors. It was suggested that common mistakes be highlighted so outreach workers and outstationed eligibility workers can ensure the application is complete before it is submitted to Med-QUEST. * Sanuk activities, poolside buffet lunch, and afternoon presentation by television anchor Kim Gennaula. As a new parent, she will share her insights on having a baby and concerns about his health. * Afternoon training on active listening, problem-solving, and working on solutions to barriers by facilitator Linda Colburn. * A resource table for participants to bring informational materials to share. 5. It was suggested we emphasize retention in the training workshops because it is a serious problem. We conduct great outreach activities, enroll children and youth, and after one year their cases are often closed. We are particularly concerned with kids who are dropped due to "failure to provide information." 6. Barbara will email committee members a registration form with conference information to disseminate to their staff and partner organizations. Neighbor Island participants must make flight reservations immediately. 7. Hawaii Covering Kids secured funding from two organizations to train outreach workers statewide to help parents and guardians complete Med-QUEST's application and reapplication forms. This will be helpful those who cannot attend Malama i na Keiki 4. The Training and Public Education Task Force will meet in July to outline a curriculum for these community workshops. Tuesday, 28 April 2003 Process Simplification Task Force Next meeting: October 2003 Present: Lillian Koller, Joanna Fong, Laverne Cox, James Chen, Momi Sonognini, Mary Rydell, Eiko Cusick, Yukie Chang, Ruth Ota, Gus Maratita, Joette Manning, Gwen Ouye-Nakama, Barbara Luksch, Kristell Corpuz, and Linda Colburn. 1. Lillian Koller welcomed everyone to the meeting and discussed her department's emphasis on simplifying the application process and retaining eligible customers in QUEST and Medicaid. She stressed that they are entitlement programs and Med-QUEST's budget should not drive eligibility policies and procedures toward hindering enrollment. Lillian emphasized other cost containment measures to keep expenditures within limits. 2. Barbara explained the outreach, enrollment, simplification, and retention goals of Hawaii Covering Kids and the task force's responsibilities (details are at http://www.coveringkids.com/about/taskforce_procsimp.asp). She reviewed the project's process simplification efforts the past four years, including a matrix handout, barriers and solutions list, and focus group studies. 3. We discussed two upcoming forums with outreach workers: Malama i na Keiki 4 on June 6 and community training workshops beginning in August. * Whose Voices Can Contribute to Overall Simplification? The Hawai'i Uninsured Project is conducting major quantitative and qualitative research. However, specific to our needs we should invite staff from public housing units, hospitals, homeless shelters, outstationed eligibility workers, and outreach workers interacting with families. We should also meet with Med-QUEST eligibility workers. * What Questions Should We Raise with These Constituencies? a.) What rules get in the way of enrolling and retaining eligible children and youth? b.) How do we identify children and youth who are eligible but not enrolled? c.) How do we enroll children and youth at sites where they are identified? * Other Issues: a.) Unnecessarily requiring absent parent reporting. b.) Outdated Hawai'i Administrative Rules. Lillian insists the state eliminate excess rules while retaining minimum requirements to successfully access federal funding. c.) Values of eligibility workers in the system--what is important to their jobs, performance incentives, and public service attitudes. Use the dialogues to bring clarity to DHS's philosophy and mission. 4.) Consistent messages. It doesn't matter whom a customer talks to, she or he should get the same, correct, and current answer in a respectful, friendly, and caring manner. 4. Lillian introduced the members to the department's new deputy director, Henry Oliva. Community groups who encounter Med-QUEST barriers should contact him at henryoliva@hawaii.gov or 586-4999. Wednesday, 7 May 2003 Application Simplification Workgroup Present: Jeffrey Young, Liane Hiramoto, Eiko Cusick, Barbara Luksch, Lillian Koller, and Cassandra Stewart Next meeting: 2 June 2003 at 3:00 PM The purpose of the meeting was to discuss a children and pregnant women application with the new DHS director. It will eliminate six unnecessary questions and be more customer-friendly for these target populations. 1. Med-QUEST administrators were concerned that other eligibility groups will request a separate application. We reviewed questions needed for ABD (aged, blind, disabled), nursing home recipients, and adults ages 19 to 64. They must complete all questions on the current 1100 application. 2. It is not discriminatory against a particular group because blind and disabled children, youth, and pregnant women can be enrolled with the separate form. 3. The question on absent parent can be eliminated. This is a huge barrier currently preventing guardians and single parents from applying for health insurance for their children. 4. Pregnancy verification should be in question 2A. Eiko inquired if certified nurse midwives or lay midwives could sign this section--Barbara will check with CMS. 5. We will continue researching the acceptance of faxed signatures without an original application. 6. A draft will be rewritten for discussion at the next meeting. It will be field tested through the Hawaii Covering Kids Local Projects in Kahuku and on Kauai. We also thanked Lillian for preventing the complex and intimidating HIPAA handout from being printed on the application. Instead, it is mailed to customers after their application is authorized. Tuesday, 23 May 2003 Evaluation Task Force Present: Wanda Kakugawa, Bill Wood, Ruth Ota, Marcia Hartsock, Piilani Pang, Kristell Corpuz, and Barbara Luksch. Next meeting: TBA 1. Wanda presented information on her focus group study of pregnant women. Many of the participants were young with poor nutrition and stressful lives. We discussed the positive feedback concerning WIC services and how the participants were extremely concerned about their health during pregnancy. Barbara will follow-up with MothersCare and WIC on the details. 2. Bill presented information on his Year 3 Data Project report. He is compiling profile information and will have a first draft of the report completed by May 31. There are problems with large volumes of emergency cards missing at public high schools. Ruth explained new scanning technology they are pilot testing, however each student must have an emergency card at the school for accurate data to be recorded. 3. We discussed public health insurance enrollment data which is necessary to monitor our project's success. We will request Med-QUEST enrollment data according to census tract and gender for these age groups: 0-1, 1-5, 6-10, 11-15, and 16-18.