Monday, 3 November 2003 Process Improvement Collaborative Present: Alan Takahashi, Jeffrey Young, Stephany Vaioleti, and Barbara Luksch Next meeting: 10 December 2003 at 3:00 PM Hawaii was invited, along with 14 other states, to participate in this yearlong initiative sponsored by The Robert Wood Johnson Foundation and Covering Kids & Families. The Hawaii team members met to prepare for Learning Session 1 in Tempe, Arizona from 10-12 December 2003. Note: more details on our year-long participation in this initiative are at Process Improvement Collaborative. 1. Confidentiality Statements Each team member signed a required form that maintains and safeguards the confidentiality of all data and information acquired through participation in the Covering Kids & Families Process Improvement Collaborative. 2. Review Strategies and Core Measures We reviewed pre-work assignments from the Process Improvement Collaborative Leadership Team. We discussed required core measures and decided the sources for available data: * Applications Received: Statewide and Individual Med-QUEST Offices * Percent Approvals and Denials: Honolulu Office * Denials by Reason: Statewide * Closures by Reason: Honolulu Office Ongoing Unit III * Percent Cases Closed at Renewal: Honolulu Office Ongoing Unit III * Caseload and Closures: Honolulu Office 3. Storyboard We discussed details to include in our storyboard: Project Title, Introduction, Description of Problem Diagnostic Activities to Date, Goal Statement, Charts, Changes Implemented to Date, and Future Planning. The deadline for submission in PowerPoint format to the Process Improvement Collaborative Leadership Team is 2 December 2003. Note: Alan, Jeffrey, and Barbara met again on 26 November 2003 to complete spreadsheets required by the Process Improvement Collaborative. Our final storyboard with the data can be downloaded in PDF format at Process Improvement Collaborative. Thursday, 4 December 2003 Renewal Simplification Workgroup Present: Andreas Cravalho, Noe Foster, Edward Nishimura, Susan Chung, Ben Fong, Cassandra Stewart, Jeffrey Young, Pearl Tsuji, and Barbara Luksch. Next meeting: 24 December September 2003 at 10:30 AM (conference call to review passive renewal form and timeline) Mahalo nui loa to Noe for bringing ono treats! 1. Memo on Hawaii Administrative Rules Lillian issued a memo to Med-QUEST to assure their 2004 compilation and rewrite of administrative rules be a collaborative process with the Hawaii State Department of Human Services (DHS) director, Med-QUEST eligibility branch staff, CMS, state agencies, and community organizations. It must involve key stakeholders during the draft process because it will save the division personnel time and money by reducing the need for immediate changes after the rules are officially adopted. There should be a minimum of two meetings with these groups to review drafts of the revised rules before the rules are submitted for public hearing and the meetings should be arranged at times and in locations convenient to the key stakeholders. 2. Process Improvement Collaborative Barbara distributed data compiled by the Hawaii team (Barbara, Jeffrey, Alan Takahashi, and Stephany Vaioleti) in preparation for Learning Session 1. 3. Review Renewal Form Draft #5 * Jeffrey explained that about 25% of customers returning the current reapplication form have changes and that cases are manually closed by an eligibility worker. Barbara distributed a prepopulated form that she, Cassandra, and Christine Wong (Honolulu Office Ongoing Unit II supervisor) drafted. Changes were suggested, revisions will be made, and it will be field tested through the Process Improvement Collaborative team. * Susan explained the vendor used by DHS, Hawaii Presort, has problems stuffing envelopes with multiple pages if the number of pages are not consistent. The workgroup prefers separate pages rather than one page printed on both sides because often recipients don't look on the back of forms. Spaces will be added under each question for an appropriate amount of preppopulated information. Also, we must allow proper spacing for the name and address that will appear in the envelope's window. * A "Rights and Responsibilities" handout must be sent with every form. * Customers have 10 days from the date the form is mailed to respond. 4. Timeline (Med-QUEST Procedures) December 24: Teleconference to Discuss Implementation January 16: Requirements Meeting February: Develop Write-Up March: Development April: Computer Test May and June Ongoing Unit III test a. Barbara will review the timeline with Lillian Koller after the teleconfrence. b. The health plans cannot deduce if churning has been impacted with a small test through one unit. However, they work with Health Coverage Management Branch (HCMB) and submit encounter data monthly. 5. Random Sample Follow-Up a. The health plans call parents and guardians if Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services for the children have not been used in one year. Also, they complete form 1179 and send it to Med-QUEST if their customers have household changes. Furthermore, the health plans contact all new members within ninety days and thereafter annually. b. Jeffrey will work with Edward to determine the correct sample size for quality control follow-up. As discussed at the previous meeting, random sampling will be conducted through ex parte reviews using Income and Eligibility Verification System (IEVS), State Wage Information and Collection Agency (SWICA), Social Security Administration (SSA), and Child Support reports. Wednesday, 24 December 2003 Renewal Simplification Workgroup Present: Susan Chung, Jeffrey Young, Pearl Tsuji, Mona Tsutahara, and Barbara Luksch. Next meeting: TBA 1. Tweaking Form Suggestions were made to tweak passive renewal form (Draft #7). Barbara will update it and send Draft #8 to all workgroup members today. 2. Spacing Question Information can be truncated to fit in spaces (e.g., first initial of person's name followed by first six letters of last name). Med-QUEST will inform Office of Information Technology (OIT) at the workshop what database information to print on the form and, if truncating is necessary, how much to truncate. 3. Approximate Timeline 30 December: Barbara will review the workgroup's progress and proposed timeline with Lillian Koller 16 January: Define Requirements Organized by Mona: Meeting with Med-QUEST, OIT, and Benefit, Employment, and Support Services Division (BESSD) to define requirements 20 January: OIT develops write-up 17 February: OIT sends write-up to BESSD/Systems Operations and Requirements Office. SORO forwards it to various offices within DHS for comments and consolidates, consolidates the comments, and returns it to OIT 23 February: OIT revises the write-up 1 March: Development to change HAWI (computer system for Med-QUEST and BESSD) April: Computer testing May and June: Ongoing Unit III test 4. Modification Information a. Susan explained that major modifications could take one month to develop write-up. b. Med-QUEST's original modification request was for the entire Medicaid program because they want computer-generated prepopulated forms for all cases. This should not delay implementation of passive renewals for cases with children. c. BESSD submitted an addendum to include their information for customers. This will help Med-QUEST customers who receive other benefits, however it could require more time. Barbara suggested we speed up rather than slow down the process to implement passive renewals.