Tuesday, 12 April 2005 Process Improvement Collaborative Present: Barbara Luksch (Hawaii Covering Kids), Alan Takahashi (Med-QUEST Eligibility Branch), Stephany Vaioleti (Hawaii Covering Kids Kahuku Local Project), Kathy Swink (Child Welfare Services), and Sarah Casken (Hawaii Foster Parent Association). The purpose of the meeting was to discuss children and youth who move in and out of the foster care system and their health insurance coverage. 1. Process Improvement Collaborative Barbara shared background information about this initiative. 2. Child Welfare Services Process Kathy explained: * All foster children and youth are eligible for QUEST and Medicaid. * If a child currently enrolled in QUEST or Medicaid is placed in foster care, an application is submitted to Med-QUEST to determine health insurance eligibility. Each child must meet citizenship and residency requirements. * Each child is assigned his/her own separate case. * Form 1108 (For Children and Pregnant Women Only) sent to the local Med-QUEST office via fax or courier and it is date stamped. * A foster child is eligible for dual coverage if she/he is under a parent’s private health insurance. * There are approximately 110 applications per month on Oahu for foster children. * Form 1102 is completed by the Hawai‘i State Department of Human Services (DHS) social worker and sent to Enrollment Call Center. It lists the preferred health plan. 3. Med-QUEST’s Process Alan explained: * When a child is placed in foster care custody, Child Welfare Services confirms if she/he is currently receiving QUEST or Medicaid benefits by checking the Hawai‘i Automated Welfare Information (HAWI) computer system. * When Med-QUEST receives a new application, it sends correspondence to the Child Welfare Services social worker not the foster parents. * The application approval date is transmitted to Med-QUEST’s claims computer system (HPMMIS) that night, therefore pharmacy staff may verify the child’s QUEST or Medicaid eligibility the following day by calling the Automated Voice Response System (AVRS) hotline or logging on to the web site. We discussed that some pharmacies are unwilling to use these services to check eligibility. * The majority of Medicaid Identification Cards are sent to Child Welfare Services because they are legal guardians for foster children. * The Child Welfare Services social worker can make a copy of the Medicaid Identification Card if it will be a long-term care foster placement. * If a child is currently enrolled in QUEST and has ongoing medical needs, access can be obtained from her/his health plan. * Child Welfare Services has procedures in place to address the children’s medical needs, including prescription medicines for uninsured children. 4. Health Insurance Continuity * When a foster child is returned to her/his home, the parents must apply for continued QUEST or Medicaid benefits. * If a parent is enrolled in QUEST or Medicaid or the child is under 18 years old, an application is required to add her/him to the parent’s active case. A new application is required if the child is 19 years old or older. * The Child Welfare Services social worker notifies the Med-QUEST ongoing worker when a child returns home and Med-QUEST mails an application to the parents. 5. Where Breakdowns Occur Form 1123 (Authorization to Disclose Confidential Information by Med-QUEST Division) must be completed before Med-QUEST can disclose information about the foster child to her/his foster parents. It authorizes another person to receive information about eligibility as well as HIPAA-protected information (e.g., health plan, health matters, etc.). 5. Follow-Up * Sarah will email questions that foster parents have about Med-QUEST process to Barbara and Kathy. * Barbara will email a PowerPoint presentation about Medicaid Identification Cards to Sarah. * Kathy will design a “going home” flyer for parents outlining steps to apply for QUEST and Medicaid when the child returns.