Thursday, 21 July 2005 Kauai Outstationed Eligibility Workers Present: Brian Higgins, Wayne Nishi, Darline Rita, Leeroy Dauz, Barbara Luksch, Michelle Martinez, and Iris Venzon Mahalo to Pacific Medicaid Services for sponsoring the meeting! 1. Pacific Medicaid Services, Inc. (PMSI) Brian Higgins explained PMSI is a for-profit company with offices in Seattle, Spokane, Portland, and Honolulu. They currently have contracts with Queens Medical Center, Wahiawa General Hospital, Maui Memorial Medical Center, Kona Community Hospital, and Hawaii Pacific Health (Kapiolani Medical Centers, Straub Clinic & Hospital, Kauai Veterans Memorial Hospital, Samuel Mahelona Memorial Hospital, and Wilcox Memorial Hospital) to assist all self-pay patients with Med-QUEST applications. There are approximately 30 employees in Hawaii. 2. Hawaii Covering Kids Barbara explained the evolution of Hawaii Covering Kids as an integral element of a national initiative since 1999. Statewide activities are broadly focused on outreach, enrollment, and simplification efforts for children’s health insurance. There are currently two local projects that are experimental models located in Kahuku (rural hospital outreach) and on Kaua‘i (linking private health care providers to public health insurance). 3. Helping Uninsured Hospital Patients with Med-QUEST Applications PMSI has contracts with Kauai Veterans Memorial Hospital and Samuel Mahelona Memorial Hospital so all uninsured and self-pay patients are referred to their staff. Recently, they linked with Hawaii Pacific Health which includes Wilcox Memorial Hospital. However, if the Med-QUEST application submitted by PMSI is denied and public health insurance is no longer pursued by their staff, it becomes a “community case” which can be followed up by Hawaii Covering Kids Kauai Local Project outreach workers. 4. Community Training Workshop Med-QUEST receives approximately three applications from Wilcox Memorial Hospital daily. It was suggested that while PMSI and the hospital configure procedures under their new partnership, Barbara and Wayne should conduct a workshop for the current hospital staff on properly completing Med-QUEST applications. Barbara will contact Wilcox Memorial Hospital’s patient access manager, Keoki Clemente, to arrange the training. (Note: The workshop was held on 4 August 2005). 5. Suggestions for Statewide Outstationed Eligibility Workers (OEWs) We discussed information that could be shared with all OEWs to help Med-QUEST offices: a. Please write clearly and legibly on all forms. If a household member completes the application, check that all information can be easily read. b. If a nonpregnant adult in the household wants health insurance, use form 1100. c. Check Med-QUEST's Internet Verification System or Automated Voice Response System (AVRS) before submitting an application. This will help eliminate applying for people who are already enrolled in QUEST or Medicaid Fee-for-Service. Barbara will draft a memo and review it with Med-QUEST Eligibility Branch. (Note: the memo was mailed on 28 July 2005). 6. Form 1100A We discussed this form’s purpose which has also been reviewed at several Hawaii Covering Kids Process Improvement Collaborative meetings. Basically, 1100A is justification for what is in HAWI and categories where Med-QUEST eligibility workers place household members. When an eligibility worker is out, other staff can review the case record to find out what is happening and why. Furthermore, when HAWI is unavailable, they can still assist the customer. Hawaii Covering Kids is a proponent of a truly paperless system, however that would entail creating templates or scanning forms and materials and saving them on compact discs. In lieu of that, Med-QUEST continues using 1100A. It was also noted that an extremely important aspect of 1100A is that the interview date is recognized by Med-QUEST as the application date when an authorized outstationed eligibility worker completes it.