Friday, 3 March 2000 Process Simplification Present: Ronnie Taamu, Momi Sonognini-Hewlen. Diane Tachera, Pearl Tsuji, Adrianne Dillard, Vicki Wallach, Barbara Luksch, Lucy Ndirangu, Rena Cuizon, Junedale Nishiyama, Mary Rydell, and Lynn Fallin Next meeting: Thursday, 27 April 2000 at 2:00 PM in the HSPCA Conference Room. 1. Barbara, Diane, and Pearl gave highlights from the recent Covering Kids conference they attended: a. need to retain eligible children (ex. 12-month continuous eligibility and making extra attempts to contact family before closing the case); a cost effective study will be released later this year on12-month continuous eligibility versus churning of children's applications b. Clinton proposed State CHIP outreach money separate from the current amount that is part of each state's 10% administrative cap c. immigration issues: most effective way to assure correct information given to families is a partnership with INS and doing public forums together; also must educate attorneys and consulates on public charge because often they give clients incorrect information d. stigma issues: Medicaid as a means-tested program may undermine the aim it intends to achieve; perceived hassles such as a complicated application, inconvenient office hours, and required documentation make the process complicated; ways to reduce stigma include: refer to Medicaid and State CHIP as "health coverage" provide customer service training to eligibility staff continue to outstation eligibility staff improve provider reimbursement rates for Medicaid explore the use of payroll deduction for coverage program premiums conduct enrollment of children in the workplace and in schools simplify the redermination process change the look of the application use insurance cards similar to those used in the private market review requirements that have been put in place for quality control purposes. Many of these rules are no longer necessary in the current system. In the past, these rules could have driven the welfare stigma that is now being transferred to public health coverage programs use the words income level instead of poverty level e. client barriers were also outlined (similar to the list this task force developed) f. delinking Medicaid from TANF in people's minds: must continue to simplify the process and promote customer service g. Hawaii's current application is very confusing because it serves several programs: what name goes where, good cause is not explained, info on EPSDT should not confuse that it is a separate program, gross income not clear, and warnings at the end are very off-putting h. presumptive eligibility for pregnant women is very helpful in getting necessary prenatal care 2. The task force discussed these issues: a. Birth certificates = cost and time. If a client was previously in the system MQD has a copy but copies are required again. If the child is born here DHS should be able to access DOH computer; currently BESSD at DHS and the Department of Labor share tapes. b. Because of application backlog and increased processing time, income verification is a problem. For example, if the application is sent late December with all required documents but is not processed until February, it is not approved until the client submits income verification for January and February. This creates further delays, increased work for the outstationed workers, and frustration by clients. c. There are problems with 17-to-18-year-olds who are claimed by parents as dependents but live separately and require health care as well as 18-to-21 year olds who are part-time students. 3. Mary shared information on her recent trip to American Samoa. Fifty-percent of their population is under age twenty. They get approximately $500,00 for their State CHIP program and use a preventive public health model focused on dental services, Title V immunizations, and a Grade 9 mental health survey that identified adolescents' needs. There also is a twice weekly television show on preventing child abuse. Tuesday, 14 March 2000 Training and Public Education Present: Alan Takahashi, Diane Tachera, Gloria Samson, Cassandra Stewart, Barbara Luksch, Junedale Nishiyama, Joseph Serrao, Ronnie Taamu, and Marlene Lee Next meeting: Thursday, 13 April 2000 at 9:00 AM in the Honolulu Med-QUEST Conference Room. 1. We worked on our sixth draft of Videotape Part B "Helping Clients Complete Applications." Barbara will meet with Gloria to review it again and then send it to the field for comments prior to the next meeting. 2. Part A script will be ready for review at the next meeting (April 13). 3. Joseph made contacts for local music to be used with the videotape.