Thursday, 11 May 2006 Process Simplification Task Force (Cit Docs Team) Present: Christine Akau, Andreas Cravalho, Rebecca Delafield, Kris Foster, Jolaine Hao, Dee Helber, Barbara Luksch, Rochelle Sparko, Kathy Swink, Alan Takahashi, and Debbie Wiss. Next Meeting: 24 May 2006 at 10:00 AM 1. Our Goal All eligible people who are currently enrolled in QUEST and Medicaid Fee-for Service retain their benefits without going on scavenger hunts. 2. Other Agencies That Should Join Our Team The Department of Health’s deputy director is gathering representatives to join our task force from Adult Mental Health, Children and Adolescent Mental Health, and Developmental Disabilities divisions. Barbara has contacted representatives from the Healthcare Association of Hawaii, Hawaii Health Systems Corporation, Hawaii Long-Term Care Association, and Housing and Community Development Corporation of Hawaii’s Homeless Project. Task force members suggested we also provide information to county police departments, county economic development organizations, and homeless shelters. 3. What Each Organization Can Do To Help Participants suggested ways their organizations can help with our goal: * Legal Aid Society of Hawaii: Rochelle will find out if their offices on Hawaii, Kauai, Lanai, Maui, Molokai, and Oahu, and can assist with birth certificates and photos. If they all agree, a contact person at each site will be listed with 211 for people to call for assistance with documents. * Community Health Centers: Executive directors will be contacted and if they agree an outstationed eligibility worker at each location throughout the islands will be listed with 211 for assistance with documents. * Department of Education: Photo of each child is kept in the student’s file at his/her school which could be a future option for identification. * DHS Benefit, Employment, and Support Services Division: Work with Social Security Administration to verify citizenship and share this link with Med-QUEST; start asking for photos from each participant. * Kaiser Permanente: Case managers can begin collecting patients’ photos. * Med-QUEST Eligibility Branch: After the HAWI computer system is updated, whenever an eligibility worker talks with a customer she/he can let the person know about missing citizenship or photo identification documents that will be needed during the renewal process. Also inform the caller to open all mail from Med-QUEST. * Med-QUEST Customer Service Section: Will be the hub collecting and processing required documents sent by outreach sites and Med-QUEST recipients. * DHS Medicaid Waiver Programs: Case managers will coordinate with Med-QUEST eligibility staff to get documents for clients. * Hawaii Medical Service Association: Can inform Community Care Services’ caseworkers about collecting documents. They serve approximately 800 severely mentally ill adults. * Aloha United Way 211: Information and referral specialists will help callers by explaining appropriate documents and direct those requiring special assistance to outreach sites. * Hawaii Covering Kids: Continue organizing and facilitating task force meetings, keep members informed about our progress and issues, link with Olomana Marketing for the media campaign, and (when the time is right) disseminate information to statewide outreach workers. It was suggested a monthly list of people who need documents be sent to the appropriate QUEST plan to call their members. Barbara will ask Kookie if this is possible. 4. Barbara’s Updates a. A videoconference session will be held in June for document site representatives (community health centers, Native Hawaiian Health Care Systems, Legal Aid Society of Hawaii, and others). b. We discussed our required media campaign. A task force member suggested the theme “Open Your Mail” so Med-QUEST information sent to households is not tossed aside or thrown away. Since only people who require citizenship and/or photo IDs will receive special pending notices, this general theme will not cause panic among all 204,000 Med-QUEST recipients (who in turn may call their eligibility workers due to fear of lost benefits). c. Reliable sources have indicated the Centers for Medicare & Medicaid Services will not issue a state Medicaid director’s letter. They will go directly to publishing interim final rules in The Federal Register followed by comments they can consider or completely ignore. 5. Pending Notices We compiled the following list to include in the two letters: * Your case may be closed * We need copies * If you have questions or need help, call 211 * Please respond by MM/DD/YYYY * Include a postage-paid envelope with the hub address on the outside * Write the hub address on the letter, too, for customers who lose the postage-paid envelope * Print notice on light blue paper * Write this message on the envelope addressed to the customer: Please Open—Very Important! Note: After the meeting, pending notice drafts were shared among task force members via email. 6. Other Business a. It was noted the new federal law does not affect Medicaid eligibility, however if a recipient does not produce U.S. citizenship documents the state cannot get federal reimbursement (Hawaii’s current matching rates for federal funds are 58.81% regular Medicaid and 71.17% expanded children’s program). b. Med-QUEST should research how to get birth certificates for people born in other states. Often, if a government official pursues this document for state purposes, there is no fee. c. Barbara requested through Kookie for Med-QUEST to update its web-based eligibility/ enrollment verification and claim system to indicate citizenship and photo ID information. This will help health care providers, including community health center outreach sites assisting with citizenship documents, access U.S. citizenship information about Med-QUEST recipients. Friday, 12 May 2006 Application Simplification Workgroup Present: Jeffrey Young, Priscilla Thode, Dawn Reppuhn, Barbara Luksch, Melba Bantay, Rebecca Delafield, and Cassandra Stewart. Next meeting: TBA 1. Application Tweaks Version 34 of 1100 and Version 17 of 1108 are completed and will be printed in June. One final tweak to 1100 was capturing information about the number of burial plans and burial plots in household assets. 2. Med-QUEST Notices Our workgroup’s next activity is to revise the Hawai‘i Automated Welfare Information (HAWI) computer-generated notices. We agreed to start with the ten-day pending notice and will create one for application information (M09) and another one for renewal information (possibly M11). We must design not only the printed notice, but also what eligibility workers see on their HAWI screens to generate the notice. We will use language that is similar to the renewal notices (110B-1 and 1100B-2) and wrote this paragraph for M09: Dear XXXXXXXX, Thank you for your application. We need more information to process it. Please return this form with COPIES of items marked (⎪X⎪) below by XX/XX/XXXX. If we do not receive them before this date, your application may be denied. We look forward to helping you! (Information list with these main topics: Social Security Number, Residency, Citizenship, Assets, Income, Other Health Insurance, Unpaid Medical Bills, Other) If you have questions, please contact %%%%% at %%%%%. Authorization: H.A.R. xxxxxxxxxxx Administrative appeal rights and other important information are on the back of this letter. For the renewal pending notice (possibly M11), we will substitute “your medical assistance may stop” for “your application may be denied.” Cassandra will email Barbara copies of sample documents for the HAWI screen that MQD staff has worked on and Jeffrey will fax a copy of the version received by customers. It was suggested that eligibility workers have the function to send a notice to more than one person. Wednesday, 24 May 2006 Process Simplification (Cit Docs Team) Present: Christine Akau, Coral Andrews, Andreas Cravalho, Kris Foster, Noe Foster, Donnie Kamiya, Barbara Luksch, Kookie Moon Ng, Anne Pierce, Rochelle Sparko, Kathy Swink, Alan Takahashi, and Alan Tang. Next meeting: 8 June 2006 at 1:30 PM 1. What Each Organization Can Do To Help Participants gave these updates: * Legal Aid Society of Hawaii: Offices on Hawaii, Kauai, Lanai, Maui, Molokai, and Oahu can assist with birth certificates and photos. * Community Health Centers: Barbara is organizing outstationed eligibility workers at each location to assist with documents. * Department of Education: Dee is researching Special Education units to determine if they have student photo identifications. * MothersCare offered to include information in packets mailed to their phone line callers. 2. “Open Your Mail” Media Campaign Alan Tang discussed campaigns during the first and last weeks of each month from June 2006 through June 2007 to coincide with pending notices mailed to households. The target audience is current consumers statewide living in rural areas as well as urban Honolulu, so the best media are radio and community newspapers. It was noted that 2006 is an election year consequently media advertising prices will be higher during the next several months. Alan suggested a price ranges for the campaign, however the exact details were open for discussion. Also, if the task force does not believe the “open your mail” message, combined with outreach by state and community groups, does not have its intended success can tweak the message. 3. Questions and Answers Guide We outlined information that should be included in a brief for professional staff. Details should include background specifics about out task force and groups represented, why we are designing our action plan, who is affected and not affected, where to learn more information, how their help will benefit them and their clients, and pending notice particulars. Barbara will email a first draft for the task force members to revise so we can distribute the guide in early June. 4. Other Business a. We tweaked our Razzle-Dazzle Filter Machine (see attached). b. Generally when a state requests a birth certificate from another state for official business, it is free. Unfortunately, there are no national links for this document. c. The first pending notice for citizenship and photo identification documents will be sent on 06/29/06, which is two days after renewal notices are mailed. d. BESSD has access to Department of Motor Vehicle records, therefore we could use this system link for photo identification. e. Med-QUEST’s web-based eligibility/enrollment verification and claim system will be updated to indicate citizenship and photo ID information, however it is not a first system change priority. f. Barbara will sponsor a conference call with the three QUEST plans to brainstorm more ideas about how they can feasibly contribute to our task force’s goal. g. Barbara will create a page on the Hawaii Covering Kids web site for professionals to easily access our task force minutes, copies of pending notices, and other details about Hawaii’s action plan. h. Task force members expressed concern reaching homeless people and severely mentally ill patients as well as gathering each child's photo identification. i. A question was raised about the hub accepting emailed documents. The documents will contain personal information and email is not secure so this is not an option. j. Barbara and Kookie are sponsoring a statewide videoconference with people at potential document sites on 7 June 2006. Wednesday, 31 May 2006 QUEST Plans (Cit Docs Team) Participants: AlohaCare (Noe Foster), HMSA (Andreas Cravalho), Kaiser (Maile Aquino), and Hawaii Covering Kids (Barbara Luksch) 1. We discussed what each plan could do to help eligible QUEST recipients keep their benefits. * HMSA’s Community Care Services: this program has approximately 850 severely mentally ill patients and case managers can try to obtain photos. * Kaiser: when case managers meet with patients they can photocopy patients’ photo identifications. * AlohaCare: if the amount allowed for promotional items can be increased from $2 per item to $5 per item they could offer gift certificates (e.g., Jamba Juice) for people who send necessary documents. 2. It was suggested having the QUEST plans sponsor a media campaign may not be the most effective method to communicate with its members. However, if each QUEST plan could get a list of members’ renewal dates, they could possibly use existing phone line services to contact them. Member lists should include the following information for each QUEST recipient: * First Name * Last Name * Birth Date * Current Phone Number (Best Number to Call) * Current Mailing Address * Case Number * ID Number * Renewal Month 3. Barbara, Kookie Moon-Ng (Med-QUEST Policy and Program Development Office), and Alan Takahashi (Med-QUEST Eligibility Branch) will meet with community health center outstationed eligibility workers on June 7. They will discuss how to help people born in other states obtain birth certificates as well as other procedural issues. 4. Subsequent to the conference call, Barbara researched sending documents to the Med-QUEST hub. Copies of citizenship documents and/or photo identifications can be sent now (please refer to the pending notices for acceptable examples): Med-QUEST Customer Service Section P. O. Box 700190 Kapolei, HI 96709-0190 Each copy should include the following recipient information: * Legal Name (First, Last, and Middle Initial) * Social Security Number (if known) * Birth Date (month/day/year) * HAWI ID Number (if known) * Current Phone Number (Best Number to Call) * Current Mailing Address The organization’s representative should also include her/his name, email address, and telephone number so the Customer Service Section representative can contact her/him if there are questions.