Wednesday, 7 June 2006 Outstationed Eligibility Workers (Cit Docs Team) Participation was via videoconference and audioconference. Mahalo to Ben for his technical assistance! Hawaii: Catherine Luthe, Jose Macias, Florencio Tabancura, Freddie Woodard, Debra Ebreo, Malia Thompson, Wendy Tamashiro, Alicia Omelau, and La Verne Lucero Kauai: Charlene Yamamoto, Darline Rita, Colette Nagao, June Munoz, and Michelle Martinez Lanai: Julieann Mock Chew Maui: Manny Agcolicol, Natasha Andaya, Cristina Munoz-Barrantes, Helene Cannella, and Noe Lecker Molokai: Cedric Alonzo and Debora Eala Oahu: Carina Agpaoa, Hiro Hara, Jasmin Nepomuceno, Dorothy Young, Regina Quimpo, Teri Roe, Grace Dole, Jennifer Tehotu, Fisii Drummondo, Michelle Malufau, Karen Guerrero, Karln Hall, Alan Takahashi, Barbara Luksch, and Kookie Moon-Ng Next Meeting: Early July Conference Call 1. Welcome and Introductions Barbara welcomed participants to the meeting and explained her first suggestion to everyone who learns about this new federal law is DON’T PANIC! 2. Handouts Prior to the meeting, Barbara emailed these handouts: “New Federal U.S. Citizenship Requirements for QUEST and Medicaid Fee-for-Service: What Professional Staff Need to Know,” “Hawaii’s Razzle-Dazzle Medicaid Filter Machine,” and samples of two letters. Recipients are required to prove both citizenship and verify their existence through a photograph. Barbara explained the filter machine creates system interfaces from other agencies to populate Med-QUEST’s HAWI computer system. Letters will be mailed to people during their renewal months. A first letter will be mailed to people who must send copies of documents and/or photo identifications if they cannot be located through system interfaces. If there is no response, a second letter will be mailed a couple weeks later. Both letters will have postage-paid envelopes for easy mailing to the Med-QUEST Customer Service Section (aka central document hub). Also, all new applicants must submit copies of birth certificates and photo identifications for everyone in the household requesting health insurance beginning July 1, 2006. 3. Document Sites Barbara requested help from the outstationed eligibility workers as document sites. People will be referred to their locations to assist with photocopying and mailing documents to the hub. Preliminary information was emailed to the community health center directors about a month ago. Barbara, Kookie, and Alan will also meet with them on 21 June 2006 to explain more. The document sites will be reimbursed for document and photo identification copies, postage fees (if the recipient’s postage-paid envelope was lost), Polaroid cameras for photographs, and a portable photocopy machine. Kookie explained this is only a one-time requirement, therefore current recipients do not have to submit these documents again. 4. Birth Certificates for People Born in Other States The task force is deciding what to do because currently there are no national databases with birth information. 5. Media Campaign The task force is working with Olomana Marketing to conduct an “Open Your Mail” media campaign via radio and community newspapers during the time period when letters are mailed. The message is not specifically focused on the new document and photo identification requirements because the task force wants to avoid mass panic. 6. Med-QUEST Eligibility/Enrollment Web Site Med-QUEST will update their web site so information is available to health care providers, including outstationed eligibility workers, to find out if the recipient must submit documents and/or photo identification. A final date has not been set for this system update. 7. Questions and Answers a. What photos are acceptable? People can mail a copy of any photo with an organization’s name on it. However, if a document site is assisting the recipient, the outstationed eligibility worker can copy a photograph and submit it as explained in the attached handout. b. Will the outstationed eligibility worker be held liable? No. The recipient or applicant is responsible for all information provided. Note: This is the same for all self-declared information. c. Should we have the recipient sign a statement? This is not a Med-QUEST requirement. d. Do we have to sign the cover sheet with information we send to the hub? No. However, please print clearly your contact information so the Customer Service Representative can discuss information if necessary. e. Must the documents be mailed to the hub? Yes. f. Does it matter if the child’s picture is old and doesn’t reflect her/his current age? No. Note: It was mentioned that copies of birth certificates are kept in each student’s file at her/his school. The parent or guardian might be able to obtain a copy at the child’s school if there aren’t other options. 8. Email Following the Meeting Barbara suggested being proactive and submitting copies of documents and/or photo identifications community health centers have on file for their patients enrolled in QUEST or Medicaid Fee-for-Service. Acceptable documents and photo identifications are listed in the letters. Attached are more details about submitting them to the Med-QUEST hub. Wednesday, 8 June 2006 Process Simplification Task Force (Cit Docs Team) Present: Lori-Lei Aponte, Kris Foster, Noe Foster, Jolaine Hao, Alice Ho, Barbara Luksch, Rich Melendez, Sandra Miyoshi, Mary Rydell, Rochelle Sparko, Kathy Sthay, Kathy Swink, Alan Takahashi, and Alan Tang. Next Meeting: 21 June 2006 at 9:00 AM Our Goal All eligible people who are currently enrolled in QUEST and Medicaid Fee-for Service retain their benefits without going on scavenger hunts. 1. Updates * Long-term care patients may not be greatly impacted because they must currently establish citizenship to qualify for Medicaid benefits and live in facilities where pictures can be easily taken. * Since 1978 birth certificates have been registered Social Security Administration’s Numident Electronic Record (birth date, place of birth, and citizenship code). Kris explained DHS has access to this database for everyone with a social security number. * There are approximately 2,500 foster care children. Documentation for Medicaid benefits is important not only while the children are in foster care, but also when they leave so health insurance benefits continue. * The information web page (http://coveringkids.com/news/Section_35.asp) has national information and will be updated with Hawai‘i details after Med-QUEST finalizes its plans with the Centers for Medicare and Medicaid Services. * Med-QUEST began testing its computer system updates on 5 June 2006 and it will take approximately two weeks. Interfaces with other databases will begin 19 June 2006 if partner agencies meet their deadlines. * Kathy Sthay suggested a shortened version of the question and answer guide for physicians. She and Barbara will work on it. Kathy will also make staff at physician’s offices aware of the pending notices. * Barbara, Alan Takahashi, and Kookie hosted a videoconference meeting with outstationed eligibility workers on 7 June 2006. There were forty-one participants from six islands. We requested their help as document sites. Minutes will be shared with task force members and there will be a follow-up presentation to the organizations’ executive directors on 21 June 2006. * Following the videoconference meeting, a handout was emailed to participants explaining where organizations helping current QUEST and Medicaid Fee-for-Service recipients can send copies of their citizenship documents and/or photo identifications. The handout was also shared with task force members. * Jolaine sent our question and answer guide, “New Federal U.S. Citizenship Requirements for QUEST and Medicaid Fee-for-Service: What Professional Staff Need to Know,” to case managers with the Medicaid Waiver Programs. They will help their clients with documentation. * Legal Aid Society Hawai‘i can help with documentation copies and provide free notary services. 2. QUEST Plan Conference Call Barbara hosted this meeting on 31 May 2006 with one representative from each QUEST plan. Highlights included: * HMSA’s Community Care Services: this program has approximately 850 severely mentally ill patients and case managers can try to obtain photos. * Kaiser Permanente: 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. * 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. 3. Homeless Populations We discussed problems with people losing documents. Sandra explained there are outreach workers for unsheltered populations as well as shelter providers who could help. She can send information to housing managers and other staff and there is a July meeting that may be a good venue to explain the new documentation requirements. 4. Public Forum for O‘ahu Agencies Barbara offered to sponsor a Honolulu meeting to provide information to agency staff that has not attended our meetings. The state has access to a videoconference system so we will research offering a similar meeting for Neighbor Islands. 5. Question and Answer Guide for General Public/211 Script We drafted questions people might ask when they receive the blue pending notices (What is this letter?, What do I do?, Where can I go to get documents?, etc.) as well as the general public (Will my case be closed?, Will I lose my benefits?, etc.). Barbara will circulate a draft with answers to the task force members. Wednesday, 21 June 2006 Process Simplification Task Force (Cit Docs Team) Present: Lori-Lei Aponte, Natalie Bostrom, Andreas Cravalho, Rebecca Delafield, Kris Foster, Noe Foster, Jolaine Hao, Dee Helber, Alice Ho, Barbara Luksch, Sandra Miyoshi, Kookie Moon-Ng, Ruth Ota, Mary Rydell, Rochelle Sparko, Alan Takahashi, and Tessy Yokota. Next Meeting: 11 July 2006 at 9:00 AM 1. Updates a. Barbara explained that people in Med-QUEST’s clone programs for immigrants and Compact of Free Association individuals must also have congruent requirements. Therefore, the letters were modified to add alien status. Also, the question and answer guide for professional staff was revised. b. The task force reviewed the updated filter machine. It was noted that DOH Vital Records matches will not occur in July due to required technology, however this system link should be enacted in early July. There were Hawai‘i State Identification matches for approximately 4,000 of the 20,000 July renewals. Kookie is researching Med-QUEST claims information for newborns from 1994 to present. Kris suggested adding DOE School Lunch and A+ Program to the photo identification section because BESSD has found these useful resources. c. Our Honolulu public forum for agency staff is June 27. Jo will help arrange a similar forum in early July using the state VCC system. d. Alan, Barbara, and Kookie will present information today to community health center directors and talk about their vital role as document sites. It was suggested the sites record the amount of time this activity takes so we can inform policymakers. 2. Questions and Answers for 211 a. We discussed Draft #1. Barbara will make changes and email Draft #2 to all task force members. The Hawai‘i State Department of Human Services (DHS) staff and general public will also use a similar guide. b. Questions about renewal dates and documents already submitted raised concern among task force members because Med-QUEST eligibility workers are currently unable to respond to all telephone calls due to their immense caseload. Lori-Lei suggested Med-QUEST’s Customer Service Section be listed as the resource for these questions, 3. Media a. The Hawai‘i State Department of Human Services requested information from the task force for its news release so consistent messages are announced. b. Natalie from Olomana Marketing unveiled a first draft of the thirty-second radio script and we discussed edits. The “Open Your Mail” campaign’s first run is 28 June to 9 July with statewide radio flights. Multilingual radio stations and community newspaper advertisements will be added next month. 4. Federal Guidance a. The state Medicaid director’s letter was released by the Centers for Medicare and Medicaid Services (CMS) on 9 June 2006 and it is far more restrictive than its April draft. A copy can be downloaded from the Hawaii Covering Kids web site. b. The interim final rules have not been published. 5. Da Kine a. Aloha United Way 211 agreed to handle calls under its current contract with Med-QUEST through Hawai‘i Covering Kids. However, if the call volume far exceeds their capacity, additional funds may be required. b. Rochelle will draft affidavits that could be used as a last resort. c. It is not definite how long we can pend for information before closing cases. d. Dee explained that teachers do not have photos of students in DOE special education classes.