Thursday, 28 August 2008 Application Simplification Workgroup Present: Melba Bantay (Catholic Charities Hawaii Immigrant Services), Jackie Berry (Healthy Mothers Healthy Babies Coalition of Hawaii), Waynette Cabral (State Planning Council on Developmental Disabilities), Pamela Cunningham (Executive Office on Aging), Connie Liu (Legal Aid Society of Hawaii), Barbara Luksch (Hawaii Covering Kids), Geneva Watts (Hawaii State Department of Human Services Civil Rights Compliance), Kari Webb (Healthy Mothers Healthy Babies Coalition of Hawaii), Christine Wong (Med-QUEST Policy and Program Development Office), Sunny Yee (Med-QUEST Eligibility Branch), and Jeffrey Young (Med-QUEST Eligibility Branch). Next Meeting: TBD 1. Welcome and Introductions We welcomed new representatives to the meeting and our Hawaii State Department of Human Services (DHS) Civil Rights guest speaker. 2. Med-QUEST Application History Barbara explained briefly how the workgroup was formed in 2000 and its decision-making role. 3. Handouts Packets were distributed that included process simplification milestones, applications data, updated question and answer guide, and Med-QUEST interpreter services. 4. Changes to Med-QUEST Application We agreed on the following: Question 1 What Language Do You Speak Best? (We will get you a FREE interpreter—see page 7.) Question 2D Parentheses Change to: (You may get business expenses deducted.) Question 6B Check YES or NO for every type of asset listed. If YES, please write information in the boxes and attach documents. Write the owner’s name, bank or company name, and value. Completing this information will help us process your application faster. Question 7A Change “Date” in column two to: Transaction Date Question 8A Does anyone listed in Question 3 have private health insurance, dental insurance, vision insurance, long-term care insurance, Medicare, TRICARE, VA benefits, or prescription drug coverage? Page 8 If I have Medicare, can I still get Medicaid? Yes. If you qualify for Medicaid, the state may pay your Medicare premiums. Page 9 MothersCare Information Line Operated by Healthy Mothers Healthy Babies Coalition of Hawaii. Links pregnant women to health and community resources. 951-6660 (Oahu), 1-888-951-6661 (Neighbor Islands), or www.hmhb-hawaii.org. Rights and Responsibilities NO DISCRMINATION: I will not be treated differently because of my race, color, age, sex, national origin, physical or mental disability, or religious or political beliefs. If I am not satisfied with the way I am treated, I should write as soon as possible to the Department of Human Services Personnel, Civil Rights Compliance Unit, P. O. Box 339, Honolulu, HI 96809-0339 or the U. S. Department of Health and Human Services, Office of Civil Rights/Region IX, 90 7th Street, Suite 4-100, San Francisco, CA 94103-6705, Attention: Regional Manager. I may also call the US DHHS at 1-800-368-1019 (toll free) or 1-415-437-8311 (TDD). I can get a Discrimination Complaint Form, Consent/Release Form, and joint Nondiscrimination Notices in multiple languages at http://hawaii.gov/dhs in the Civil Rights Corner. BILINGUAL, SIGN INTERPRETER, OR OTHER ACCOMMODATIONS: All Department oral and written communication to me will be in English. If I do not understand what I hear or read, I will contact the Department right away. I can get free help to access medical assistance with sign or foreign language interpreters, large print, taped materials, or accessible parking, etc. ASSETS AND OTHER PROPERTIES: I must give the Department information about any asset or property that is owned by my household unless I am only applying for medical assistance for children or as a pregnant woman. If I get rid of any asset or property for less money than the fair market value, it may affect my eligibility for nursing facility level care. An annuity purchased after February 8, 2006 must name the State as a remainder beneficiary. 5. Additional Inserts “State of Hawaii National Voter Registration Act Questionnaire,” “Wikiwiki Voter Registration,” and “Access Hawaii Services to the Public: Your Rights and Responsibilities” (DHS 050) are now required. It was suggested to articulate information in one or two sentences from DHS 050 and put it in the application’s Rights and Responsibilities section. This would keep everything together for applicants as well as save paper, printing, and postage. 6. Other Ideas Suggestions that were changed, deferred, or decided against: 211 If someone needs help with the application, she or he can call 211 and be referred to an outreach worker. It was decided this could be written on 8000J (documents list). Request for U. S. Citizenship, Alien Status, and Photo Identification Documents (8000J) We do not want these permanently on the application because we hope the federal government will eventually rescinded this requirement. Question 4B: Add Annuity Annuity is a type of retirement income which is already on the list. Question 8F: Add “Has anyone ever been in an accident or incident?” This wording was on the old blue 1100 and information provided by applicants was not helpful for determining eligibility. Question 9: Add Second Signature It is only needed for common law situations and therefore would be confusing to the majority of applicants. Important Resources: Head Start There is no single Head Start telephone number for people to call, therefore we only list the web site address. 7. Additional Language Access Information One of the workgroup’s overall objectives is to improve access to Med-QUEST eligibility services. In addition to application changes listed above, Med-QUEST will collect language data and seek ways to better understand what languages are priorities for populations served. Barbara will meet with the Med-QUEST Administrator and Department of the Attorney General’s DHS representative. Application Question 1: What language do you speak best? The HAWI language field will become a mandatory screen and we will request all outreach workers complete the question on applications. Med-QUEST staff will also review applications dropped off to assure there is an answer. DHS has a web site link for more information. 8. Generational Lands There are many different types depending inheritance situations and traditions. Connie and Chris will research details and recommend possible solutions to the workgroup. Friday, 5 September 2008 Process Simplification (PERM Team) Present: Barbara Luksch (Hawaii Covering Kids), Kookie Moon-Ng (Med-QUEST Policy and Program Office), Alan Takahashi (Med-QUEST Eligibility Branch), and Christine Wong (Med-QUEST Policy and Program Development Office). Next Meeting: 17 September 2008 at 11:00 AM 1. Citizenship Documentation Forms a. We discussed changes to U. S. citizenship and photo identification documents listed on Form 8000J (“Request for U. S. Citizenship, Alien Status, and Photo Identification Documents”) based on revised Hawai‘i Administrative Rules. Chris will research the Code of Federal Regulation (CFR) for Hawaii State ID and Permanent Resident Card for our next meeting. b. We decided Form 8000J and 8000K (“Statement of Parent or Guardian for Children Under 16 Years Old”) will be added to the last pages of the typeable PDF applications that can be downloaded from Med-QUEST’s web site. c. Form 1106 (“CWS/MQD/BESSD Communication Form Foster Children”) was recently issued. This internal communication form has checkboxes for photo identification in Child Welfare Services (CWS) file and U.S. birth certificate in CWS file. Barbara suggested additions to the instructions attached to PPD O6-03b PC Pre-Placement Physical/Ongoing Medical Care for Foster Care Children explain who codes the HAWI system and what is considered a CWS photo identification. Wording will be discussed at our next meeting. 2. Third Party Liability Two questions arose from outstationed eligibility workers that Chris and Aileen will research: a. Forms 1125 (“Assignment of Payment, Repayment Agreement, and Authorization & Waiver for Release of Information”) and 1125A (“Supplement to Assignment of Payment—DHS 1125”): All other Med-QUEST forms allow faxed copies as legal documents. Is it possible to eliminate requiring original of these two forms based on the best evidence rule? Later mailing originals and having the Med-QUEST office match them to the application costs money and takes additional staff time. b. If someone is receiving medical treatment due to an accident or incident and does not submit Forms 1125 and 1125A the application is denied. Does not completing these forms remain in the HAWI computer system in perpetuity, thereby preventing the person from ever receiving public health insurance benefits? 3. PERM Tasks The Centers for Medicare & Medicaid Services (CMS) began a new Payment Error Rate Measurement (PERM) program. Contractors perform statistical calculations, medical records collection, and medical/data processing review of selected State Medicaid and CHIP claims. Hawaii will be audited in 2008. Our team’s goal is to develop internal Med-QUEST procedures for consistent ex parte reviews to eliminate application and renewal error rates without forcing customers to go on scavenger hunts. a. We reviewed the public information handout, “PERM Implementation Recommendations,” revised on 05/25/08 and assigned tasks to team members. * Chris: Check on #1 Align Hawaii Administrative Rules with Code of Federal Regulations. * Barbara: Add to #5b (Residency): something in the case record showing the applicant’s address. * Alan: Discuss #3 (Provide Internet Access for Eligibility Workers) and #7 (Hawaii State Department of Labor Access) with Med-QUEST Administrator. * Kookie: Request 5a (Residency) be integrated with the upcoming Eligibility Pilot Project. * PERM Team: Add a line on Form 1100B-1 (Passive Renewal) explaining if there is an adult receiving health insurance, the form must be returned with copies of income and assets and a signature (see minutes from 01/11/08 PERM Team meeting). b. We discussed questions posed by Med-QUEST Eligibility Branch supervisors and possible answers. Chris will update this handout for review at our next meeting. Wednesday, 17 September 2008 Process Simplification (PERM Team) Present: Barbara Luksch (Hawaii Covering Kids), Kookie Moon-Ng (Med-QUEST Policy and Program Office), Alan Takahashi (Med-QUEST Eligibility Branch), and Christine Wong (Med-QUEST Policy and Program Development Office). Next Meeting: TBD 1.Citizenship Documentation Forms a. We wrote changes to U. S. citizenship and photo identification documents listed on Form 8000J “Request for U. S. Citizenship, Alien Status, and Photo Identification Documents” based on revised Hawaii Administrative Rules. Barbara will email a draft to team members for final review. b. Based on conversations with Kathy Swink (Child Welfare Services) and Alan, it was recommended this information be added to the instructions for Form 1106 (“CWS/MQD/BESSD Communication Form Foster Children”): Input HAWI Codes The office that owns the case must code HAWI for citizenship and photo identification documents. CWS Picture Identification Procedure * CWS staff take the child's picture * A hard copy is printed. * The photographer will write his or her name, job title, child's name, child's birth date, date picture was taken on the hard copy. * Hard copy is placed in the CWS case file. 2. PERM Tasks The Centers for Medicare & Medicaid Services (CMS) began a new Payment Error Rate Measurement (PERM) program. Contractors perform statistical calculations, medical records collection, and medical/data processing review of selected State Medicaid and CHIP claims. Hawaii will be audited in 2008. Our team’s goal is to develop internal Med-QUEST procedures for consistent ex parte reviews to eliminate application and renewal error rates without forcing customers to go on scavenger hunts. We discussed PPD 08-113 Self-Declared Information for Applications, including these updates: * Add Pregnant Women to the flow chart. * Delete Lawful Permanent Resident Pregnant Women from the fourth box on the flow chart because they will be included in the new box. * Revise phrase “the family shall be provided the opportunity” in paragraph three on page two to better explain the process. * Clarify about acceptance of ATM receipts on the Med-QUEST Eligibility Branch question and answer page. Chris will send a revised draft to the team members.