Thursday, 20 November 2008 Conference Planning Committee Present: Linda Colburn, Chris Jackson, Lisa Kahahane, Barbara Luksch, Gwen Palmer, Mary Rydell, Alan Takahashi, and Arnold Villafuerte. 1. Malama i na Keiki 10 Goal: We will work together to find, enroll, and retain all eligible children and youths in health insurance. We reviewed the Malama i na Keiki 9 evaluation report, including suggestions for the next conference. It was agreed presenters will focus on Hawaiian culture and awareness. We chose Friday, 13 March 2009 at the Best Western Plaza Hotel near the Honolulu airport. The theme will be “Values That Transcend Culture and Economic Hardship.” 2. Agenda (8:00 AM - 4:00 PM) We brainstormed these ideas for guest speakers: * Welcome: Kenny Fink, Med-QUEST Administrator * Guest Speaker: Kepa Maly, Executive Director, Länai Culture and Heritage Center * Med-QUEST Supervisors: Training workshops * Kim Gennaula and Guy Hagi: “Got Less But Gotta Do More” * Linda: Egg drop activity requiring teamwork and thriftiness Barbara will contact the speakers and organize specific times. There will be a morning small group activity among participants assigned to tables; interaction will be reflecting on expressions emulating cultural values handed down in each person’s family. Sanuk activities will be interspersed throughout the day and Barbara will prepare fun music. It will be a “cellphone free” event which will be explained on the registration form. 3. Participants The limit is 100 and will include conference planning committee members and four Oahu Med-QUEST supervisors to conduct training workshops. All other participants must be agency staff whose full-time responsibility is directly interacting with families, such as outreach workers, outstationed eligibility workers, public health nurses, Head Start educators, and social workers. We will also invite two Med-QUEST eligibility workers per unit. 4. Travel Barbara will book travel for Med-QUEST’s Neighbor Island eligibility workers through a DHS grant. Travel scholarships will be offered to others who stay the entire day. Participants from Ka‘ü and Häna can be reimbursed for hotel accommodation on 12 March 2009. Participants will be reminded to book early. Tuesday, 25 November 2008 Save Keiki Care Senator Josh Green and Senator Suzanne Chun Oakland sponsored the event and there were 26 participants. These points summarize the discussion: * We are committed to all kids in Hawaii having health insurance. * We understand it costs less to cover children and youths with health insurance than pay expensive hospital care for uninsured kids when families cannot afford emergency health care bills. * We are researching private foundation funding to replace Keiki Care state funds beginning 01/01/09. The cost is about $600,000 per year. * Approximately 40 additional children per month have been enrolled in Keiki Care since it started 04/01/08. * Health care utilization for children in Keiki Care has been higher than those enrolled in the HMSA Children’s Plan. We surmise these kids may have initially used more health care services because they entered Keiki Care without having health insurance for at least six months which created pent-up demand. It also shows “gap group” kids need health care services. * Children currently in Keiki Care can sign up for the HMSA Children’s Plan at a subsidized $55.00 per month per child premium. Payments will be assessed beginning 01/01/09. * Outreach workers reported to Hawaii Covering Kids that most parents they helped with Keiki Care applications have at least three children. These families cannot afford HMSA Children’s Plan premiums so their children will become uninsured. * There is a nationwide misperception that state funding ended due to extensive dropping of private health insurance coverage to enroll in the free Keiki Care plan (called “crowd-out”). Hawaii has never had a crowd-out problem in any children’s health insurance program, therefore Hawaii Covering Kids is working with national organizations and other Covering Kids state projects to dispel this myth. Friday, 5 December 2008 Oahu Outstationed Eligibility Workers Present: Lori-Lei Aponte, Karen Gardner, Jonnette Kamakea, Barbara Luksch, Michelle Malufau, Kookie Moon-Ng, Jasmin Nepomuceno, Regina Quimpo, Teri Roe, Cassandra Stewart, Alan Takahashi, and Sunny Yee. Next Meeting: 20 February 2009 1. Customer Service Branch Lori-Lei gave an overview of their services, including: a. Call Center: Helps customers, providers, and other people b. Member File Integrity: Transfer files between MQD Eligibility Branch and health plan enrollment c. Outreach and Education: New responsibility The Call Center can provide general information, health plan enrollment, dental information, ongoing eligibility status from HAWI including denial reason, and application assigned unit number and clerk’s telephone number. It also reorders Medicaid ID cards, refers foster care questions to a general phone number, works with pharmacies and Medicaid fiscal agent (ACS) to help customers with approved applications get prescriptions filled, and assists patients at physician offices if they are not currently in the health care provider’s online system. 2. Med-QUEST Honolulu Office Pilot Project Kookie explained the process with these highlights: Started: Monday, 6 October 2008 * Mail opened and divided; faxes organized three times per day * Applications for Unit 117 and from Queen’s Hospital are registered same day * Pending notices go to contractor which sends to applicant the same day and makes arrangements to get required information * Shows if need more staff and which positions, evaluation of worker performance standards, and reexamination processes to simplify for efficiency. Great Success * Cuts down duplicate applications * Papers are efficiently sorted * MQD clerical staff freed up to do other work * Applications for other units registered within one week * Observation: If person mails or brings application, she/he has a vested interest and there is a better chance the process will be completed. Next Step RFP issued to continue and expand the pilot project to other Honolulu units. 3. Limited English Speaking Customers We discussed service for customers with limited English proficiency. Med-QUEST and Outreach Services use TeleInterpreters. Community health center have onsite interpreters. It was noted some Med-QUEST staff at the Honolulu office’s reception desk may not know Med-QUEST’s interpreter procedure. Alan will follow-up so all walk-in customers receive appropriate interpreter services. 4. OEW Recommendations to Honolulu Office Based on information shared at the 5 September 2008 meeting, Oahu OEWs suggested three actions to better assist mutual customers: a. When an application with 1100A is registered, list outstationed facility as the authorized representative in the address screen. Next require all eligibility workers call the OEW if documents are missing or other information is needed to process the application. Positive Outcome: Overall it will save the eligibility worker time if she/he uses the OEW to get paperwork or details rather than sending a pending notice. b. Assign two eligibility workers to process pregnant women (PW) and medical emergency (ME) applications. This system was extremely efficient and inexplicably disappeared. Positive Outcome: PW and ME applications will be processed on time (5 business days and 2 business days respectively). Also, OEWs and customers know exactly who to call with questions about these applications. c. Allow all community health center OEWs to send applications to the Kapolei office. Positive Outcome: More efficient process. Overall it will build a positive public-private partnership and provide better customer service. Alan will review the recommendations and give an update at the next meeting. 5. Other Information a. We discussed the newborns eligibility process for Med-QUEST’s programs. Hospitals complete a form that goes to the local Med-QUEST office. If the mother is a Medicaid recipient, it is an add-on which is not registered but goes to the ongoing eligibility worker. If a customer contacts Med-QUEST’s call center about the newborn, information will be recorded and sent to the ongoing eligibility worker. If it is a financial assistance case, BESSD requires an application (1240). b. PERM: (1) See attached filter diagram for applicants not required to submit copies; (2) If it is a ME, eligibility will be determined for the urgent health care service and a pending notice sent for necessary documents; (3) If an employee works for cash, the employer can sign an income note. c. Children and Pregnant Women: Absent parent information is NOT required—use 1108. d. Some faxes arrive at the Med-QUEST office black. Alan will tell the senders so they can fix their machine. e. Retroactive Coverage: Effective 02/01/09 all Med-QUEST customers can receive retroactive coverage for 30 days from application date.