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Roula K. Sweis M.A., Psy.D Supervisory Program Advisor HUD’s Office of the Assistant Secretary for Community Planning and Development Using Medicaid with.

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Presentation on theme: "Roula K. Sweis M.A., Psy.D Supervisory Program Advisor HUD’s Office of the Assistant Secretary for Community Planning and Development Using Medicaid with."— Presentation transcript:

1 Roula K. Sweis M.A., Psy.D Supervisory Program Advisor HUD’s Office of the Assistant Secretary for Community Planning and Development Using Medicaid with HUD’s Homeless Assistance Programs

2 Strategies for Coordinating and Integrating Medicaid Reimbursable Services with Homeless Assistance

3

4 Presentation Outline Overview of the H² TA Approach and Initiative Onsite Action Planning Events Framework Used to Structure Events Tools and Handouts

5 Overview of the H² TA Approach 1.Data Analysis Identified Gaps and Challenges 2. Gaps and Challenges 5 Pronged TA Proposal 3.Consultations on Proposal Finalized TA and Built Coalition 4. Implementation Constant Feedback Loop and Refinement

6 Data Analysis Most CoCs (79% or greater) did not report a relationship with the federally-defined entities designated to support ACA implementation in local communities. The most commonly-reported relationship was with in- person assisters (IPAs), who are trained to help individuals enroll in ACA-related programs, followed by certified enrollment counselors (CECs). Least common was the use of Certified Enrollment Entities/Agencies (CEE/CEA) and federally-qualified health centers (FQHCs).

7 Data Analysis (Cont.) More than half of all CoCs (59%) did not mention the use of Navigators in their responses to the ACA enrollment question. Of those who mentioned Navigators, most described a relationship of partnership between the CoC and a local or state organization who had one or more navigators. It was rare to find CoCs referring clients to navigators with whom the CoC had no relationship. Only a small number of CoC-funded agencies (32) were home to ACA navigators.

8 Data Analysis (Cont.) Very few CoCs reported planning or providing training for their staff or their clients to prepare for ACA enrollment. In addition, about 10% of CoCs reported receiving training through a mandatory state- driven training mechanism, and in most of these cases (9% of the 10%) this was the only ACA training the CoC members received. Almost no CoCs (96%) reported planning or holding trainings for their clients and just over two-thirds of CoCs (68%) made no mention of training their agencies or staff to prepare for ACA implementation.

9 Data Analysis (Cont.) The most common enrollment strategy utilized by CoCs was referral to an outside agency that specialized in ACA/medicaid enrollment. About 20% of CoCs (82) were not able to articulate any strategies being used to enroll clients in ACA coverage. Not surprisingly, most of these CoCs (52%) came from non-expansion locations.

10 Data Analysis (Cont.) The most common community strategies for enrolling clients in ACA services were using existing public health or social service entities(e.g., hospitals, clinics, Social Security), followed by having public events such as enrollment fairs and training other local human service providers to assist with the enrollment process.

11 H² - A 5 Pronged TA Initiative 1.Listserv Messages and ACA Website Enhancement 2. Webinars 3. Homeless & Healthcare Systems Integration Action Planning Sessions 4. Assessment (Case studies/tools and products for widespread dissemination) 5. Health Insurance Data Collection & Quality Improvement

12 Framework Used to Structure Events Five Healthcare Related Model Strategies to Consider in Developing an Action Plan: 1.Enrollment: Facilitate enrollment of people who are homeless and at-risk in Medicaid; 2.Access: Facilitate access to care, engagement with providers, and appropriate use of health services; 3.Integration: Integrate housing, health and other services to facilitate housing retention and ongoing wellness; 4.Data: Develop data-driven service interventions targeted to priority sub-populations; 5.Resource Maximization: Maximize use of Medicaid to finance homeless housing and services, including PSH and recuperative/transition care.

13 Framework Used to Structure Events Cross-Cutting Issues to be considered as part of the implementation: 1.Training: What training will be needed for staff? 2.Partnerships: What partnerships are needed and how can they be forged? 3.Targeting: Should particular sub-populations be targeted and how should they be identified? 4.Scale: What will be needed to bring the strategy to a scale appropriate to meet the need? 5.Systems: How can individual programmatic efforts be aligned into a unified system working toward shared outcomes?

14 Action Planning Schedule Pilot Sites: State of Nevada; State of Virginia Utah: March 4-5 Connecticut: March 18 – 19 North Carolina: April 28 – 30 New Mexico: May 13 – 14 Idaho: May 27 – 28 Tennessee: June 9-10 Chicago, Illinois: July 8-9 Texas: TBD

15 Tools and Handouts 1.Overview of On-Site Action Planning Session 2.Agenda Topics for Action Planning Sessions 3.Model Strategies Checklist 4.Stakeholder Outreach List

16 Resources HUD https://www.hudexchange.info/aca/ CMS Medicaid and Chip basics: Supporting enrollment efforts: topics/outreach-tools/supporting-enrollment-efforts/supporting-enrollment-efforts.htmlhttp://www.medicaid.gov/medicaid-chip-program-information/by- topics/outreach-tools/supporting-enrollment-efforts/supporting-enrollment-efforts.html ASPE Let’s Get Everyone Covered: HRSA Find a health center: SAMHSA Homeless and Housing Resource Network (HHRN): SOAR works: Administration for Children and Families: Information on youth accessing healthcare: care-of http://www.acf.hhs.gov/programs/fysb/resource/getting-taken- care-of

17 Resources (Cont.) National Health Care for the Homeless Council NHCHC outreach information: https://www.nhchc.org/resources/clinical/tools-and- support/outreach/https://www.nhchc.org/resources/clinical/tools-and- support/outreach/ NHCHC enrollment toolkit: https://www.nhchc.org/policy-advocacy/reform/nhchc-health- reform-materials/https://www.nhchc.org/policy-advocacy/reform/nhchc-health- reform-materials/ NHCHC training website: https://www.nhchc.org/training-technical-assistance/request- training-or-ta/https://www.nhchc.org/training-technical-assistance/request- training-or-ta/ NHCHC website including policy briefs: https://www.nhchc.org/policy- advocacy/reform/nhchc-health-reform-materials/https://www.nhchc.org/policy- advocacy/reform/nhchc-health-reform-materials/ Families USA State private insurance checklist: advocacy-checklist-getting-know-your-states-health-insurance-landscapehttp://familiesusa.org/product/private-insurance- advocacy-checklist-getting-know-your-states-health-insurance-landscape Medicaid Expansion helps low-wage workers: expansion-helps-low-wage-workershttp://familiesusa.org/product/medicaid- expansion-helps-low-wage-workers

18 Questions/Comments Roula K. Sweis HUD – Community Planning and Development Supervisory Program Advisor


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