Lead Organization Responsibilities Build local network of community-based organizations Lead outreach and education activities for service area Train Navigators within the service area Financial agent for network partners Performance monitoring Reporting 3
State and County Projections Projected Population by 12/31/2013 Projected Population of Uninsured under age 65 Uninsured Estimated who would qualify for Medicaid Expansion Uninsured who would qualify for subsidies Percent of Population who would benefit from the ACA Yakima County 250,60076,800 *30,80024,50072% ** Kittitas County 42,1008,400*3,1003,20075%** Two County Total 292,70085,200*33,90027,700 Washington State 6.9 million1.1million328,000447,40074% 5
Need for In-reach in Yakima/Kittitas Counties Community Health Centers # of Patients at 3 CHCs Medicaid% of County Medicaid Uninsured% of County Uninsured Children34,15059%3,63239% Adults11,00045%21,68344%
Community Partners Collaboration Non-Contracted Partners: People for People Homeless Resource Center Yakima Yakima Valley Memorial Hospital Children’s Village Yakima Regional Medical & Cardiac Housing Authority of Kittitas Maher Insurance Yakima Housing AuthoritySanelli Insurance ESD 105 Prosser Memorial Medical CenterCentral WA Disabilities La Casa Hogar SE WA Aging & Long Term CareHomeless Resource Center Sunnyside Triumph Services Lower Valley Crisis & Support ServicesCentral WA Comprehensive Mental Health MSDR Department of Social & Health ServicesHearing and Speech
Roles for Community Partners o In-Person Assister (IPA) Training and having an IPA certified through the Health Benefit Exchange (requires 25-30 hours of training & successfully passing the state certification exam.) o Hosting a location for a certified IPA to assist clients on a regularly scheduled basis. o Hosting a special event for a presentation / Q&A session and assistance. o Willingness to distribute Outreach & Assistance information.
Type of Training LengthFormatFeaturesOffered by Assisters / Navigators (different name for same roles) 30 hoursIn person training Certification Dashboard access Ongoing account access with consumer permission Medicaid and QHP enrollment YNHS (Lead Org) Certified Application Counselor 10 hoursRecorded webinars Certification Dashboard access Short term account access Medicaid and QHP enrollments Health Benefit Exchange (state) MedicaidOne dayIn person trainings No certification Dashboard access Short term account access Medicaid enrollment authorization only Health Care Authority (state Medicaid) Education about Training Different Roles 9
Outreach Handouts Offering various points of contacts for clients seeking IPA/Navigator Assistance
1 Neighborhood Connections Health Care for the Homeless 3 Housing 2 Homeless Respite 4 Community Outreach Resource Center, HEN & Basic Needs Assistance Healthplanfinder Opportunities
Integration of YNHS Staff Expertise Health Care for the Homeless In 2013, served 2,231 homeless Permanent Supportive Housing In 2013, served 67 people in 28 households Transitional Housing 107 people in 35 households Emergency Housing / Medical Respite Care – 38 individuals Homeless Services (non-health care) 2,037 clients in 1,553 families
Cross Training Staff to Enroll in WA Healthplanfinder Dedicated Patient Navigators (3) Health Care for the Homeless Outreach staff (3) Housing Specialists (5) WIC Certifiers (3) Maternity Support Case Managers (2) Reception / Billing staff (6) Dental Reception (1) Behavioral Health Specialist (1) 17
Other Reasons People Come to Us Consolidated Homeless Grants (CHG) State support to Counties / CACs Emergency Solutions Grants (ESG) State support to Counties / CACs Housing & Essential Needs (HEN) Dept of Commerce to Counties Clients already on Medicaid- but often attached to uninsured Low Income Energy Assistance Program (LIHEAP) 18
20 For additional benefits (TANF, SNAP, etc, customers will apply here in Washington Connections - a “virtual handoff” from the HPF SSI Recipients SSI related clients Medicare Savings Program Nursing Home clients Alien Emergency Medical (AEM )
PEOPLE WHO DON’T WORK / DON’T FILE TAXES Self Attestation of Income accepted MEDS unit looks at ACES (SNAP, cash, Medicaid eligibility system). Random sample will be reviewed According to Health Care Authority, the focus will be on: Data matches showing income over Medicaid standard. 21
Homeless Youth The Issue of “Legal Contracts” HCA will now offer a contact person to assist in the processing of homeless teen applications: ▪ HCA CONTACT: Jessica Cottom (only available during regular HCA office hours of Monday – Friday from 8:00am – 5:00pm) ▪ PHONE: (360) 725-2050 ▪ EMAIL: email@example.com ▪ FAX: (360) 664-2186
Once They Have Coverage… Picking a health plan and a primary care provider (PCP) Understanding how to use the local health care system Reducing Churn – recertification Partnering on the application and accepting receiving copies of information is important 27
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