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Regional Coordinator Training Healthcare Reform in New York State 1.

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Presentation on theme: "Regional Coordinator Training Healthcare Reform in New York State 1."— Presentation transcript:

1 Regional Coordinator Training Healthcare Reform in New York State 1

2 Regional Coordinator Training Sponsored by: SAMHSA BRSS TACS 2

3 Training Objectives Project Overview and Roles & Responsibilities Understanding the Affordable Care Act (ACA) and Health Care ReformProject Outcomes and Evaluation ToolsTips, Resources/LinksTime LineGetting Started 3

4 The Affordable Care Act (ACA) signed on March 23, This is a federal mandate, so it affects the whole country. Completed implementation slated for January 1, In March 2010 President Obama signed federal health reform into law. 4

5 President Obama has initiated significant reform in health insurance for all Americans through the Affordable Care ACT Federal reform will take effect January 1,

6 It’s important that all New Yorkers understand how this will roll out in our state. – Restoration Society, Inc. (RSI), based in Buffalo, NY, is leading a project to inform fellow New Yorkers of health care reform. 6

7 Share health care reform information with peers (individuals with behavioral health conditions) across your region. Host or participate in a community health or wellness fair or event where health care information can be distributed. Reach as many people across New York State as possible. 7

8 Reduce the number of eligible uninsured with behavioral health conditions. Inform uninsured individuals with mental health and substance abuse disorders about ACA. A peer-to-peer project intended to: 8

9 Partner with peers in each region across NYS. Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. Efforts will always be made to reach the greatest number of people as possible in the target population. 9

10 Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. Efforts will always be made to reach the greatest number of people as possible in the target population. Partner with peers in each region across New York State. 10

11 Partner with peers in each region across NYS. Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. Efforts will always be made to reach the greatest number of people as possible in the target population. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. 11

12 Partner with peers in each region across NYS. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. Efforts will always be made to reach the greatest number of people as possible in the target population. Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. 12

13 Partner with peers in each region across NYS. Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. Efforts will always be made to reach the greatest number of people as possible in the target population. 13

14 Partner with peers in each region across NYS. Regional Coordinators reach out to individuals with behavioral health conditions, families, & providers. Shortly after training, Peer Regional Coordinators will receive outreach material printed in English and Spanish, including: posters, flyers, handouts. Efforts will always be made to reach the greatest number of people as possible in the target population. 14

15 Identify places where the high risk, difficult-to-engage population pass or congregate: Mental health/substance abuse clinics Soup kitchens Homeless programs Emergency rooms Bus stations Public libraries Identify places where the high risk, difficult-to-engage population pass or congregate: Mental health/substance abuse clinics Soup kitchens Homeless programs Emergency rooms Bus stations Public libraries 15

16 Post in places where the target population frequents or passes; making contacts at the specific locations when possible and appropriate. 16

17 Offer a minimum of 2 presentations per region regarding the ACA and enrollment support. 17

18 Submit outcome data monthly. 18

19 Participate in a monthly conference call. 19

20 Purpose Important terms What it means in NYS What it means to peers Understanding the Affordable Care Act 20

21 Purpose of the Affordable Care Act: more accessible less expensive prevent insurance companies from denying services for pre-existing conditions 21

22 Thoughts to Consider January 2014: Full implementation of Affordable Care Act (ACA). Is it constitutional? New York versus other states 22

23 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 23

24 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 24

25 Defining Important Terms – Organized market place where consumers and small businesses shop for insurance coverage that allows easy comparison on plans, price and quality. – Insurance coverage will be more affordable through the Exchange. Health Benefit Exchange 25

26 Defining Important Terms How many New Yorkers will gain health insurance as a result of health care changes? 1.200,000 New Yorkers 2.500,000 New Yorkers 3.1 million New Yorkers 4.5 million New Yorkers Health Benefit Exchange 26

27 Defining Important Terms – About 1 million New Yorkers will gain health insurance when the Exchange is implemented. – Individuals will be able to use a “state of the art” website to “shop” for health insurance. – Consumers will be able to compare plans and choose the one best suited to their needs! – The Exchange must be up and running by January 1, Health Benefit Exchange 27

28 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 28

29 Essential Benefits Defining Important Terms – Health services that are mandated by Health Care Reform and the Affordable Care Act. Must be available to all individuals without exception. 29

30 Defining Important Terms Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services including behavioral health treatment Essential Benefits 30

31 Defining Important Terms Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services Chronic disease management Pediatric services including oral and vision care Essential Benefits 31

32 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 32

33 Pre-Existing Conditions Defining Important Terms The Affordable Care Act provides coverage for those with pre-existing conditions UNTIL the full ACA Law takes effect. The new program is called the “Pre-Existing Condition Insurance Plan” (PCIP). 33

34 Pre-Existing Conditions Defining Important Terms PCIP increases insurance coverage of pre- existing conditions which were not covered before. In New York State the PCIP is the called the “Bridge Plan”. 34

35 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 35

36 New York State Bridge Plan Defining Important Terms Bridge Plan is a temporary plan until January It provides coverage for individuals with pre- existing conditions, who have NOT had insurance for 6 months. 36

37 New York State Bridge Plan Defining Important Terms Coverage at special rates: – Upstate Counties: $362/month – Downstate Counties: $421/month 37

38 New York State Bridge Plan Defining Important Terms Mental health and behavioral health conditions qualify for the Bridge Plan: Panic Disorders, Depression, Bipolar Disorder Schizophrenia Obsessive Compulsive Disorder Eating Disorders, Anorexia & Bulimia Alcohol & Chemical Dependency 38

39 For more information & enrollment Go to: Or call: New York State Bridge Plan 39

40 Defining Important Terms Health Benefit Exchange Essential Benefits Pre-Existing Conditions New York State Bridge Plan Facilitated Enrollment 40

41 Facilitated Enrollment Defining Important Terms Health insurance application assistance and eligibility screening for children and adults seeking health insurance through one of the (3) NYS health insurance programs - all of which are based on income and NYS residency. 41

42 Facilitated Enrollment Defining Important Terms Enrollment specialists meet with individuals to complete the application process and help become enrolled in a program (if eligible). – Assist with the selection of a medical provider (obtain an appointment with a specialist) or access prescription medication. – Provide education on all possible health care options for individuals and families. 42

43 Facilitated Enrollment Defining Important Terms In New York State there are numerous non- profit human service agencies that can assist individuals in the enrollment process. Here are two: 43

44 Reduce the number of eligible uninsured with behavioral health conditions. Inform uninsured individuals with mental health and substance abuse disorders about ACA. 44

45 Project Outcomes and Evaluation Tools 2 Primary Tools To Achieve Objectives: 1.Dissemination of information (indirect method) 2.Outreach and education (direct method) 45

46 Project Outcomes and Evaluation Tools We need to measure: 1.Dissemination of information 2.Outreach and education 46

47 Project Outcomes and Evaluation Tools 1.Dissemination of Information – Regional coordinators will complete a log identifying the places information is dispersed and estimated number of people that pass through monthly. # of indirect outreach efforts (#of posters, flyers, handouts dispersed) # (estimate) of people exposed to the educational material. 47

48 Project Outcomes and Evaluation Tools 1.Dissemination of Information 48

49 Project Outcomes and Evaluation Tools 2.Outreach and Education – Information will be gathered via post-presentation evaluation: # of direct outreach efforts # of people educated through each direct outreach effort (# attending educational presentation) # of attendees who are eligible but not insured # who are uninsured who plan on enrolling 49

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51 Remember… The goal of this project is to empower individuals with behavioral health conditions by educating them about health care reform and their options. 51

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53 Dank u ありがとう Вы Merci Σας ευχαριστούμε 謝謝 Gracias 너를 감사하십시요 Thank you 53


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