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Covering Kids and Families Collaborative Georgia Columbia County Dept. of Family and Children Services Terry Greene Georgia Dept. of Community Health Fran.

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Presentation on theme: "Covering Kids and Families Collaborative Georgia Columbia County Dept. of Family and Children Services Terry Greene Georgia Dept. of Community Health Fran."— Presentation transcript:

1 Covering Kids and Families Collaborative Georgia Columbia County Dept. of Family and Children Services Terry Greene Georgia Dept. of Community Health Fran Ellington Covering Kids and Families State and Augusta Pilot Site Fran Yelton Robyn Freeh Addressing the issues of Medicaid ineligible families transitioning to PeachCare for Kids and newborns attaining and maintaining coverage from birth through their first year by working with eligibility workers, Dept. of Health, and local hospitals.

2 Goals 1. Improve the transition from Medicaid to PeachCare for Kids 2. Improve the time it takes to add newborn children to the Medicaid rolls. 3. Improve the number of eligible children turning one year of age who remain covered by Medicaid or transition to PeachCare for Kids.

3 Changes Tested Completion of PeachCare for Kids application online by DFCS staff for all Medicaid ineligible children either at renewal or application. Completion of PeachCare for Kids application online by DFCS staff for all Medicaid ineligible children either at renewal or application. Staff trained on online process. Staff trained on online process. Notification letters developed and tested. Notification letters developed and tested. Ineligible children identified. Ineligible children identified. Online applications completed (in test loads). Online applications completed (in test loads). Acceptance of PeachCare for Kids and Medicaid application information over the phone. Acceptance of PeachCare for Kids and Medicaid application information over the phone. Identified staff to accept phone calls. Identified staff to accept phone calls. Advertised local phone number in community through Valentine and Pre-Kindergarten promotion. Advertised local phone number in community through Valentine and Pre-Kindergarten promotion. Monitored volume and source of calls. Monitored volume and source of calls.

4 Changes Tested Access actual practice of Presumptive Eligibility and Newborn Medicaid process. Access actual practice of Presumptive Eligibility and Newborn Medicaid process. Interviewed Health Dept. and hospital staff. Interviewed Health Dept. and hospital staff. Mapped Process and compared to policy. Mapped Process and compared to policy. Evaluated data to confirm stated process. Evaluated data to confirm stated process. Trained Health Dept. and hospital staff on desired process including provision of or elimination of new and/or unnecessary forms. Trained Health Dept. and hospital staff on desired process including provision of or elimination of new and/or unnecessary forms. Monitor use of new forms and transfer of data. Monitor use of new forms and transfer of data. Utilize information currently provided to DFCS concerning newborn births. Utilize information currently provided to DFCS concerning newborn births. Screen lists sent from state computer system as a result of hospital report of births to identify newborns. Screen lists sent from state computer system as a result of hospital report of births to identify newborns. Input data in DFCS computer system as report of birth and residency status. Input data in DFCS computer system as report of birth and residency status. Confirm case status in state computer system to transition newborn from temporary to ongoing status. Confirm case status in state computer system to transition newborn from temporary to ongoing status.

5 Results DFCS staff processing PeachCare for Kids online for all Medicaid ineligible children in 2 caseloads. DFCS staff processing PeachCare for Kids online for all Medicaid ineligible children in 2 caseloads. DFCS staff accepting applications over the phone. DFCS staff accepting applications over the phone. Health Dept. processing new applications and sharing correct policy information with clients Health Dept. processing new applications and sharing correct policy information with clients

6 Results Hospitals reporting births, residency of newborn and pediatrician on state computer system and attempting to provide temporary Medicaid card prior to discharge. Hospitals reporting births, residency of newborn and pediatrician on state computer system and attempting to provide temporary Medicaid card prior to discharge. DFCS utilizing hospital birth report as notification of birth and converting from temporary to ongoing Medicaid case. DFCS utilizing hospital birth report as notification of birth and converting from temporary to ongoing Medicaid case.

7 Denials By Reason

8 Closed At Renewal

9 Closures By Reason

10 Next Steps Complete testing related to retention of children turning one. Complete testing related to retention of children turning one. Update Medicaid provider manual to clarify newborn procedures. Update Medicaid provider manual to clarify newborn procedures. Clarify newborn procedures for local eligibility offices. Clarify newborn procedures for local eligibility offices. Make changes to PeachCare system to facilitate the transition from Medicaid to PeachCare. Make changes to PeachCare system to facilitate the transition from Medicaid to PeachCare. Do testing of provider selection fields in newborn process. Do testing of provider selection fields in newborn process.


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