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Access Health CT Community Outreach. Addresses Core Issues. People are uninsured for many reasons, including : Inability to afford coverage Ineligibility for public programs Being denied coverage based on a pre-existing condition The complexity of enrollment processes
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Access Health CT Community Outreach
Addresses Core Issues • People are uninsured for many reasons, including: • Inability to afford coverage • Ineligibility for public programs • Being denied coverage based on a pre-existing condition • The complexity of enrollment processes • Living in remote areas • Low literacy and health literacy • Limited understanding of health insurance • Cultural and linguistic barriers 2
OHA – AHCT Partnership • In order to address the challenges in implementing the ACA, Access Health CT and the Office of the Healthcare Advocate created a unique partnership. • Designed to provide support through linguistically and culturally appropriate community engagement initiatives and outreach programs. • Trusted community-based organizations help consumers enroll in the health coverage plan that is best for their families.
Access Health CT Consumer Assistance • Through Access Health CT, different types of consumer assistance entities are available to help consumers learn about their health coverage options and enroll through the Marketplace. These entities include: • Navigators • Non-Navigator assistance personnel (also known as Assisters in CT) • Certified application counselors (CACs) • Certified Brokers
AHCT Community Outreach Programs (NIPA) • The state of Connecticut has been divided into six regions – each with a Navigator and a number of Assisters based on the number of uninsured in that region • Federally-Qualified Health Centers (FQHCs), Hospitals, Municipal Health Departments and other health care-related institutions provide trained staff to assist consumers as Certified Application Counselors • Trusted community-based organizations • Linguistically and culturally appropriate community engagement • Engage, educate and enroll consumers in health coverage and educate consumers on how to use their new coverage • Bring the health insurance marketplace to the consumer • Connect to the public health infrastructure
The Uninsured Marketplace Source: Thomson Reuters
The Insurance Marketplace 1 Enter Applicant Information 2 Carrier 6 Medicaid Process Application Verify With Data “Hub” 5 3 Complete Enrollment Display Plan Options 4 Select Plan
Simplifying Medicaid and CHIP Modified Adjusted Gross Income (MAGI) Tax-based concept of family size and household income No Asset Test Elimination of current income disregards and deductions Standard 5% income disregard applied to applicable coverage group No longer considers household composition rules as we currently know them 8
What is a Qualified Health Plan? • an insurance plan that is certified by an Exchange, • provides essential health benefits, minimum coverage • follows established limits on cost-sharing, and • meets other requirements
Navigator Organizations • Work with Access Health CT to guide outreach strategies in the state • Assign 2-4 Key Staff members (senior staff) who manage the program • Organize regional and community-wide strategies, creating a structure for the outreach work in each of six regions • Support the work of the Assisters in their region by coordinating tactical planning, answering questions, convening and training • Support and conduct public education activities and enrollment events in each region • Link consumers to the Office of the Healthcare Advocate, DSS, 211 InfoLine, Brokers and Agents, and other services • Partner with Community Health Centers, Hospitals, City/Town Governments, School Systems, Public Health Departments, Community Foundations, United Ways, chambers of commerce and others • Engage volunteers to promote outreach • Contract runs from September 1, 2013 – June 30, 2014
In-Person Assisters • Community, faith, unions, social service organizations, health departments and small businesses responded to an Request for Proposals to receive $6,000 contracts • Approximately 250 contracts given for existing staff to help community members and their constituents learn about and enroll in health care coverage • Assisters in each community have developed their outreach programs collaboratively and with their Navigators • Assisters facilitate consumers’ enrollment in health coverage • Each Assister is responsible for at least 100 enrollments • Assisters present plan options but will not recommend a particular plan • Will refer consumers to other sources if they need information • Offer consumers the opportunity to register to vote
Action of Bridgeport Community Development, Inc. AFCAMP Agency on Aging of South Central Connecticut AIDS Connecticut, Inc. AmeriCares Free Clinics, Inc. Beulah Heights Church, Inc. Bridgeport Child Advocacy Coalition Bristol Community Organization, Inc. Bristol Family Resource Centers Brookfield Social Services Career Resources Inc. Catholic Charities Archdiocese of Hartford CCMAA Center for Latino Progress - CPRF Central Area Health Education Center Inc. Chase School FRC Chatham Health District Child and Family Agency of Southeastern CT, Inc Christian Activities Council Christian Community Action City of New Britain Community Services Department City of Stamford Department of Health & Social Services Clifford W. Beers Guidance Clinic, Inc. Community Action Agency of New Haven Community Health Resources Community Renewal Team, Inc. Connecticut Center for Arts and Technology Connecticut Pharmacists Association Coram Deo, Inc. CSEA SEIU Local 2001 East End Baptist Church Enfield Family Resource Center Episcopal Social Services of Connecticut IRIS Family Strides, Inc. Farmington Valley American Muslim Community Center First Congregational Church of Washington FSW, Inc. CT GBAPP, Inc. Gifts of Love Greater New Haven Business & Professional Association, Inc. Griffin Hospital Hamden School Public Schools Hartford Dispensary: HJ Clinic Hartford Gay and Lesbian Health Collective Hartford Public Library Hercules Helping Hands Hispanic Center of Greater Danbury Hispanic Coalition of Greater Waterbury Hispanic Health Council Human Resources Agency of New Britain Indian Hindu Religious Temple International Institute of Connecticut Jafaria Association of CT Jamaica Renaissance Society Jewish Family Service of New Haven, Inc. John J Driscoll United Labor Agency Junta For Progressive Action Khmer Health Advocates Latino Community Service, Inc. Ledge Light Health District Liberty Community Services, Inc. LULAC Head Start Inc. Marrakech, Inc. MCCA Ministries of Love and Hope Mount Aery Development Corporation Mutual Housing Association of Greater Hartford, Inc. NAACP Norwich Branch NAMI Connecticut NEON, Norwalk Economic Oppurtunities Now, Inc. New Britain-Berlin YMCA New Haven Free Public Library New Haven Home Recovery, Inc. New Life Corporation New London Homeless Hospitality Center New Opportunities, Inc. Newington Senior and Disabled Center North Central Area Agency on Aging North End Action Team, Inc. Northwestern CT AHEC Old Saybrook Social Services One Eleven Group Parkers Pampering LLC PequenasLigasHispanas de New Haven, Inc. Plainville Senior Center Pomperaug Health District Project Access of New Haven Quinnipiac Valley Health District Right Now Ministries, Inc Safe Futures, Inc. South Park Inn Southington Community Services Southwestern CT Agency on Aging Spanish Community of Wallingford St John Episcopal Church St. James R.C. Church St. Vincent's Health Partners, Inc. TEAM, Inc. Thames Valley Council Comm. Action, Inc. The Access Agency The Community Action Committee of Danbury, Inc The Open Hearth Association Thompson Ecumenical Empowerment Group (TEEG) Torrington Municipal & Teachers Federal Credit Union Town of Enfield - Neighborhood Services Town of Glastonbury Human Services Town of Plymouth, Human Services Town of Stratford Town of Windsor, Social Services Uncas Health District United Way of Coastal Fairfield County Urban League of Greater Hartford Griffin Hospital Valley Parish Nurse Program ViVa Fitness & Wellness Center Waterbury Department of Public Health Waterbury Hospital West Hartford-Bloomfield Health District West Haven Child Development Center Western Connecticut Area Agency on Aging Witness Project of CT, Inc. YWCA New Britain Assister Organizations – Some Have Multiple Assisters
Navigator Key Staff and Assister Certification Process • Following selection of the Navigator and Assister organizations, candidates must: • Pass background check • Sign Privacy and Security and Conflict of Interest statements • Sign contract and other documents • Complete 34-40 hours of training • Pass certification test with grade of 80% or better • Receive photo identification badge and special laptop
Certified Application Counselors • CACs can be staff or members of community health centers, hospitals, health care providers, and certain governmental entities. CACs fulfill some of the same roles and responsibilities as Navigators and Assisters, but aren't responsible for conducting outreach and education. • Their responsibilities include: • Providing free information to consumers about insurance affordability programs (e.g., Medicaid) and coverage options • Assisting consumers in applying for coverage and insurance affordability programs in the Marketplace
Five Ways to Find an Assister or Certified Application Counselor • Go to AccessHealthCT.com - use the “Get Help” tab • Visit an Enrollment Center • Come to an Enrollment Fair -- See the “Events Page” at AccessHealthCT.com for dates and locations • Call Access Health CT’s Toll Free Phone Number: 1-855-805-4325 • Use the AHCTCommunity.org website – for community groups
Assister Languages Khmer Laotian Lingala Mandarin Chinese Polish Portuguese Punjabi Romanian Spanish Swahili Thai Tigrinya Ukrainian Urdu Vietnamese Yoruba American Sign Language (ASL) Arabic Bosnian Burmese Cantonese French Galician German Greek Gujrati Haitian Creole Hebrew Hindi Italian Jamaican Patois Karen up to $94,200 up to $45,960 up to $43,567 up to $15,856 ChithsereyOuk taking questions about ACA at Danbury Cambodian New Life Evangelical Church. September 29th, 2013
People are already benefitting from some very real changes. Thank You! Kate Gervais Kate.Gervais@ct.gov 860-985-5580 www.ahctcommunity.org