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HRSA Health Center Outreach and Enrollment Technical Assistance Call September 27, 2013. Presentation Overview. Introduction CAC Designation Update (For FFMs Only ) Success Stories Review of FAQs Outreach and Enrollment Quarterly Progress Reports (OE QPR) Resources Questions and Answers.
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HRSA Health Center Outreach and Enrollment Technical Assistance Call September 27, 2013
Presentation Overview • Introduction • CAC Designation Update (For FFMs Only) • Success Stories • Review of FAQs • Outreach and Enrollment Quarterly Progress Reports (OE QPR) • Resources • Questions and Answers
CAC Application Update (for FFM and SPM states only) • If your health center is in a state-based marketplace, you do not need to complete a federal CAC application, unless your state has determined that you must do so. • CMS continues to prioritize health center CAC applications and is reviewing them as quickly as possible. HRSA is in daily communication with CMS on this issue. • If the CAC application process has delayed your O/E assistance worker training, report that in the barriers section of your October QPR. • In order to expedite CAC application review: • Submit your signed agreement electronically • Send CAC issues to your PCA and to HRSA at bphc-oe@hrsa.gov. If you can’t find your CAC designation number in the body of your email from CMS, it should also be in the subject line of the message.
FFM/SPM Marketplace “Get Ready for Open Enrollment” Informational Calls • Who: For all organizations awarded/approved as Navigators, Certified Application Counselors, and Enrollment Assistance Programs (i.e., health centers in FFMs and SPMs) • What: The latest news and tips to help you assist consumers in the Marketplace. • When and How to Register: • Monday, September 30, 10:00 a.m.- 11:30 a.m. ET: https://webinar.cms.hhs.gov/mpa930am/event/registration.html • Monday, September 30, 1:30 p.m.- 3:00 p.m. ET: https://webinar.cms.hhs.gov/mpa930pm/event/registration.html • Ask questions before and during the call via email at training@cms.hhs.gov. Please refer to the call in the subject line.
Highlight Your Health Center’s O/E Success through Stories • HRSA needs your health center success stories • These will be shared for non-media purposes (inclusion in speeches, social media, healthcare.gov) • Kinds of successes you might share: • October 1 events—let us know what you have planned • Health center events that used creative strategies, unique settings, and/or attracted lots of people • Successful one-on-one connections to service area residents • Provider-patient stories • Non O/E health center staff-patient stories
Success Stories—How to Share Them • If you think you might have a good story, you probably do. Err on the side of sharing! • Be specific • “280 people attended the event held at the grocery store” is better than “many people attended the event” • The bi-lingual provider was able to explain options to the Spanish-speaking patient who then… • Copy your PCAso they can see the great things that are going on in the state/region. • If you have communications staff who are sharing stories regularly with local media, ask them to add HRSA’s inbox to their list of contact. Send stories to bphc-oe@hrsa.gov.
Training • FAQs, separated for health centers in FFMs/SPMs and in SBMs are available at http://bphc.hrsa.gov/outreachandenrollment/. • Key points: • First and foremost, health centers must comply with all federal and state requirements. Consult with your PCA if you are not sure of the requirements in your state. • Requirements apply to all O/E assistance workers, whether or not they are supported by HRSA supplemental dollars. • The O/E Quarterly Progress Reports (O/E QPR) will allow you to provide context for the data you report, e.g., if training is not available yet, you can indicate that as a barrier in your O/E QPR.
Sharing Information about Health Centers’ QHPs—FFMs/SPMs “Can health center O/E assistance workers let consumers know which plans our health center participates in?” • Health center CACs in FFMs and SPMs mayprovide information to consumers about the plans in which the health center participates, unless there are additional state restrictions. • Health center CACs in FFMs and SPMsmay not offer recommendations to consumers or advise consumers on what plan to choose.
Sharing Information about Health Centers’ QHPs—SBMs “Can health center O/E assistance workers let consumers know which plans our health center participates in?” • Health center O/E assistance workers in SBMsmust comply with all conflict of interest requirements as determined by their state Marketplace and their consumer assistance role. • Follow the guidelines provided in the required training in yourin the state.
Sharing Services Available at the Health Center • “Can I promote the services provided by the health center as part of my O/E activities?” • Health centers can announce an O/E event to be hosted by the health center and/or share information about the availability of the health center as a location where O/E assistance is available. • These communications must be reasonable and consistent with the intent of the O/E supplemental funding opportunity and must not promote the health center or its services. • To the extent possible, O/E messages should rely on pre-approved federal and/or state materials.
Health Center O/E Quarterly Progress Report (QPR) Key Dates • October 9 • Technical assistance call from 2:00 PM -3:00 PM ET. • Overview of the data elements, timelines, and the O/E QPR submission process. • Call information will be included in the BPHC Primary Care Digest and will be posted at http://bphc.hrsa.gov/outreachandenrollment/ • October 10 • QPR system opens in EHB. • October 24 • Deadline for submission.
Health Center O/E QPR • A QPR sample, reporting definitions, and FAQs will be available available at http://bphc.hrsa.gov/outreachandenrollment/ • Reporting is essential. • HRSA will place the entire section 330 grant award on drawdown restriction for any health centers who received O/E supplemental funding and do not submit their QPR.
Health Center O/E QPR Metrics • Number Trained • Number of health center O/E assistance workers that have successfully completed all required federal and/or state training. • Health center O/E assistance workers include all health center staff, contractor, or volunteer assistance personnel who are trained to facilitate enrollment of individuals into the Marketplace, Medicaid and/or CHIP. • If there are barriers in your state that have prevented staff from getting training, note that in the barriers section of the O/E QPR.
Health Center O/E QPR Metrics • Number Assisted • In-person education about affordable insurance coverage options (one-on-one or small group) and any other assistance provided by a trained health center O/E assistance worker to facilitate enrollment. • HRSA does not expect health centers to track assistance by individual. • Health centers should report each interaction with an individual that includes an assist (even if the assistance occurs with the same person on different days).
Health Center O/E QPR Metrics • Number Assisted continued • Number assisted may encompass • Identifying eligibility for coverage in the Marketplace (e.g., confirming that an individual is a citizen or legal resident as defined at www.HealthCare.gov) • Setting up an account • Filing affordability assistance information • Receiving an eligibility determination for subsidies in the Marketplace or for enrollment in Medicaid or CHIP • Assisting with understanding of qualified health plan or Medicaid/CHIP plan options.
Health Center O/E QPR Metrics • Number Assisted with an Eligibility Determination • Number of individuals who have received an eligibility determination for subsidies through the Marketplace or who were estimated to be eligible for Medicaid or CHIP. • Include all individuals who received an eligibility determination, even if the individual is not eligible for a subsidy through the Marketplace or for Medicaid/CHIP.
Health Center O/E QPR Metrics • Number Assisted with Enrollment • Health centers should report an estimate of the individuals who have selected a qualified health plan or who have filed Medicaid/CHIP enrollment documentation. • Health centers in SBMs with systems that allow health center O/E assistance workers to track their facilitation of enrollment, report enrollment as captured by that state system.
Health Center O/E QPR Metrics • Number Assisted with Enrollment (continued) • In states that restrict or prohibit health center facilitation of enrollment: • Health centers should report to HRSA only those activities that are permitted (e.g., number trained, assists, and/or eligibility determinations). • Please explain the state limitations in the narrative portion of the O/E QPR.
Q&A Questions?
For More Information Contact Your PCA BPHC Primary Care Digest BPHC Outreach and Enrollment Team Inbox bphc-oe@hrsa.gov BPHC O/E supplemental funding technical assistance web page http://bphc.hrsa.gov/outreachandenrollment/ BPHC O/E Grantee Enrichment Series http://bphc.hrsa.gov/technicalassistance/trainings/index.html Other important websites: https://www.healthcare.gov/ http://marketplace.cms.gov/ http://www.hrsa.gov/affordablecareact/ /