Texas CHIP Coalition Minutes
Friday, January 21, 2005, 11:00 a.m. - 1:30 p.m.
Thompson Auditorium, 1st Floor
Texas Medical Association
Anne Dunkelberg called the meeting to order at 11:10 a.m.
Covering Kids & Families National Program Office
Sonia Lara introduced representatives from the Covering Kids & Families (CKF) National Program Office (NPO). Over the course of several days, the NPO representatives participated in a series of meetings with the CKF state grantee, Texas Association of Community Health Centers (TACHC) and other key CHIP coalition partners. Sarah Shuptrine, CKF National Program Director, highlighted the possibility of Texas participating in the CKF collaborative focusing on process improvement strategies. Judi Cramer, CKF Southern Regional Director, provided an overview of the previous meetings with emphasis on sustainability beyond the grant period.
Legislative Developments
The base budget does not include adequate funding for current services offered under Medicaid. The base budget does account for Medicaid enrollment growth, but not Medicaid cost increase or inflation. CHIP funding includes dental and vision restoration, but not caseload OR cost growth even, at 6-month coverage. Together, Medicaid and CHIP at HHSC and DADs need approximately another $1.3 billion state dollars, for CURRENT SERVICES alone. To RESTORE Medicaid and CHIP cuts, at least another $520 million is needed.
Some funds have been allocated for Children with Special Healthcare Needs (CSHCN) and for the restoration of vision and dental care under CHIP.
HHSC Updates
Joanne Molina addressed the issue of gap in coverage when children transition between the two programs, Medicaid to CHIP and vice versa.
She addressed one particular issue where the Medicaid Advisor(s) were not entering the appropriate end date that would let ACS know that a `good cause reason', waiving the 90-day wait, should be applied. However, if the client has a good cause reason, but does not apply on time, the 90-day wait would be appropriate.
Joanne indicated that web-base trainings on policies are available for the Advisors and this particular problem was a training issue.
Kimberly Davis reported on the impact of the assets test that was implemented August 24, 2004. From September 2004 to December 2004 1,543 applications have been denied due to the assets test. Anne requested a report on the actual number of children denied since the implementation of the assets test and an update on the 14,000 pending applications reported at the December coalition meeting. Several people thought it would be beneficial for HHSC to conduct a cost analysis of administering the assets. Is it cost prohibitive in comparison to the additional work required? There is a false perception that several families are denied due to owning expensive vehicles, and for that reason, several people thought it would be valuable to know how much over the asset limits are families that are being denied.
Note: Since the meeting HHSC has clarified that the numbers provided to the Coalition were for individual children (not families or applications). HHSC is working separately to update their analysis of how many applications are being "pended' (delayed) because of incomplete asset information, and will at some future time release updates. Reminder: HHSC reported earlier that applications "pending" (need more information regarding assets) at the end of the first 5 weeks of asset test implementation included 7,709 accounts or 14,772 children. For renewals, there were 731 accounts pending.
Kimberly also reported on the historical outreach for TexCare. Originally, TexCare started with a $7 million dollar budget, $5 million for Community Based Organizations (CBOs) and $2 million for advertisements. By Spring 2001, the outreach expenditure grew to approximately $15.3 million due to the external pressure and aggressive goal to enroll 428,000 children by September 1, 2001. Once the goal was met, TexCare's focus shifted from enrollment to proper utilization and renewal of children already in the program. This change in focus also applied to the CBOs. In fiscal year 2002-2003, the biennium outreach spending was about $9.8 million. There were no more media buys by the state after August 2002; instead the budget was applied toward research with Worthlin Worldwide to study behavior patterns. In fiscal year 2004, TexCare Outreach spending was approximately $2.5 million. A majority of that $2.5 million was for CBO contracts, which was reduced by approximately 30%. CBOs were contracted to focus on renewal of existing clients. In fiscal year 2005, TexCare expects to spend about $1.6 million on CBO contracts. CBO contracts expire April 30, 2005. The state budget for Sherry Matthews for fiscal year 2005 is about $124,000 and the contract expires in February 2005. Renewal of CBO contracts will be contingent upon the new Integrated Eligibility contractor who will be responsible for the work CBOs are currently contracted to do.
Anne inquired about the status of the internal discussions on the CHIP premium policy and expressed that advocates still have interest to provide input. Kimberly explained that advocates would have an opportunity for input once HHSC staff analyzes the recommendations that were made, based on the budget.
Senator Averitt's office
Stacy Holley spoke on Senator Averitt's bill, SB 59. Senator Averitt is coordinating a campaign for the full restoration of CHIP. He is interested in working with all organizations and is seeking help in dispelling the myths about CHIP and Medicaid.
Senator Shapleigh's office
Andrea Varnell addressed Senator Shapleigh's bill, SB 69, which restores CHIP and Medicaid service levels to pre-January 2003. Senator Shapleigh has about seven bills addressing the uninsured. For a list of Senator Shapleigh's bills, you may contact Andrea at 512.463.0129 or at andrea.varnell@senate.state.tx.us.
Advocacy Day
Patti Everitt provided a draft one-pager explaining the position of the Campaign to Restore CHIP for legislators. Comments or suggestions on the one-pager should be given to Patti at the email below.
CHIP Advocacy Day will be on Wednesday, April 6. An Advocacy Day planning meeting has been scheduled for Friday, February 4th at the insure.a.kid office located at 1213 I-35 (East side of I-35 & 12th St.) from 1:30 p.m. - 3:00 p.m. The legislative planning meeting will immediately follow the advocacy meeting, 3:00 p.m. - 4:00 p.m. Please contact Patti Everitt @ PEveritt@childrensdefense.org if you are able to attend.
Other Business
The Kaiser Foundation will be releasing a new report on Wednesday, January 26, 2005, on what is really driving the cost of Medicaid.
The CHIP coalition received a grant from the Amerigroup Foundation to revamp the CHIP coalition website. The new website is still under construction, but can be accessed at www.texaschip.org. All archived information from the previous website still needs to be transferred, but current information is posted. If you have any suggestions or comments on how to improve the website, please contact Anne Dunkelberg.
The next CHIP coalition meeting will be held on Friday, February 18, 2005 from 12:00 p.m. - 2:00 p.m. at TMA in the May Owen Conference Room, 10th floor.
With no other agenda items, the CHIP Coalition meeting adjourned at 1:30 p.m.
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