Texas CHIP Coalition Minutes
Friday, October 21, 2005 11:00 a.m. - 1:00 p.m.
May Owen Conference Room, 10th Floor
Texas Medical Association
Anne Dunkelberg called the meeting to order at 11:00 a.m.
Coalition guests from HHSC included Kimberly Davis, Medicaid and
CHIP Acute Care Manager; Skye Kilaen, External Relations Specialist;
Aurora LeBrun, Associate Commissioner for Office of Eligibility Services;
Leslie DeHay, Director for Performance Improvement and Change, Office of
Eligibility Services; and Mary Lou Franks, Manager of Community Initiatives,
Office of Eligibility Services.
HHSC Updates
Kimberly Davis gave an update on the Women's Health Waiver. A concept paper
for the waiver was submitted to Center for Medicare & Medicaid Services (CMS)
in August. CMS has given the state feedback on several points. CMS does
not want the renewal process at 12 months to be conducted in a passive
manner, but at a minimum, request client's signature indicating that the
information on the form is still true. CMS believes a very rigorous evaluation
component will be needed. The bill text for SB 747 (by Senator Carona) says,
"The department, for the purpose of the demonstration project, may not contract
with entities that perform or promote elective abortions or are affiliates of
entities that perform or promote elective abortions." HHSC reads this as that
any doctor or clinic that refers a patient who requests abortion to an abortion
provider may fall under the "promotion" prohibition. Advocates do not agree
with this narrow interpretation, and fear few providers will qualify if it is
applied; greater clarity on the word "promote" is needed. A draft waiver will
be available for comments. It was suggested by coalition members that the state
also solicit comments from health care advocates beyond the family planning organizations.
Ms. Davis proceeded with an update on the CHIP Perinate program
(see July 2005
attachment for the CHIP Perinate Policy)  . Ms. Davis indicated that the program's
State Plan Amendment (SPA) will be submitted by November 1st and upon completion,
a notice will be posted in the Texas Register. Information contained in the SPA
will include the eligibility process, benefits & effective dates, HHSC budget and
the number of unborn children up to 200% FPL that it will cover. An implementation
date will be stated in the SPA, and will not start in January 2006 as previously
planned.
HHSC released an Request for Information (RFI) to "explore options for developing
a high quality, cost-effective Healthcare for Children in Foster Care Model by
soliciting input from healthcare and child welfare professionals, community
partners, and the healthcare community. HHSC will develop one or more procurements
for the delivery and administration of health services to foster children, and
children who are at risk of or who are victims of child abuse and neglect in Texas."
The Foster Care project will be targeted for implementation in January 2007.
Navigant Consulting, with Therese Ruffing and Debbie Berndt as the state of
Texas consultants, are developing the Request for Proposal (RFP) and anticipate
the draft RFP will be completed by December 15. The final RFP will be released
by March 10, 2006. Ms. Davis will be heading up this project with Ms. Kay Gharemani.
The amendment to the Hurricane Katrina waiver to include 6 additional
Louisiana parishes affected by Hurricane Rita was submitted to CMS. If approved,
the effective date will be September 24, 2005. September 24 - September 30
would not count against the evacuees’ coverage period. HHSC's Rick Allgeyer
will be tracking enrollment of evacuees and by mid-November, HHSC should know
how many evacuees have been enrolled in Medicaid since the Katrina waiver. The
waiver will be effective through June 30, 2006. After the evacuees coverage
period ends those who wish to remain in Texas and continue receiving Medicaid
benefits will have to apply as Texas residents. Under the waiver, the state is
allowed to extend coverage beyond the 5 months for continuity of care (pregnant
women in most cases). However, approval for extended care beyond the 5 months
(e.g., for those involved in ongoing treatment) will be reviewed on a
case-by-case basis.
A CHIP dental contract has been awarded to Delta Dental and is under contract
negotiations. No firm implementation date is confirmed, but early Spring 2006
is possible.
TexCare Applications have been received and the state will fulfill back orders
first. The applications are printed in black & white. In November, the Integrated
Eligibility & Enrollment (IEE) contractor, Texas Access Alliance, will be
responsible for applications and orders can be placed on their website.
The TexCare applications will be replaced with the new Children's Insurance
application, which will request four new data elements: 1) Migrant Indicator;
2) Children with Special Health Care Needs; 3) Native American Tribal
Affiliation; and 4) additional language encouraging accurate information.
The new Children's Application is designed to be more seamless and with
less distinction between the children's Medicaid program and CHIP. A
separate, new universal application for all state programs is a total of 8
pages. Families do not have to fill out the entire 8-page application if
they know which program they wish to apply for. The new applications have
not been approved and are not yet available for release. The contractor
will continue to accept the old applications when the new ones become
available.
Aurora LeBrun gave an update on the IEE system. The Texas Access Alliance
was awarded the contract for the new IEE system and has been in transition
phase since July 1. The IEE system will roll-out in phases based on
geographical areas. Areas where a large percentage of clients already
utilize the phone system and minimum training is needed will be first.
Areas requiring more training on the phone system will be implemented last.
The projected dates for implementation are as follows:
- November 1, 2005 – Enrollment Broker for Medicaid Managed Care
- November 1, 2005 – Texas Access Alliance assumes maintenance of TIERS
- Mid-November 2005 – CHIP Cutoff and Texas Access Alliance assumes work in progress from ACS
- December 1, 2005 – Texas Access Alliance have full scope of CHIP eligibility
(the P.O. Box will continue to be available through transition for extended period
of time and no forwarding will be necessary, and the TexCare 1-800 number will
remain in operation)
- January 1, 2006 – TIERS Pilot Offices and Children's Medicaid
- January 1, 2006 – Austin Call Center
- April 2006 – San Antonio Call Center
- March/April 2006 – East Texas Call Center
Some information on IEE can be found on HHSC's website.
HHSC Deputy Executive Commissioner Anne Heiligenstein is
conducting a community meeting on Nov. 7 to provide an update on the
roll-out. Meeting details: The Commons Building (# 137)
10100 Burnet Road, Austin, TX 78758, University of Texas J. J. Pickle
Research Campus, Big Tex Auditorium, Room Number 1.102, Monday,
Nov. 7, 2005, 1 p.m. - 3 p.m.
HHSC notified its staff about job placements on October 3.
No HHSC staff will be released prior to April 30, 2006. Some
will remain until October 2006. HHSC is actively working to
coordinate employment opportunities with the vendor and the
Department of Family Protective Services.
HHSC (not Accenture, aka "Texas Access Alliance") will continue
its oversight of Community Base Organizations (CBOs) and the
new contact person will be Mary Lou Franks. According to Ms.
Franks, the role of the CBOs has not been amended to include other
programs besides children's health insurance. A re-procurement
would be necessary to expand the scope in the contract agreement.
CBOs will continue to be compensated through HHSC. The current
contracts were extended through August 31, 2006. During this extension,
HHSC will analyze the new IEE system and how the role of CBOs can interface
with the new system.
Although no plans on outreach were shared, HHSC did indicate that they were
responsible for outreach and not the Texas Access Alliance.
Ms. LeBrun gave an overview of the 3 divisions within the Office of
Eligibility Services: 1) Vender Operations; 2) State Operations; and 3)
Performance Improvement & Change Management, which oversees community
initiatives for which CBOs fall under. One function under State Operations
is the management of outstationed
eligibility workers (OEWs). There are approximately 600 OEWs and
about 300 of them are contracted OEWs. OEWs are fully trained and are
qualified to test for all programs. With the closing of local eligibility
offices, approximately 2,400 state eligibility workers will be displaced;
however, senior staff will have the opportunity to bid for current OEWs'
positions.
The 2-1-1 number will take on a different role with the new IEE system.
Once the caller enters into the call center system, a cue is given for the
next available operator to take the call. The state will retain the TexCare
1-800 number for an undetermined period of time, but eventually plan to use
the 2-1-1 number. The TexCare logo will be replaced with the HHSC logo
and the coalition was advised that there are rules that apply in utilizing
the state logo.
Skye Kilaen informed the group of the HHSC's conversion from the traditional
Medicaid/CHIP Public Forum to the HHSC Public Form. This will offer a broader
public forum for discussion of other issues beyond CHIP and Medicaid that may
be of interest to stakeholders. HHSC is also working to create a more
user-friendly communication structure. Conference calls will be scheduled a
week after each forum and on-line presentations will be available to view while
conferencing. This model may not be accessible until January 2006. The Office
of Communications will also be developing occasional internet chats with HHSC
executives and stakeholders. These questions will later be archived, along
with the presentations from the public forums. HHSC is also developing an
E-Newsletter. The newsletter will be more comprehensive than the current E-news.
The newsletter will provide background information, articles, and a link for
on-line questions & answers. HHSC will also be revamping their website. The
new and improved website will allow the capability to request an update on a
topic/issue of interest.
Congressional Update on Medicaid
Anne Dunkelberg informed the group that the House did not vote on increases to
Medicaid cuts from $35 billion to $50 billion.
Ms. Dunkelberg stressed that although 50 thousand phone calls were made in
opposition of budget cuts and reconciliation, the battle to reserve cuts
from the Medicaid entitlement program is far from being over.
The next CHIP coalition meeting will be held on Friday, November 18, 11:00 a.m.
– 1:00 p.m. at TMA, 401 W. 15th Street, in the May Owen Conference Room, 10th floor.
With no other agenda items, the CHIP Coalition meeting adjourned at 1:00 p.m.
Related Information
Other Coalition Meeting Minutes
This document in pdf format [pdf]
|
