CHCACT UPCOMING MEETINGS

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1 CHCACT UPCOMING MEETINGS February 12, :00 a.m. DPH Transportation Advisory Council Subcommittee Conference Call Conference call number: Access Code: #. Agenda: patient tracking forms. If you are unable to participate or have any questions, please contact Program Manager Rebecca Willis via phone or no later than Tuesday, February 10, February 18, :00 11:00 a.m. The Ryan White Part D Steering Committee Monthly Conference Call. Conference call number: Access Code: #. Agenda: Preparations for the competitive project renewal application and the HRSA site visit scheduled for March 17-19, The complete agenda for the meeting will be available February 11, 2009 on the CHCACTwebsite: New Webinar: The Nuts and Bolts of Innovating Your Health Center, Be Ready to Create Open Access and Redesign At Your Center. Sponsored by CHCACT and funded by CTDPH. Three onehour sessions, hosted by the Primary Care Development Corp, who have implemented Redesign and Open Access at health centers in New York and San Francisco. Audience: Administrative and clinical leadership. February 26, 2009, 1:30-2:30 p.m. March 11, 2009, 10:00-11:00 a.m. March 31, 2009, 12:00-1:00 p.m. For more details please contact Scott Selig at or sselig@chcact.org. UPCOMING EVENTS February 10, a.m. to 12:00 p.m. Department of Public Health (CTDPH) Public Meeting, Community Health Network, Wallingford. Presentation of Year One integration of Medical Case Management within Ryan White HIV/AIDS service programs. Presentations from Ryan White grantees on successful and unsuccessful program implementation. HRSA expectations for Medical Case Management and compliance will be discussed. CHCACT will represent CHCs at the meeting. If health centers are unable to attend but would like to add input or discuss outcomes of the meeting, please contact Jack Rustico, CHCACT Director of Programs at or jrustico@chcact.org. February 27, :00 11:30 a.m. CMS-1500 Claim Form Instructions Teleconference. Presented by National Government Services, Inc. This teleconference will provide attendees with information needed to complete the paper CMS 1500 (08/05) claim form. Please note that preregistration is not required. Visit for event details and dial-in information: Choose Part B (business type) and your state. Select Calendar of Events under the Education & Support tab (on dark blue line). For additional information on this session, please contact Provider Outreach and Education at March 10, :00 a.m. 5:00 p.m. Access and Redesign Learning Session 4, at the Delaney House in Holyoke, MA. This is a rescheduled date of the postponed January 28 learning session date due 1

2 to inclement weather. If you have already registered for the January 28 session, you will be automatically registered for the March 10 session. Please contact Arianna Thompson, if you wish to update your registration information. EDUCATIONAL OPPORTUNITIES February 19, :00 4:30 p.m. Asian American Problem Gambling in Context, Problem Gambling Services and the Connecticut Council on Problem Gambling present an afternoon panel presentation and discussion of the multi cultural issues affecting problem gambling among Asian Americans. Issues to be addressed include trauma, barriers to care, and the cultural context of gambling. Culturally relevant approaches to outreach, prevention and treatment will be discussed. Presentation will be held at Merritt Hall, Connecticut Valley Hospital. To register, call Ellen Cipolla at or or Mary Lou Costanzo at or March 3, :00-11:30 a.m. Grant Writing Technical Assistance, location TBD. Snow date will be March 10 at the same time. The session is a hands-on training for diabetes prevention proposals and is sponsored by Diabetes Prevention and Control Program, CT DPH. Please RSVP by February 20 to Cindy Kozak, or cindy.kozak@ct.gov. The Connecticut AHEC Medical Interpreter Program is accepting registrations for medical interpreters training. For a schedule of trainings and fee schedule, go to CHCACT website at: MPH Scholarships The Connecticut Health Foundation and Southern Connecticut State University are offering scholarships for minority health professionals interested in completing a Master of Public Health degree. The scholarship covers tuition, fees, stipend for books and funding to attend local and national public health conferences. It is for part-time study beginning in the Fall 2009 and ending in Spring/Summer Application deadline is March 30. For more information, please visit: Unified Health Communication 101: Addressing Health Literacy Free, online training available on Addressing Health Literacy, Cultural Competency, and Limited English Proficiency will help you improve your patient communication skills increase your awareness and knowledge of health literacy, cultural competency and low English proficiency implement patient-centered communication practices that demonstrate cultural competency and appropriately address patients with limited health literacy and low English proficiency For more information and to register, * Go to TRAIN (not a U.S. Government Web site) NACHC is offering the 2009 Health Center Financial/Operations Management Seminars. There are six trainings being offered: Financial/Operations Management Level I Orlando, FL- April 22-23, 2009 Las Vegas, NV- June 3-4, 2009 Financial/Operations Management Level II Las Vegas, NV- April 29-30, 2009 Miami Beach, FL- July 8-9,

3 Financial/Operations Management Level III New Orleans, LA- May 6-7, 2009 Las Vegas, NV- August 5-6, 2009 Registration is limited. To register, follow the link NACHC Webinar Schedule: February 12, 2009, 2 p.m., Essentials of Registration and Eligibility Verification February 19, 2009, 2 p.m., Managing Cash during Difficult Times February 26, 2009, 2 p.m., Preparing for the Financial Section of the OPR March 5, 2009, 2 p.m., Using the UDS as a Management Tool March 19, 2009, 2 p.m., Measuring Patient Cycle Time and Waiting Time To register for any of the listed webcasts, please go to: Once registered, you will receive instructions for logging into the webcast from RSM McGladrey. If you have any questions, please contact Carla Brathwaite at either cbrathwaite@nachc.com or phone POLICY DEVELOPMENTS Highlights of Governor Rell s Biennial Budget Recommendations for SFY Dept. of Public Health DPH Reduce funding to Community Health Centers by $2,035,762 to impact only those new or expanded initiatives which have not begun Reduce funding to School Based Health Center by $1.4 million to only impact new or expanded initiatives which have not begun Consolidate and Reduce Funding for Loan Programs $150,000 -Funding for the Nursing Student Loan Forgiveness Program and the Loan Repayment Program is consolidated to fund loan repayment assistance to health care professionals. Reduce funding to various accounts for a total of $477,225 including Services for Children Affected by HIV/AIDS, Needle & Syringe Exchange, Services For persons with AIDS, Children s Health initiative Department of Development Services DDS Funding for continued dental services for DDS consumers to ensure continuity of coverage after the elimination of non-emergency dental services for adults under Medicaid in the amount of $1 million 3

4 Department of Social Services-DSS CHCACT W E E K L Y B U L L E T I N Positive Developments: Expansion of Food Pantry Nutritional Assistance by $300,000 including a portion to FoodShare and the Connecticut Food Bank Expansion of Elderly Nutrition by $450,000 to address the waiting list for home delivered meals Increase Eligibility for Food Stamp program by $130,100 Create an Employment Services Block Grant within the Community Services account but cut $458,522 REDUCTIONS: Eliminate State-Funded Non-Emergency Medical Assistance to Non-Citizens Under federal rules, non-citizens who have been in the country for more than five years are eligible for Medicaid and their costs are federally reimbursable. States have the option of providing coverage to non-citizens who have been in the country for less than five years, but the costs are 100% state funded. Connecticut is one of only fourteen states providing coverage for non-citizens through stateonly funds, and at least two of those states have proposed cutting these services. Under this proposal, DSS will only provide non-citizens with emergency health care services allowable under the Medicaid program, which are federally reimbursed. Limit Dental Services Benefit for Adults to Emergencies This proposal scales back dental services for adults under Medicaid and SAGA. The department will continue to provide emergency dental services, including dentures, x-ray, limited oral evaluation, emergency treatment of dental pain, and extractions. In the last few years, many states have reduced or eliminated adult dental benefits offered through Medicaid. According to a study conducted in 2004, only eight states, including Connecticut, provided full dental benefits for adults. Impose Cost-Sharing Requirements on Individuals Receiving Medicaid Services A total of 44 states impose co-payments under their Medicaid programs. Under this proposal, DSS will require co-pays not to exceed 5% of family income on allowable medical services (excluding hospital inpatient, emergency room, home health, laboratory and transportation services). Under federal rules, co-pays for FFY2009 can range from $0.50 to $5.70, depending on monthly family income and size, and are indexed annually based on inflation. Co-pays for pharmacy services will be capped at $20 per month. Consistent with federal rules, certain children under age 18, individuals at or below 100% of the federal poverty level, SSI recipients, pregnant women, women being treated for breast or cervical cancer and persons in institutional settings are exempt from the cost sharing requirement. Establish Premiums for HUSKY A Adults Under this proposal, DSS will require a monthly premium, not to exceed federal maximum levels. Premium amounts will be determined on a sliding scale, up to 10% or 20% of the cost of the service, depending on the individual's family income. Consistent with federal rules, certain children under age 18, individuals with income at or below 100% of the federal poverty level, pregnant women and individuals in hospice are exempt from paying premiums. 4

5 Eliminate Coverage of Most Over-the-Counter Drugs This proposal eliminates coverage of over-the-counter drugs, with the exception of insulin and insulin syringes, under the department's pharmacy programs. This change is consistent with the current policy under the ConnPACE program. To comply with federal rules, Connecticut will continue to provide coverage of over-the-counter drugs to all children under the age of 21 under the HUSKY A program. Increase the Discount off the Average Wholesale Price Paid for Certain Drugs This proposal reduces the reimbursement level to pharmacy providers from the average wholesale price (AWP) minus 14% to AWP minus 15%. Based on surveys in a number of states, the Office of Inspector General for the federal Department of Health and Human Services reported that pharmacies tend to purchase their brand name drugs for AWP minus 22%, with generics purchased at AWP minus 66%. (In Connecticut, generic drugs are already governed by a maximum allowable cost reimbursement schedule.) Eliminate Medical Interpreters under Medicaid Under this proposal, DSS will not amend the Medicaid state plan to include foreign language interpreter services as a covered service under the Medicaid fee-for-service program. Delay implementation of HIV/AIDS waiver for up to 100 individuals OPM has stated that there is a reduction of $3.1 million in AIDS services between DSS & DPH Update Medical Necessity and Appropriateness Definition under Medicaid Under this proposal, DSS will replace the current outdated medical necessity definition under Medicaid with the definition that has been in effect for the State Administered General Assistance medical program since January The revised medical necessity definition combines the concepts of medical necessity and appropriateness as is done in Medicare and under most public sector and commercial health care programs. The proposed definition incorporates the principle of providing services which are "reasonable and necessary" or "appropriate" in light of clinical standards of practice. Cap Medicare Part D Co-payment Coverage for Dually Eligible Clients As of 2007, Connecticut was one of only eight states covering the costs of the Medicare Part D co-payments for persons dually eligible for Medicare and Medicaid. DSS is covering the costs of the Part D prescription copays, which range from $1.10 to $6.00 in Under this proposal, dually eligible clients will be responsible for paying up to $20 per month in Medicare co-pays for Part D covered drugs. Limit Maximum Allowable Cost Reimbursement for Certain Drugs Maximum Allowable Cost (MAC) programs are designed to ensure state Medicaid programs pay appropriate prices for generic and multi-source brand drugs. This proposal revises MAC reimbursement under DSS' pharmacy programs from the average wholesale price (AWP) minus 40% to AWP minus 50%. Eliminate Self-Declaration Provisions at Application and Redetermination In FY2002, DSS implemented new verification procedures for the HUSKY A program that allow the department to accept a client's self-declaration of income. Under this policy, DSS does not verify the 5

6 information provided unless the department believes such declaration to be inaccurate. This proposal eliminates the self-declaration provision. Suspend Supplemental Payments to FQHCs and Hospitals for Unreimbursed Costs for Pregnant Women Beginning in FY2009, DSS plans to make payments to participating providers - FQHCs and hospital clinics - on a first come, first served basis, with the payments totaling $800 per person for prenatal care when the mother is undocumented. Since the funding available under SAGA is capped at $2.0 million per year, once that amount is expended, no further grants will be made in the fiscal year. Under this proposal, FQHCs and hospital clinics will not receive these supplemental grant payments over the biennium. Modify Premium Payment Requirements under HUSKY B HUSKY B offers a full health insurance package for children and teenagers up to age 19, regardless of family income. The program is divided into three income bands: the first band (185% to 235% of the federal poverty level (FPL)) pays no premiums; the second band (236% to 300% FPL) has monthly premiums of $30 for families with one child and $50 for families with two or more children; and the third band (over 300% FPL) is responsible for the full premium. Under this proposal, monthly premiums for Band 2 will increase to $50 for families with one child, $75 for families with two children and $100 for families with three or more children. Establish an Online Eligibility Information Verification System Based on the positive results achieved by other states that have an online verification system, DSS will, under this proposal, contract with a private entity to develop an online eligibility information verification system to support and supplement the department's eligibility determination verification process. The system will verify applicants' income and asset information to ensure that applicants are eligible for assistance prior to awarding benefits. The system will review all applications for public assistance in the Medicaid, SAGA, TFA, and State Supplement programs, as well as SNAP. (Although SNAP is 100% federally funded, use of the system may help the state avoid federal penalties due to eligibility errors.) Require Prior Authorization for High Cost Drugs Prior authorization is required when a drug is within one of the classes included on the preferred drug list (PDL), but the drug being requested is not on the PDL. Under this proposal, DSS will require prior authorization for certain high cost classes of drugs to ensure medical necessity. Eliminate Automatic 30-Day Fill for New Prescriptions Requiring Prior Authorization Currently when a recipient presents at the pharmacy with a new prescription that requires prior authorization (PA), the pharmacist can immediately (at the point of sale) dispense a 30 day supply without going through the PA process. On subsequent fills of the same medication, if no PA is requested and obtained, the claim will deny because the prescriber must be contacted to request and receive prior authorization. Under this proposal, this first 30 day fill without prior authorization will be eliminated. This is consistent with the department's policy prior to the pharmacy carve-out. This change will not eliminate the 5 day "emergency" supply when the prescriber cannot be contacted or DSS' contractor cannot complete the prior authorization within the required timeframes. 6

7 Eliminate Limited Vision and Non-Emergency Medical Transportation Benefits In FY2007, the legislature provided funding for a limited vision and non-emergency medical transportation program under SAGA. Under this proposal, these expanded benefits are eliminated. It is anticipated that DSS will continue to provide transportation for dialysis and cancer treatments. Reduce Funding for HUSKY Outreach Given the outreach efforts already underway through the Governor's Enrollment in Schools and Enrollment at Birth initiatives, and in light of the significant increases in the HUSKY A caseload over the last year, the amount of funding needed to conduct further outreach efforts can be reduced. Funding of $1.2 million is provided to continue outreach efforts. Child Advocate is recommended to be consolidated with the Attorney General The Office of Workforce Competitiveness and the Commission on Culture & Tourism are recommended for consolidation with the Department of Economic & Community Development The Governor s budget proposal is posted on-line: Governor Rell: Governor's Budget Main Page S-CHIP Passes The Children s Health Insurance Program (CHIP) Reauthorization Act of 2009 passed the Senate on January 29th and the President signed the $33 billion bill on February 4. The bill is expected to reduce the number of uninsured children in American by half over the next 4 ½ years. Funding for the health coverage expansion will be covered by increasing the federal tax on cigarettes by $.61 a pack. The legislation creates an FQHC prospective payment system (PPS) similar to the current Medicaid payment system, which allows health centers to expand primary care services to more SCHIP beneficiaries while ensuring adequate reimbursement. It also allows states to cover children and pregnant women who are legal immigrants to receive health services. sources: The Chicago Tribune and NACHC Washington Update. GRANT OPPORTUNITIES DPH Tobacco Use Cessation Treatment Programs The CT Department of Public Health has announced funding for grants to provide tobacco use cessation services. A total of $412,456 is available. The deadline for proposals is February 18, To see the entire RFP and obtain application forms, go to: DHHS Telehealth Grant The DHHS is awarding 14 grants totaling $3.4 million to nonprofits or public entities that can provide services through a telehealth network to rural or underserved urban communities (Funding Opportunity Number: HRSA , CFDA Number: ). To see the grant listing, click on this link, enter in the CFDA box and click enter. The application deadline is March 6, Diabetes Learning Opportunity - Diabetes "MicroFellowships" are available for community health center professionals at the Joslin Diabetes Center affiliate at the Hospital of Central Connecticut in New Britain. This half day program enables CHC staff to "shadow" a Joslin physician to learn about their approaches to diabetes using the newer medications. It also allows the opportunity for CHC staff to ask questions about recent diabetes studies and how the results of these studies may affect treatment decisions. To enroll in this program contact Cindy Kozak at the CT Department of Public Health Diabetes Prevention and Control Program at cindy.kozak@ct.gov or

8 Award of Recognition -- The HIMSS (Healthcare Information and Management Systems Society) Nicholas E. Davies Award of Excellence has recognized excellence in the implementation and value from health information technology. Health centers who utilize EHR systems may apply for the Community Health Organizations award. Recipients of the Davies Award will have the opportunity to be recognized by their peers, patients and other entities for excellence in achieving HIT. Recipients can present their projects to the Annual HIMSS Conference and Exhibition, expenses paid. For more information and application, go to the Davies Award website at Deadline is May 15, RESOURCES HRSA-funded Health Workforce Information Center This new website offers information on health workforce programs and funding sources; workforce data, research and policy; educational opportunities and models; best practices; and related news and events, also available through updates. To access the website, go to ANNOUNCEMENTS January 26, 2009 March 20, 2009 Vacancies for Advisory Committee on Interdisciplinary, Community-Based Linkages HRSA requests nominations to fill 10 upcoming vacancies on the Advisory Committee on Interdisciplinary, Community-Based Linkages (ACICBL), which receives agency staff support. The ACICBL provides advice and recommendations to the Secretary and Congress on policy, program development and other matters related to interdisciplinary, community-based health professional training programs authorized under Title VII of the Public Health Service Act. Candidates will be invited to serve a three-year term. Nominations must be submitted to HRSA by March 20,

The Affordable Care Act, HRSA, and the Integration of Behavioral Health Services

The Affordable Care Act, HRSA, and the Integration of Behavioral Health Services Indiana Council of Community Mental Health Centers Ft. Wayne, Indiana May 19, 2011 David B. Bingaman, LCSW, ACSW U.S. Department