SB 75 FULL SCOPE MEDI-CAL FOR ALL CHILDREN APRIL 11, 2016
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1 SB 75 FULL SCOPE MEDI-CAL FOR ALL CHILDREN APRIL 11, 2016 Danice Cook, HealthPAC Administrator Health Care Services Agency Jessica Woodward Nicholas, Policy and Planning Coordinator Center for Healthy Schools and Communities, Health Care Services Agency Diane Domestici-Durham, Program Manager Social Services Agency Alpha De Los Reyes, Program Specialist Social Services Agency
2 SB 75 Full Scope Medi-Cal for All Children SB 75 Overview SB 75 Population Challenges and opportunities Outreach strategies Questions
3 SB 75 Overview Senate Bill (SB) 75, expands full scope Medi-Cal benefits to all children younger than 19 years of age whose families have incomes at or below 266% of the Federal Poverty Level, regardless of immigration status. Children will be eligible no sooner than May 1, Children on Restricted Medi-Cal will be transitioned no sooner than May 16, New applicants will be able to submit an application through CalHEERS or the County no sooner than May 16, 2016.
4 Health Coverage for Immigrant Children
5 SB 75 Population 170,000 estimated eligible in California (DHCS) 9,000 estimated eligible in Alameda County - 5 th largest population in California (from DHCS) County figures 3,473 HealthPAC 4,100 Kaiser Child Health Program 2,486 Restricted Medi-Cal 553 are in HealthPAC and Restricted Medi-Cal We know that there may be more overlap among program participants 5
6 SB 75 HealthPAC Data HealthPAC Kids by Age n = 3,473 HealthPAC Kids by Medical Home n = 3,473 West Oakland Health Center 12% 12% Tri-City Health Center 11% 11% 16% 0-5 yrs 6-10 yrs yrs 16 yrs 17 yrs Tiburcio Vasquez Health Center Native American Health Center LifeLong Medical Care La Clinica de la Raza 18 yrs Axis Community Health 38% Asian Health Services Alameda Health System ,000 1,200 1,400 Median age among HealthPAC kids is 14 years. Over half of HealthPAC children (66%) are assigned to La Clinica and Alameda Health System clinics.
7 Challenges and Opportunities Challenges Many undocumented families may be hesitant to participate out of fear that it would put at risk their chance to obtain a legal immigration status (this is not true). Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach eligible families. Administrative hurdles or delays caused by the transition could bring about disruptions in care. DHCS communicates by snail mail and may not have the most up to date addresses. Opportunities Long term investment that will bring down health care costs by reducing trips to the ER for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement. Access to preventive care, especially dental and vision. Larger provider network available to kids.
8 SB 75 DHCS Outreach Strategies First Notice Beneficiary outreach letter to transition population with general information about new coverage, including benefits and managed care enrollment (mailed out 30 days prior to the implementation start date) Second Notice For new enrollee and transition population informing the change in benefits and hearing rights Third Notice Managed care enrollment notice for eligible transition population DHCS will post a provider bulletin approximately 45 days prior to the transition date on the Medi-Cal Provider website. Provider bulletin is available to FFS providers and will be shared with MCPs. DHCS SB 75 website -
9 SB 75 SSA Outreach Strategies Informational Flyer in: English Spanish Cambodian Mandarin Dari Tagalog Vietnamese
10 SB 75 SSA Outreach Strategies Information and/or enrollment provided at sites throughout Alameda County such as: Community Health Fairs Partnership Meetings School Partnerships Clinic Sites Faith Based Organizations Media
11 SB 75 HCSA Outreach Strategies Partner with HPAC contracted providers (CHCN and AHS) to implement the following outreach strategies: Flyers posted at CHCN and AHS clinics (April) Mail notices (April) Outreach calls (April/May) CHCN/AHS will educate and enroll families at point of service (on-going) HCSA Health Insurance Technicians will prioritize providing application assistance to eligible families in our office, at community based locations, and at events.
12 SB 75 Center for Healthy Schools and Communities (CHSC) Outreach Strategies Disseminate information and outreach materials about SB75 to our school-based and school-linked programs and providers Support partners to develop culturally-responsive messaging and FAQs Facilitate enrollment appointments for families with HITs and ETs in OUSD, HUSD, and SLUSD (through existing CKC projects in each district) Link uninsured Unaccompanied Immigrant Youth identified by the UIY Care Team and Alameda County school districts with enrollment specialists
13 SB 75 Kaiser Child Health Program Outreach Strategies End of May 2016 Direct Mail Members will receive a Transitions kit to notify them of the possible changes to their health coverage. The kit will advise them to apply for Medi-Cal or recertify their Kaiser CHP. June Automated Outbound Call The call will reiterate the Direct Mail message. Mid-July Reminder Post Card Reminder to apply for Medi-Cal or recertify.
14 Questions?
15 DRAFT DRAFT HealthPAC Alameda County Health Care Services Agency 1000 San Leandro Blvd, Suite 300 San Leandro, CA «First_Name» «Last_Name» «Street1», «Street2» «City», CA «Zip» «Date» * * * Notice about HealthPAC and insurance through Medi-Cal * * * Dear «First_Name» «Last_Name» «Suffix»: Your child is enrolled in HealthPAC, but HealthPAC is not insurance. Starting May 16, 2016 your child may qualify for insurance through Medi-Cal. Full-scope Medi-Cal: Will cover children under 19 years old, regardless of immigration status. Is insurance, so it covers health care in more places than HealthPAC. Covers more than just emergency care. Provides FREE or low-cost medical, dental, mental health, and vision (eye) care. To find out if your child may qualify for full-scope Medi-Cal, please contact your Medical Home at: <ServiceLocationName > <Phone> <Address1> <City > <State> <Zip> You can also call , Monday Friday, 8:30 a.m. 5 p.m. for health care coverage help. If you have any questions about this letter, please contact HealthPAC Customer Service at , Monday Friday, 8:30 a.m. 5 p.m., and we will assist you. Thank you, HealthPAC Customer Service April 4, 2016
16 DRAFT DRAFT NOTICE Do you have children in HealthPAC? If so, they may qualify for full-scope Medi-Cal starting May 16, 2016 Health insurance is important for your child s well-being. Your medical home can help you determine if your child may qualify for full-scope Medi-Cal and help you apply for health care coverage. Starting May 16, 2016, Alameda County residents under 19 years of age may qualify for full-scope Medi-Cal. April 4, 2016
17 HEALTH CARE FOR ALL CHILDREN Alameda County Social Services Offices Fremont Office Liberty St., Ste. C330 Fremont, CA (510) Eden Area Multi-Service Center Amador St. Hayward, CA (510) Livermore Office 3311 Pacific Ave. Livermore, CA (925) Eastmont Self-Sufficiency Center 6955 Foothill Blvd. Oakland, CA (510) Enterprise Self-Sufficiency Center 8477 Enterprise Way Oakland, CA (510) North County Self- Sufficiency Center 2000 San Pablo Ave. Oakland, CA (510) APPLY NOW! Apply now for emergency Medi-Cal to get full Medi-Cal in the Summer Make sure your child gets full Medi-Cal coverage! You don t need immigraon papers for your children and it does NOT affect your applicaon for residency. Apply at: Or apply by calling: Any Alameda County Social Services office, or Your local health clinic. (510) , or (800) Or apply online at: or PPS New 1/2016
18 ATENCIÓN MÉDICA PARA TODOS LOS NIÑOS Oficinas de Servicios Sociales del Condado de Alameda Oficina de Fremont Liberty St., Ste. C330 Fremont, CA (510) Eden Area Multi-Service Center Amador St. Hayward, CA (510) Oficina de Livermore 3311 Pacific Ave. Livermore, CA (925) Aplique ahora para Medi-Cal de emergencia para conseguir Medi-Cal completo en el verano del Asegúrese que su niño obtenga cobertura completa de Medi-Cal! Usted no necesita papeles de inmigración para sus niños y eso NO afectará su aplicación para la residencia. Eastmont Self-Sufficiency Center 6955 Foothill Blvd. Oakland, CA (510) Enterprise Self-Sufficiency Center 8477 Enterprise Way Oakland, CA (510) North County Self- Sufficiency Center 2000 San Pablo Ave. Oakland, CA (510) APLIQUE AHORA! Aplique en: O aplique llamando al: Cualquier oficina de Servicios Sociales del Condado de Alameda, o En su clínica local de salud. (510) , o (800) O aplique en línea en: o PPS New 1/2016
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