INLAND EMPIRE CCI STAKEHOLDER ADVISORY COMMITTEE MEETING (APPROVED MINUTES FOR- March 25, 2014)

Transcription

1 INLAND EMPIRE CCI STAKEHOLDER ADVISORY COMMITTEE MEETING (APPROVED MINUTES FOR- March 25, 2014) Lcatin: Inland Reginal Center (IRC) 1425 S. Waterman Ave. San Bernardin, Ca Date: Tuesday, March 25, :30 pm -4:30pm Minutes By: Heidi Pringle, Inland Empire Health Plan Appinted Cmmittee Members Present: Persn Title Affiliatin Chris Stttlemyer (Vice-Chair) Administratr Califrnia Assciatin f Health Facilities Darren Gray Lma Linda University-Adult Day Health Services CBAS Dianne Sceranka fr Sarah Eberhardt-Ris Deputy Directr San Bernardin Cunty Department f Behaviral Health Dimitris Alexiu Vice President Hspital Assciatin f Suthern Califrnia Eric Hernandez Prgram Specialist Riverside Cunty In- Hme Supprt Services Felice Cnnlly Prvider Riverside Cunty In- Hme Supprt Services Public Authrity Gilbert Sauceda Directr Health Insurance Cunseling and Advcacy Prgram Iley Whiting fr Ricard Cisners Reginal Crdinatr United Dmestic Wrkers Leti Fierr (Attended by phne) Senir Administrative Analyst Riverside Cunty In- Hme Supprt Services Public Authrity Mary Ris (Attended by phne) Multicultural Affairs Advcate Disability Rights Califrnia Megan Juring Deputy Directr Department f Rehabilitatin Paul Van Dren Executive Directr Cmmunity Access Center Rd Verbeck fr Steve Steinberg Prgram Chief Riverside Cunty Department f Behaviral Health Rn Stewart Deputy Directr Riverside Cunty Office n Aging Miguel Benitez fr Wendy Duchen SEIU- ULTCW Cmmittee Members Absent Persn Title Affiliatin Dr. Brad Gilbert Chief Executive Officer Inland Empire Health Plan Dr. Sctt Allen Physician Prvider Kristine Lmis Cnsumer Riverside Cunty In- Hme Supprt Services Michele Haddck Directr Riverside Cunty Office n Aging, Myette Christian Registry Manager San Bernardin Cunty In- Hme Supprtive Services Public Authrity Fran Bates Executive Directr Rlling Start Rn Buttram (Chair) Directr San Bernardin Department f Aging and Adult Services Sergi Caldern Directr Alzheimer s Assciatin Randy Schlecht Cnsumer San Bernardin Cunty In- Hme Supprtive Services Sharn Swayzer Prvider San Bernardin Cunty IHSS Public Authrity Wasima Alvi Clinical Services Manager Inland Reginal Center IEHP Cmmittee Members Present: Persn Title Ben Jauregui (Attended by phne) Disability Prgram Manager Rger Uminski Directr f Health Administratin Mlina Healthcare f Califrnia Cmmittee Members Present: Persn Title Debrah Miller Vice President f Health Services Dr. Richard Tmpkins Chief Medical Officer Lisa Hayes Directr, Disability & Senir Access Services

2 I. Welcme and Intrductins and Annuncements Chris Stttlemyer (Vice-Chair) INLAND EMPIRE CCI Stakehlder Advisry Cmmittee Meeting Meeting Minutes fr March 25, 1:30-4:30 pm Agenda Item Discussin f Agenda Items Actin A. Intrductins were made. N Actin Required B. It was annunced that G.G. Crawley has retired and will be replaced Rxanne Yung, Lisbeth Rberts will be replaced but Gilbert Sauceda, and Barbra Prter will be replaced by Darren Gray. II. Acceptance f minutes frm Chris Stttlemyer (Vice-Chair) A. Minutes apprved. N Actin Required III. Review f Actin Lg frm Chris Stttlemyer (Vice- Chair) A. 11. T share presentatins with the Stakehlders that will be utilized. The HICAP presentatin was distributed t the grup. It was reprted that this presentatin is t explain all f the ptins that will be available t the beneficiaries. The presentatin will be tailred t the specific audience. Megan Juring- Hw are peple receiving the infrmatin? Gilbert reprted that he has been able t sit in a Spanish presentatin. Gilbert stated that all infrmatin sent frm the State was prvided t the audience in Spanish and was discussed thrughly. Grup left presentatin with a better understanding. Lisa Hayes- Are the presentatins targeted fr under 65 years f age? Are the under 65 attending? It is fr the Dual Eligible ppulatin. The percentage f the under 65 ppulatin that is attending these presentatins is unknwn as f this time. Claudia Hensel- When yu talk abut the Tlkit that the audience gets, are they printuts f certain things like the ntices, etc.? The Tlkit is in the develpment phase. Rger Uminski- Is there anything that HICAP needs r wuld like t have frm the Stakehlders. D yu need assistance n getting the wrd ut n presentatins that yu will be cnducting? Gilbert t create a wish list t distribute t the Stakehlders. Als, a schedule f presentatin dates can be sent t the grup. Lisa Hayes- we will be able t pst the dates f the presentatins t the new calendar n the website. Gilbert reprted that there will need t be an edit made t the presentatin t include Health Care Optins (HCO) new telephne number. In Prcess New Actin Item B. 12. T reach ut and try t get in tuch with the crrect peple at The San Bernardin Medical Assciatin s the Harbage Cnsultants can educate them abut CCI. Cmpleted Page 2 f 8

3 Agenda Item Discussin f Agenda Items Actin Dimitris reprted that he tuched base with bth San Bernardin and Riverside Medical Assciatins. Bth are willing t cmmunicate in regards t CCI during ne f their pre existing meetings. Dimitris t prvide the Plans with the cntact infrmatin fr bth Cunties Medical Assciatins. On Ging In Prcess C. 15. T cme up with ways t mitigate the tp fur identified risks. (See IV under Risks) D. 16. An electrnic survey will be mailed t the CCI Stakehlder Advisry Cmmittee during the first week f February. This survey will help us identify specific stakehlder needs related t data. Strategies t vercme the barriers identified will be wrked n based n the survey results and further input frm the CCI Stakehlder Advisry Cmmittee. (See IV under Risks) E. 17. T get apprval t send the Fact Sheet n Cal MediCnnect t the Stakehlders. (See IV under Risks) F. 18. T prvide Harbage Cnsulting with Inland Empire Disability Cllabrative (IEDC) Member events Ben reprted that Kim frm Harbage has becme a member f IEDC and will be receiving updates abut upcming meetings and events thrughut the Inland Empire. Kim has als attended the last few IEDC meetings. Ben als reprted that IEDC has created a facts sheet that is being distributed at all f the meetings. The Department f Health Care services has been invited t present at the upcming IEDC meeting in April. IV. Risks A. The sub-grups were asked t reprt n the tp 4 risks that were identified in the September 24, 2013 meeting. The tp fur risks identified frm 1-4 with the subgrup vlunteers are as fllws: 1. Nt Preparing cnsumers and prviders t best navigate/ use the Managed Care Organizatin system, as well as the lack f educatin and participatin by nn- cntracted prviders. Sarah Eberhardt-Ris, Ben Jauregui, Mary Ris Create a PwerPint t train cnsumers n Managed Care 101. Ben asked if he culd share t the cmmittee fr apprval. Als, hw d we prepare Prviders (dctrs)? Paul Van Drn- Suggested asking thse wh have nt had Managed Care what they had previusly and highlight the differences f what they are used t and what will be cvered in Managed Care. 2. Use clear and simple language. Prper/adequate interpretatin and alternate frmats. Lisa Hayes, Megan Juring, Fran Bates, Felice Cnnlly, Lisa prvided handuts t the grup. The handuts include Medi-Cal and Medicare (Full Duals) and Medi-Cal nly. Yu will find frequently asked questins n the back. It was expressed that the wrds Dental Benefit is cnfusing. It was decided by the grup t separate Additinal Visin and Dental Benefit int tw separate lines. Instead f just saying Additinal Dental Benefit say Additinal Dental Benefit t Denti Cal. The new number fr HCO is (844) Page 3 f 8

4 Agenda Item Discussin f Agenda Items Actin Rn Stewart suggested t add the meaning ut the acrnym FFS (Fee fr Service). Rd Verbeck- n the Medi-Cal nly handut it says IEHP and Mlina nly, What abut Kaiser? Rger stated that IEHP will be delegating MLTSS services thrugh Kaiser. (Crrectin t initial respnse: Kaiser will nt participate in Cal MediCnnect. IEHP will initially handle the MLTSS fr their Medi-Cal line f business nly.) It was reprted that the State s Plan Chice letters fr Riverside and San Bernardin Cunties were cnfusing. Megan Juring- Wuld it be pssible t add the new CCI mbudsmen prgram number? 3. Beneficiaries in treatment during transitin, cntinuity f care. Dr. Tmpkins, Kristine Lmis Nthing new t reprt Cmpleted V. CCI/ Cal MediCnnect Updates Rger Uminski, IEHP Debrah Mille, Mlina Healthcare 4. Interperability f data systems, and data sharing prcess. Rger Uminski, Steve Steinberg, Sarah Eberhardt-Ris, Leti Fierr A draft Survey was passed ut t the Stakehlders. The grup wuld like fr the Stakehlders t prvide feedback n hw the questins can be imprved r if any specific questins were left ut. The grup will then make the adjustments and distribute the survey via Survey Mnkey. Rger asked wh shuld this be sent t and hw it be sent ut. Questins frm the grup are as fllws: Rn Stewart- Lking at #4 Which data elements can yur rganizatin share with ther CCI stakehlders wuldn t that depend n wh the stakehlder is? There may be sme cntractual issues. Different Stakehlder rganizatins might have different feelings as t what their bligatin is. Hw many Stakehlders feel like there is infrmatin that they can share and t what extent? If there are sme that cannt share, that is als gd t knw. A link culd be put nt the website. Lisa stated that she believes the website can be set up t have the respnses frm the survey set t g directly t specific persn s . Marci Aguirre (IEHP) - Suggested that it be made clear wh the data will be shared with. Als putting in an ptin f an MOU r Business Agreement if it s between just tw entities ther than just the individual patient release. A. It was reprted that n March 19 th CMS apprved the 1115 waiver that makes CCI fficial. B. The Plans are ready fr the April 1 implementatin. C. Due t a delay in the State sending ut ntificatin letters, there will nt be passive enrllment beginning n April 1. Passive enrllment will begin in May. Beneficiary can actively enrll as f April 1. Page 4 f 8

5 Agenda Item Discussin f Agenda Items Actin D. DCHS is cnducting an audit at IEHP in April. E. Due t delays n the implementatin f CCI the State asked the Plans t amend the Plans MOU s with the Cunties. F. MOU Updates: All MOU s between the Plans and the Cunties have been executed. State has requested sme adjustments t the MOU s. Amendments are in prcess. VI. Website Details A. Lisa Hayes reprted that a calendar was added t the website. Bth Plans will have access t add events. Grup was asked t frward any events that they wuld like t share t either Lisa Hayes r Heidi Pringle. Mary Ris- Is there ging t be any infrmatin available in any ther languages n the website? They are nt as f this time. Mst f the infrmatin prvided n the website has been passed dwn frm the State websites. This website wasn t initially intended fr anyne utside f the CCI Stakehlder Advisry Grup. Megan Juring- Will lk int getting the infrmatin prvided by the State in ther languages. Claudia Hensel- Shuld Harbage put any f their Inland Empire Events n the Inland Empire CCI calendar? Grup agreed that wuld be a gd idea. VII. Public Cmment 1. Claudia Hensel- Stated that their utreach effrts in the Inland Empire ver the last few mnths have varied between different grups. On the Cal Duals website there is nw a link called Train the Trainer. Individuals are able t g there and request a presentatin. The utreach in the Inland Empire is nt as active as it culd be. Claudia stated that they are happy t cme and present. Harbage has presentatins fr beneficiaries, prviders, and advcates. Ben Jauregui- Where is Harbage in recruiting a lcal Inland Empire utreach cnsultant? As f right nw there has been nbdy hired in that psitin. 2. Paul Van Drn- Reprted that his clients are bringing in letters regarding their Medicare and what will happen t it. He stated that the letters are stating that the member is ging t be disenrlled when the member has nt yet selected t be a part f Cali MediCnnect r nt, this is causing cnfusin. 3. Darren Gray- Stated that when he is cntacting Health Care Optins n behalf f sme f his clients, Health Care Optins is telling the client they will, r will nt be enrlled int Cal Medi-Cnnect when in fact the client had nt yet made the decisin. VIII. Next Steps See Actin Lg IX. Clsing Cmments A. There were n clsing cmments t reprt. Page 5 f 8

6 Agenda Item Discussin f Agenda Items Actin X. Next Meeting A. May 27,2014, 1:30 pm-4:30pm Inland Reginal Center 1425 S. Waterman Ave. San Bernardin, Ca ACTION ITEM 11. T share presentatins with the Stakehlders that will be utilized. 13. Grup t prvide feedback n Website 14. T cme up with ways t mitigate the tp fur identified risks. 15. T read thrugh the handut given by the Use clear and simple language. Prper/adequate interpretatin and alternate frmats. Subgrup and prvide feedback. 16. An electrnic survey will be mailed t the CCI Stakehlder Advisry Cmmittee during the first week f February. This survey will help us identify specific stakehlder needs related t data. Strategies t vercme the barriers identified will be wrked n based n the survey results and further input frm the CCI Stakehlder Advisry Cmmittee. 19. Gilbert t create a wish list t distribute t the Stakehlders. Als, a schedule f presentatin dates can be sent t the grup. Actin Lg RESPONSIBLE STAKEHOLDER OPEN DATE DUE DATE STATUS NOTES COMPLETION DATE Gilbert Sauceda 7/23/13 9/24/13 Pending HICAP s plan fr utreach is t maintain the fcus n Medicare. It depends n the additinal funding that will be prvided by the State f Califrnia t assist in the Duals Demnstratin wrk. HICAP will be happy t partner with any rganizatin t d presentatins that will be tailred t each client. Grup 7/23/13 9/24/13 On Ging Risk Subgrups 9/24/13 11/13 On Ging Gilbert Sauceda /Grup 1/28/14 In Prcess 3/25/14: Gilbert prvided hand-uts t the cmmittee and received suggested edits. Grup 1/28/14 In Prcess 3/25/14: Draft survey shared with the Cmmittee. Suggested edits prvided. Edits t be made. Link t survey via Survey Mnkey t be added t Stakehlder Website. Gilbert Sauceda 3/25/14 Pending Page 6 f 8

7 20. Rger (SB C.) and Lisa (Riv C.) t get in cntact with the Medical Assciatins t crdinate dates fr Harbage present. 21. Send ut a cpy f the draft Managed Care 101 presentatin t the Stakehlders. 22. Grup was asked t review the draft survey and prvide feedback. 23. T check with the State t see if any f the infrmatin prvided n their website is available in ther languages. ACTION ITEM 1. Create Website fr Cmmittee/ Public- Status Update: A draft picture f what the website will lk like was presented. Rger Uminski/ Lisa Hayes 3/25/14 Pending 3/25/14: Dimitris received cnfirmatin that the Medical Assciatins are willing t have presentatins. Lisa will cntact Riverside t get dates; Rger will cntact S.B. t get dates. Ben Jauregui 3/25/14 4/4/14 Pending Stakehlders 3/25/14 4/4/14 Pending Megan Juring 3/25/14 Pending Actin Lg - Reslved RESPONSIBLE OPEN DUE STATUS NOTES COMPLETION STAKEHOLDER DATE DATE DATE Lisa Hayes 1/29/13 7/23/13 Cmplete 7/23/13 2. Create 2 list serves. One fr Cmmittee and One fr Public- Bth Cmmittee and Public list servers will be available n the website. Heidi Pringle 1/29/13 7/23/13 Cmplete 3/21/13 3. Send Acrnyms t Stakehlders Heidi Pringle 7/23/13 9/24/13 Cmpleted 9/24/13 4. Prvide the HICAP link t Lisa Hayes t add t the CCI Stakehlder Website. Lisbeth Rberts 7/23/13 9/24/13 Cmpleted and bth links lead t the same site. 9/24/13 5. The Plans t verify hw ften the Websites are updated when a Prvider is added r remved. 6. Lisa t lk int a pssible cutff perid where the member culd nt g back. They wuld have t chse a Cal MediCnnect Plan if they are Dual eligible. 7. Lk int materials and trainings t supprt HICAP with cunseling persns with a disability. 8. The Plans t check with CMS guidance n the unique SHIP ID number. Ben Jauregui/ Lisa Hayes 7/23/13 9/24/13 Cmpleted 9/24/13 Lisa Hayes 7/23/13 9/24/13 Cmpleted 9/24/13 Lisa Hayes/ Ben Jauregui IEHP/Mlina 11/23/1 3 7/23/13 9/24/13 Cmplete 1/28/13 Cmpleted Ben researched and fund that CMS recmmended the use f the SHIP ID but it was nt a requirement Page 7 f 8

8 9. T reach ut and try t get in tuch with the crrect peple at The San Bernardin Medical Assciatin s the Harbage Cnsultants can educate them abut CCI. 10. T reach ut and try t get in tuch with the crrect peple at The Riverside Medical Assciatin s the Harbage Cnsultants can educate them abut CCI. 9. Lk int the State Health Insurance Assistance Prgram (SHIP) HICAP is assigned by CMS a unique ID number t be able t cntact Health Plans and Medicare Advantage Plans n behalf f the member withut the member being present in rder t advcate fr them 18. T prvide Harbage Cnsulting with IEDC Member events 17. T get apprval t send the Fact Sheet n Cal MediCnnect t the Stakehlders. Dimitris Alexiu 1/28/14 Cmpleted Dr. Allen 1/28/14 Cmpleted Gilbert Sauceda, IEHP, Mlina 7/23/13 9/24/13 Cmpleted It wuld be helpful fr the HICAP cunselrs and helping the clients if IEHP and Mlina wuld utilize the same prcess that the Plans may already have the guidance fr under the Medicare D-SNP, The Plans can then utilize this prcess fr the Cal MediCnnect Prgram s if HICAP needs t advcate and ask mre questins there will be a direct SHIP aligned t the Plans that the cuncilrs can utilize. Ben Jauregui 1/28/14 Cmpleted Gilbert Sauceda 1/28/14 Cmpleted 3/25/14: Cmmittee suggested changes and apprved distributin. Page 8 f 8