INLAND EMPIRE CCI STAKEHOLDER ADVISORY COMMITTEE MEETING (APPROVED MINUTES FOR- ) Lcatin: IRC 1425 S. Waterman Ave, San Bernardin, CA 92408 Date: Tuesday, - 1:30 pm -4:30pm Appinted Cmmittee Members Present: Persn Title Affiliatin Barbara Prter Prgram Directr Inland Empire Adult Day Healthcare Center Cindy Chiu fr Megan Juring Deputy Directr Department f Rehabilitatin Dianne Sceranka fr Sarah Eberhardt-Ris Deputy Directr San Bernardin Cunty Department f Behaviral Health Dimitris Alexiu Vice President Hspital Assciatin f Suthern Califrnia Felice Cnnlly Prvider Riverside Cunty In- Hme Supprt Services Public Authrity G.G Crawley Deputy Directr San Bernardin Cunty In- Hme Supprtive Services Jhnny Andrade Supervising Prgram Specialist Riverside Cunty In- Hme Supprt Services Kristine Lmis Cnsumer Riverside Cunty In- Hme Supprt Services Leti Fierr Senir Administrative Analyst Riverside Cunty In- Hme Supprt Services Public Authrity Lisbeth Rberts Directr Health Insurance Cunseling and Advcacy Prgram Mary Ris (Attended by phne) Multicultural Affairs Advcate Disability Rights Califrnia Miguel Benitez fr Wendy Duchen SEIU Myette Christian Registry Manager San Bernardin Cunty In- Hme Supprtive Services Public Authrity Paul Van Dren Executive Directr Cmmunity Access Center Ricard Cisners Reginal Crdinatr United Dmestic Wrkers Rn Stewart Deputy Directr Riverside Cunty Office n Aging Sergi Caldern Directr Alzheimer s Assciatin Steve Steinberg Prgram Chief Riverside Cunty Department f Behaviral Health Wasima Alvi Clinical Services Manager Inland Reginal Center Cmmittee Members Absent Persn Title Affiliatin Chris Stttlemyer (Vice-Chair) Administratr Califrnia Assciatin f Health Facilities Dr. Brad Gilbert Chief Executive Officer Inland Empire Health Plan Dr. Sctt Allen Physician Prvider Fran Bates Executive Directr Rlling Start Michele Wilham Directr Riverside Cunty Office n Aging, Randy Schlecht Cnsumer San Bernardin Cunty In- Hme Supprtive Services Rn Buttram (Chair) Directr San Bernardin Department f Aging and Adult Services Sharn Swayzer Prvider San Bernardin Cunty IHSS Public Authrity IEHP Cmmittee Members Present: Persn Title Ben Jauregui 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 Bck Chief Medical Officer Lisa Hayes Directr, Disability & Senir Access Services
I. Welcme and Intrductins Rger Uminski, IEHP (Interim Chair) II. Acceptance f minutes frm March 21, 2013 Rger Uminski, IEHP (Interim III. INLAND EMPIRE CCI Stakehlder Advisry Cmmittee Meeting Meeting Minutes fr @ 1:30-4:30 pm 1 CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin A. Due t the absence f bth the Chair and Vice-Chair, Rger Uminski f IEHP was appinted N Actin interim Chair fr the CCI Stakehlder Advisry Cmmittee Meeting. Required Chair) Review f Actin Lg frm May 21, 2013 Rger Uminski, IEHP (Interim Chair) A. A crrectin was made in attendance. Steve Steinberg was nt an attendee f the May 21, 2013 meeting. B. Minutes were accepted with crrectin. A. Create Website fr Cmmittee/ Public- Status Update: A draft picture f what the website will lk like was presented. B. Create 2 list serves. One fr Cmmittee and One fr Public- Bth Cmmittee and Public list serves have been created. They will be updated/ Peple will be able t add themselves via a link n the website. IV. Cmmunicatin A. The requested items that have been accmplished thus far include : The CCI Stakehlder Advisry Cmmittee Website Brchure template created by SCAN t custmize and distribute A list f Acrnyms has been created. Additinal acrnyms can be added as they surface. 1. Kristine Lmis- If the grup develps any kind f dcument; a prcess that may wrk the easiest wuld be t develp an pt ut prcess. S, whatever a dcument that needs review and apprval can circulate n the list serve giving each member f the cmmittee 24-48 hurs t pt ut, if the member des nt pt ut than their names will be added t the dcument as a participant. The Trailer Bill language asks the State t use Stakehlder Reviews fr the public fur times a year; we might als want t cntribute smething as a cmmittee t that prcess. A cncern n having an pt ut prcess is that many f the Stakehlders n the panel are incredibly busy and d nt see all emails within the 24-48 hurs and there may be smething that is bjected r sensitive t that persn, with that being said if this prcess may need t be mdified. G.G. Crawley- In the Department f Aging and Adult services, if there is crrespndence that is being signed it isn t just that specific department, it will have t g further up fr apprval t put a name n it. If this prcess is decided upn, there will need t be a unanimus vte in a future meeting. Every rganizatin is different and it will be tugh t get cnsensus. Barbara Prter- Wuld it be pssible t pick a certain day t send ut crrespndence fr review? A way t nt be cntrversial is t pssibly submit the minutes frm the meetings t the N Actin Required Cmplete Cmplete
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin State t infrm them f specific tpics, and maybe highlight them t shw what has been talked abut in the meetings. In the meantime anything that will be sent ut crrespndence wise will be vted n at the meetings. Brenda Prim- It wuld be apprpriate t designate t bth Plans and then send the crrespndence t the State with the minutes and state that We d nt believe this is understandable, thse frms can be changed and if enugh f the Plicy Cmmittees agree then CMS will have t g back and lk at the input prvided. Lisbeth Rberts- Because the HICAP cunselr are a part f 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, it wuld be helpful fr the HICAP cunselr 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. 2. Rger Uminski- As this grup s purpse is t prvide input t assist the Plans as the Plans are develping this prduct, what are sme f the things that the grup wuld like t see n the agenda fr the next time that this grup meets? Are there specific things that the grup wuld like t prvide input n? Lisbeth Rberts- The rates. Als, a Plan Benefit Design t shw what the benefits will be. Barbara Prter- Hw ften d the Plans update their websites fr when the Plans get new Prviders? Is there a way t get that infrmatin as current as pssible? The Plans will lk int it and reprt back t the grup. Paul Van Dren- Suggested that the Plans share a reprt f the findings frm the Readiness Review. If the Plans have that infrmatin by the next meeting they will share that infrmatin. G.G. Crawley Suggested revisiting Cmmunicatin, and any updates abut the flyers. Rn Stewart- Lk at the SPD experience, where they may have drpped the ball and nt V. CCI/ Cal MediCnnect Updates Dr. Richard Bck, Mlina Rger Uminski(Interim Chair), IEHP carried it frward as best as it culd have been in attempt t get geared up fr January. A. CCI is still n track t mve frward January 1, 2014. Bth Plans are in preparatin fr the Readiness Review. The cntractr (NORC) which was selected by CMS t review the Readiness Review dcuments and cnduct an nsite review is currently nsite at IEHP. The review started yesterday July 22, 2013. The same review will take place at Mlina the fllwing week n July 29-30 th. 600 + Readiness Review dcuments frm each Plan were submitted t Department f Health Care Services (DHCS) April 19, 2013. Bth Plans received a deficiency reprt back frm the State requesting additinal infrmatin fr further preparatin fr the nsite review. The rates are still unknwn. Cntracts will need t be in place by September 1 fr January 1 2
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin implementatin. B. The Medi-Cal prtin f CCI is mandatry. If yu have bth Medicare and Medi-Cal, yu can pt ut f the Cal Medi-Cnnect prtin f the Crdinated Care Initiative. This means yur Medicare benefit will remain fee fr service; this is smetimes called straight Medicare. C. The state will use a passive enrllment prcess. The State will enrll eligible individuals by their birth mnth int a health plan that cmbines their Medicare and Medi-Cal benefits unless the individual actively chses nt t jin and ntifies the state f this chice. Eligible beneficiaries will receive three ntices abut the change: 90 Day Ntificatin: Will ntify members abut the Crdinated Care Initiative and describe hw their Medicare & Medi-Cal benefits will be changing. 60 Day Ntificatin: Will Infrm beneficiaries f their health plan chices (IEHP r Mlina), prvide a timeline and encurage them t chse. 30 Day Ntificatin will remind beneficiaries f the time remaining t chse a health plan and urge beneficiaries t make a chice. Eligible beneficiaries that have nt chsen a health plan will be passively enrlled int either Mlina Healthcare r IEHP. D. There are sme beneficiaries that are exempt and will nt be impacted by CCI: Beneficiaries under age 21 ICF-DD Residents Peple participating in the fllwing waiver prgrams are excluded: Nursing Facility/Acute Hspital, HIV/AIDS, Assisted Living, and In- Hme Operatins; Beneficiaries with Other Health Cverage 1. Kristine Lmis- What abut peple that are straight Medi-Cal? Like yunger persns with disabilities wh dn t have Medicare? Will it affect their Lng Term Care? This prgram will nt impact thse under 21. They shuld already be a part f a Managed Care Plan. If they are nt a part f a Health Plan they may have received a ne year emergency exemptin. Hwever, it will affect thse in Lg Term Care. E. The State has decided t de-link The CCI Prgram and Cal MediCnnect. This means if the State cannt cme up t an agreement with CMS fr the Cal MediCnnect Prgram, the CCI Prgram will cntinue, and be implemented January 1, 2014. 2. Paul Van Dren- What d yu think the biggest effect wuld be fr a persn that is Medi-Medi that chses nt t get int HMO fr the Medicare? They lse the advantage f the demnstratin prject. Plans will nt be able t fully leverage crdinating the Medi-Cal and Medicare benefits. Because f that the Plans will have a hard time managing care and transitins f care services n discharge. The Plans will als nt be able t crdinate the Lng Term Care piece. 3. Paul Van Dren- There are sme things that Medi-Cal will pick up fr peple that 3
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin are n Medicare, if the persn chses t pt f HMO Medicare is Medi-Cal still ging t pay fr thse things? The Plans use what is called Medi-Cal wrap. Wrap services are still cvered under the Health Plan. It is a matter f crdinating. The ability t maximize the benefits frm bth Medi-Cal and Medicare diminishes tremendusly. 4. Barbara Prter- It will behve all f the Stakehlders t get n bard and stress the advantages f being all in. 5. Kristine Lmis- Can yu clarify the difference between cntract and an MOU? Cntract and MOU are just different names fr agreements. The Memrandum f Understanding (MOU) that was presented was between CMS and the State, saying that CMS has accepted the waiver that the State f Califrnia is prpsing fr this demnstratin prject. Subsequent t that, the details need t be put tgether which include cntracts which are referred t as three-way cntracts. These are agreements between the State, CMS, and the health plans. The cntracts have nt been signed and cntain the rates. 6. Dimitris Alexiu- It was said that Sept 1, 2013 is the date that all cntracts need t be signed. We are almst t August and yu have nt released the rates yet, are yu still ging back and frth n the rates? Wuld yu sign the cntracts withut having feedback n the readiness review? When wuld yu envisin sharing rates with the prviders? CMS and the State have nt yet released the rates t the Plans. There will be an exit cnference fr the readiness reviews that will give bth Plans a feel f whether the Plans will pass r fail and the details will cme after. The Plans will share the rates as sn as there is a signed agreement. 7. Wasima Alvi- Fr clarificatin purpses is the Reginal Center Ppulatin excluded fr Lng Term Care as well as Skilled Nursing Facilities? The excluded ppulatins fr the Reginal Centers are the children under 21, and thse in ICF. Senirs r adults that are 21 and ver will be included in the prject. 8. Kristine Lmis- What abut peple under 21 wh receive IHSS r Lng Term In- Hme supprt services? Will they als be impacted? The under 21 ppulatin will be exempt. 9. Brenda Prim- Suggest that this grup request fr DHCS t answer that questin fr the Reginal Centers in writing. 10. Felice Cnnlly- Anyne that is ver 21 that is receiving In-Hme services has t be enrlled in this demnstratin? Will a persn that has Other Health Cverage qualify? Yes, they will have t be in Managed Care. N, thse with ther health cverage will be excluded frm enrllment but will keep IHSS. 4
VI. CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin Outreach Discussin Fllw- A. During the Outreach Discussin that tk place at the May 2013 Stakehlder meeting, the grup Up suggested it wuld be best fr the Plans t prvide materials and tls fr each rganizatin t educate and pass the infrmatin n t their cnsumers. Each rganizatin has already created a rapprt with their cnsumers and may have a bigger impact. B. Lisbeth Rberts f the Health Insurance Cunseling and Advcacy Prgram (HICAP) explained what the HICAP prgram des and hw they will be able t assist with spreading the wrd. HICAP is available t prvide unbiased infrmatin abut all individuals benefits. A way t assist HICAP wuld be t refer the cnsumers t HICAP by calling 1-800-434-0222. HICAP will prvide this infrmatin t the cnsumer in effrt t find the best service pssible fr that persn. The fcus is n the cnsumers that are the mst vulnerable and peple that have a hard time understanding wh need intensive ne n ne cunseling. 1. Lisa Hayes- What is HICAP s capacity? There are arund 80,000 individuals in the Inland Empire. HICAP is nt yet at capacity. With the current resurces HICAP can serve up t 5,600 per year. They currently serve 4,800. HICAP recently received a grant ver 2 years f $100,000 frm the Califrnia Wellness Fundatin. HICAP was abut t hire tw additinal staff, and are lking t add ne mre. Each member f the staff is able t cuncil 1,000 cnsumers per year. With the increase in staff, the number f clients that HICAP can serve will increase. 2. Kristine Lmis- D yu serve in Orange Cunty? D yu have Vietnamese persnnel? Yes, HICAP serves in Orange Cunty. HICAP als has Vietnamese speaking staff. C. 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. 3. Rger Uminski- When HICAP des presentatins that are tailred t the specific ppulatins; d the presentatins generally answer mst peple s questins? If the Stakehlders are successful in getting the wrd ut abut HICAP and HICAP becmes verwhelmed, des that help with receiving mre funding t be able t handle the vlume? Yes it des tend t elicit mre appintments fr HICAP. But, the appintments tend t run faster and smther because the cnsumer already has the basic knwledge rather than the cnsumer nt having any knwledge and having t start frm scratch. Yes. Als, if anyne can prvide referrals t any fundatins that wuld be interested in funding a nn-prfit rganizatin. 4. Rger Uminski- During the SPD s transitin when the members received the 30day, 60day, 90 day ntices, this is pssibly a large percentage f members that d nt pay 5
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin very clse attentin and gt assigned t a Plan whether they wanted t r nt. There may be ptential issues. Des HICAP get invlved, r say it s t late. HICAP will cntinue t cuncil, they will nt turn anyne away. 5. Barbara Prter- Are yu ging t have a chance t view the frm that will be sent t the prspective cnsumers? During the CBAS transitin the frms that were used were very misleading and peple signed the incrrect bx and lst the ability t jin the Managed Care Plan at that time. The Plans have prvided feedback n the ntices t the State. The State has nt yet sent ut the final frms that will be sent. Brenda Prim- The State has a Stakehlder prcess like this cmmittee, the recmmendatins f the peple that have prvided feedback n that frm. Infrm the State f this prblem. 6. Lisa Hayes- Can we add the HICAP website under resurces n the CCI Stakehlder Advisry Cmmittee Website? Lisbeth will prvide the link t the HICAP Website t Lisa Hayes. 7. Ben Jauregui- Is HICAP listed in the 211 database? Yes HICAP is listed in the 211 database. 8. Rger Uminski- S that everyne is using cnsistent messaging, is HICAP is using the SCAN Fundatin infrmatin and brchures? The SCAN Fundatin put ut a draft brchure that needed wrk. SCAN is hping t place this infrmatin at Senir Centers, libraries and ther places that senirs frequent. It will cntain numbers n wh t call depending n ptins. This brchure is a template that they will prvide t the Cunties that can be mdified. Any agency can put their Lg and cntact infrmatin n the flyer and persnalize it fr cnsumers that yu are serving. 9. Rger Uminski- It was talked abut at a previus meeting t add a flyer in with the Meals n Wheels. 10. G.G. Crawley- The IHSS wrkers r APS wrkers can prvide this infrmatin when they g n visits. 11. Lisa Hayes- An issue with the SCAN Fundatin is that it lks like junk mail and wuld prbably be thrwn away. Lisbeth Rberts- The brchure is nt intended t be put in the mail; it will be placed in Senir Centers and Scial Services and places f that nature. It is nt finalized at this time. It will just be a template and infrmatin can be added and remved a needed. It des nt belng t the Scan Fundatin; it can be persnalized. 12. G.G. Crawley- IHSS cnducts Care Prvider Orientatins every week. IHSS can present this infrmatin t the prviders that will be caring fr the clients and trusted by them. 13. Mary Ris- Dr. Bck mentined the 30-, 60-, 90-, day letters; the medical facilities 6
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin in themselves have sme bligatins under title 3 and public accmmdatins fr peple with disabilities, in terms f the transitin. If peple are having difficulty transitining hw are accmmdatins ging t be prvided? Brenda Prim- There is a plan t d alternate frmats; there is als infrmatin abut sign language interpreters which will cme dwn t the Plans. Once the member is int a Plan it then becmes that Plans respnsibility. As far as accmmdatins that have t d with physical r guidance that rganizatin cannt prvide that care. That will cme dwn t the Reginal Centers r the Health Plans t prvide that transitin. The Plans will wrk t gather materials and trainings t prvide t HICAP in an effrt t train the HICAP cunselrs n prperly assisting persns with disabilities. VII. Website A. The new CCI Stakehlder Advisry Cmmittee Website has been launched. The website Lisa Hayes, Mlina includes Tabs such as: 1. Hme 2. Abut CCI- This tab cntains links t: Abut CCI- Overview Abut CCI- Ppulatin Summary Abut CCI- Participating Ppulatins 3. Advisry Cmmittee- This tab cntains dcuments such as : List f Cmmittee Members Cmmittee Charter Meeting Agenda s Meeting Minutes 4. News and Annuncements 5. Resurces- This tab cntains: FAQ s Useful Links 6. Cntact Us B. There is an Ask a Questin Tab at the bttm that cntains a frm t add any questins that need t be answered abut the Crdinated Care Initiative. C. The website address is www.inlandempirecci.rg D. Cmmittee Members were asked t g t the website, explre and prvide feedback. VIII. Public Cmment 1. Marjrie- Is HICAP services available thrughut all f Califrnia r nly the 8 cunties that are a part Cal MediCnnect? HICAP is available fr every cunty in Califrnia. 2. Burma Lee Manns- Wuld like infrmatin frm HICAP. The African American Mental Health Calitin has funding thrugh the Department f Behaviral Health and they g int husehlds and d free mental health presentatins. Lisbeth Rberts f HICAP stated she has 10,000 flyers available that can be 7
CCI Stakehlder Advisry Cmmittee Meeting Agenda Item Discussin f Agenda Items Actin distributed. 3. Sandy Salced- In Medicare if the persn nt nly pts ut but if they chse anther Medicare Advantage Plan, hw much disruptin will this cause fr the recipient? Hw will the cst be cvered n things that are nrmally cvered by Medi-Cal? The beneficiary always has the pprtunity t change. If smene is a Dual and they chse t pt ut f Medicare Managed Care, thse services that are nt cvered by Medicare will be cvered by Managed Care Wraparund Services. IX. Clsing Cmments A. Ben Jauregui- The Natinal Senir Law Center has been fllwing Cal MediCnnect and have been prviding trainings and webinars. B. Ben Jauregui- Asked members t sign an IEHP Cde f Cnduct Frm C. Ben Jauregui- The IEDC will be hsting an Aging Well with a Disability cnference Tuesday, September 17, 2013. The IEDC currently has abut 580 members and meets mnthly. X. Next Meeting A. September 24, 2013. Future meetings will ccur n the last Tuesday f every ther mnth. 8
CCI Stakehlder Advisry Cmmittee Meeting Actin Lg ACTION ITEM RESPONSIBLE OPEN DUE STATUS NOTES COMPLETION STAKEHOLDER DATE DATE DATE T share presentatins with the Lisbeth Rberts 7/23/13 9/24/13 HICAP s plan fr utreach is t maintain Stakehlders that will be utilized. 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. Prvide the HICAP link t Lisa Hayes Lisbeth Rberts 7/23/13 9/24/13 t add t the CCI Stakehlder Website. Lk int materials and trainings t Lisa Hayes/ Ben 7/23/13 9/24/13 supprt HICAP with cunseling Jauregui persns with a disability. Send Acrnyms t Stakehlders Heidi Pringle 7/23/13 9/24/13 Cmpleted Lk int the State Health Insurance Lisbeth Rberts, 7/23/13 9/24/13 It wuld be helpful fr the HICAP Assistance Prgram (SHIP) HICAP is IEHP, Mlina cuncilrs and helping the clients if IEHP assigned by CMS a unique ID number and Mlina wuld utilize the same t be able t cntact Health Plans and prcess that the Plans may already have Medicare Advantage Plans n behalf f the guidance fr under the Medicare D- the member withut the member being SNP, The Plans can then utilize this present in rder t advcate fr them 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 The Plans t verify hw ften the Websites are updated when a Prvider is added r remved. 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. Ben Jauregui/ Lisa Hayes 7/23/13 9/24/13 Lisa Hayes 7/23/13 9/24/13 9 can utilize. Grup t prvide feedback n Website Grup 7/23/13 9/24/13 Actin Lg - Reslved ACTION ITEM RESPONSIBLE STAKEHOLDER OPEN DATE DUE DATE STATUS NOTES COMPLETION DATE Create Website fr Cmmittee/ Public- Status Update: A draft picture f what Lisa Hayes 1/29/13 7/23/13 Cmplete 7/23/13
the website will lk like was presented. Create 2 list serves. One fr Cmmittee and One fr Public- Bth Cmmittee and Public list servers will be available n the website. CCI Stakehlder Advisry Cmmittee Meeting Heidi Pringle 1/29/13 7/23/13 Cmplete 3/21/13 10