HRSA Health Center Outreach and Enrollment Technical Assistance

Call

September 27, 2013

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Presentation Overview

• Introduction• CAC Designation Update (For FFMs Only)• Success Stories• Review of FAQs• Outreach and Enrollment Quarterly Progress Reports (OE

QPR)• Resources• Questions and Answers

2

CAC Application Update (for FFM and SPM states only)

• If your health center is in a state-based marketplace, you do not need to complete a federal CAC application, unless your state has determined that you must do so.

• CMS continues to prioritize health center CAC applications and is reviewing them as quickly as possible. HRSA is in daily communication with CMS on this issue.

• If the CAC application process has delayed your O/E assistance worker training, report that in the barriers section of your October QPR.

• In order to expedite CAC application review:

– Submit your signed agreement electronically– Send CAC issues to your PCA and to HRSA at bphc-oe@hrsa.gov.

If you can’t find your CAC designation number in the body of your email from CMS, it should also be in the subject line of the message.

3

FFM/SPM Marketplace “Get Ready for Open Enrollment” Informational

Calls

• Who: For all organizations awarded/approved as Navigators, Certified Application Counselors, and Enrollment Assistance Programs (i.e., health centers in FFMs and SPMs)

• What: The latest news and tips to help you assist consumers in the Marketplace.

• When and How to Register:– Monday, September 30, 10:00 a.m.- 11:30 a.m. ET: https://

webinar.cms.hhs.gov/mpa930am/event/registration.html– Monday, September 30, 1:30 p.m.- 3:00 p.m. ET: https://

webinar.cms.hhs.gov/mpa930pm/event/registration.html• Ask questions before and during the call via email at

training@cms.hhs.gov. Please refer to the call in the subject line.

4

Highlight Your Health Center’s O/E Success through Stories

• HRSA needs your health center success stories• These will be shared for non-media purposes (inclusion in

speeches, social media, healthcare.gov)• Kinds of successes you might share:

– October 1 events—let us know what you have planned– Health center events that used creative strategies,

unique settings, and/or attracted lots of people– Successful one-on-one connections to service area

residents – Provider-patient stories– Non O/E health center staff-patient stories

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Success Stories—How to Share Them

• If you think you might have a good story, you probably do. Err on the side of sharing!

• Be specific – “280 people attended the event held at the grocery store” is better

than “many people attended the event”– The bi-lingual provider was able to explain options to the Spanish-

speaking patient who then…• Copy your PCA so they can see the great things that are going on in

the state/region.

• If you have communications staff who are sharing stories regularly with local media, ask them to add HRSA’s inbox to their list of contact.

Send stories to bphc-oe@hrsa.gov.

6

Training

• FAQs, separated for health centers in FFMs/SPMs and in SBMs are available at http://bphc.hrsa.gov/outreachandenrollment/.

• Key points:– First and foremost, health centers must comply with all federal and

state requirements. Consult with your PCA if you are not sure of the requirements in your state.

– Requirements apply to all O/E assistance workers, whether or not they are supported by HRSA supplemental dollars.

– The O/E Quarterly Progress Reports (O/E QPR) will allow you to provide context for the data you report, e.g., if training is not available yet, you can indicate that as a barrier in your O/E QPR.

7

Sharing Information about Health Centers’ QHPs—FFMs/SPMs

“Can health center O/E assistance workers let consumers know which plans our health center participates in?”

– Health center CACs in FFMs and SPMs may provide information to consumers about the plans in which the health center participates, unless there are additional state restrictions.

– Health center CACs in FFMs and SPMs may not offer recommendations to consumers or advise consumers on what plan to choose.

8

Sharing Information about Health Centers’ QHPs—SBMs

“Can health center O/E assistance workers let consumers know which plans our health center participates in?”

– Health center O/E assistance workers in SBMs must comply with all conflict of interest requirements as determined by their state Marketplace and their consumer assistance role.

– Follow the guidelines provided in the required training in your in the state.

9

Sharing Services Available at the Health Center

• “Can I promote the services provided by the health center as part of my O/E activities?” – Health centers can announce an O/E event to be

hosted by the health center and/or share information about the availability of the health center as a location where O/E assistance is available.

– These communications must be reasonable and consistent with the intent of the O/E supplemental funding opportunity and must not promote the health center or its services.

– To the extent possible, O/E messages should rely on pre-approved federal and/or state materials.

10

Health Center O/E Quarterly Progress Report (QPR) Key Dates

• October 9– Technical assistance call from 2:00 PM -3:00 PM ET. – Overview of the data elements, timelines, and the O/E

QPR submission process.– Call information will be included in the BPHC Primary

Care Digest and will be posted at http://bphc.hrsa.gov/outreachandenrollment/

• October 10– QPR system opens in EHB.

• October 24– Deadline for submission.

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Health Center O/E QPR

• A QPR sample, reporting definitions, and FAQs will be available available at http://bphc.hrsa.gov/outreachandenrollment/

• Reporting is essential.

• HRSA will place the entire section 330 grant award on drawdown restriction for any health centers who received O/E supplemental funding and do not submit their QPR.

12

Health Center O/E QPR Metrics

• Number Trained– Number of health center O/E assistance workers that

have successfully completed all required federal and/or state training.

– Health center O/E assistance workers include all health center staff, contractor, or volunteer assistance personnel who are trained to facilitate enrollment of individuals into the Marketplace, Medicaid and/or CHIP.

– If there are barriers in your state that have prevented staff from getting training, note that in the barriers section of the O/E QPR.

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• Number Assisted– In-person education about affordable insurance

coverage options (one-on-one or small group) and any other assistance provided by a trained health center O/E assistance worker to facilitate enrollment.

– HRSA does not expect health centers to track assistance by individual.

– Health centers should report each interaction with an individual that includes an assist (even if the assistance occurs with the same person on different days).

Health Center O/E QPR Metrics

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Health Center O/E QPR Metrics

• Number Assisted continued– Number assisted may encompass

o Identifying eligibility for coverage in the Marketplace (e.g., confirming that an individual is a citizen or legal resident as defined at www.HealthCare.gov)

o Setting up an account o Filing affordability assistance informationo Receiving an eligibility determination for subsidies in

the Marketplace or for enrollment in Medicaid or CHIPo Assisting with understanding of qualified health plan

or Medicaid/CHIP plan options.

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• Number Assisted with an Eligibility Determination– Number of individuals who have received an eligibility

determination for subsidies through the Marketplace or who were estimated to be eligible for Medicaid or CHIP.

– Include all individuals who received an eligibility determination, even if the individual is not eligible for a subsidy through the Marketplace or for Medicaid/CHIP.

Health Center O/E QPR Metrics

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• Number Assisted with Enrollment– Health centers should report an estimate of the

individuals who have selected a qualified health plan or who have filed Medicaid/CHIP enrollment documentation.

– Health centers in SBMs with systems that allow health center O/E assistance workers to track their facilitation of enrollment, report enrollment as captured by that state system.

Health Center O/E QPR Metrics

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• Number Assisted with Enrollment (continued)– In states that restrict or prohibit health center facilitation

of enrollment:o Health centers should report to HRSA only those

activities that are permitted (e.g., number trained, assists, and/or eligibility determinations).

o Please explain the state limitations in the narrative portion of the O/E QPR.

Health Center O/E QPR Metrics

18

Q&A

Questions?

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For More Information

Contact Your PCABPHC Primary Care Digest

BPHC Outreach and Enrollment Team Inbox bphc-oe@hrsa.gov

BPHC O/E supplemental funding technical assistance web pagehttp://bphc.hrsa.gov/outreachandenrollment/

BPHC O/E Grantee Enrichment Series http://bphc.hrsa.gov/technicalassistance/trainings/index.html

Other important websites:

https://www.healthcare.gov/ http://marketplace.cms.gov/

http://www.hrsa.gov/affordablecareact/

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