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Health Care Reform Webinar

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Welcome Health Care Reform Webinar January 21, 2011 We will begin promptly _at_ 1PM EST Event Host John Lozier Executive Director, National Health Care for the Homeless ... – PowerPoint PPT presentation

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Title: Health Care Reform Webinar


1
Welcome
  • Health Care Reform Webinar
  • January 21, 2011
  • We will begin promptly _at_ 1PM EST

Event Host John Lozier Executive Director,
National Health Care for the Homeless Council
This presentation is supported through a
Cooperative Agreement with the Health Resources
and Services Administration.
2
Health Care Reform An Overview for HCH
Grantees January 21, 2011
  • Health Care Housing Are Human Rights

3
Presenters
Barbara DiPietro, PhD
Claire Goyer, M.Ed
Tom Andrews, BS
  • Director of Policy, National Health Care for the
    Homeless Council
  • Director of Policy, HCH of Baltimore, MD
  • Technical Assistance Program Coordinator,
    National Health Care for the Homeless Council
  • Executive Director (Retired), Duffy Health Center
  • President, St. Josephs Mercy Care Services
  • President, Board of Directors, National Health
    Care for the Homeless Council

4
Overview of Todays Presentation
  • Current status of Health Reform law
  • Medicaid expansion
  • Remaining uninsured
  • Advocacy opportunities
  • Health Center funding opportunities
  • A Grantee perspective

Health Care Housing Are Human Rights
5
Current Status at Federal Level
  • PPACA has been in effect for 10 months, but
    confusion remains among general public and
    controversy continues
  • Courts Mixed federal court decisions regarding
    individual mandate possible Supreme Court
    determination
  • Congress Incoming Congress has pledged to
    repeal or reduce laws impact/implementation
  • Administrations HHS implementing current
    provisions and planning for future changes

Health Care Housing Are Human Rights
6
Current Status at State Level
  • States vary widely in political/policy philosophy
    and stages of planning 20 states are part of
    federal lawsuit
  • Establishing State Exchange systems
  • Applying for federal planning grants
    demonstration projects
  • Projecting impact of law on rate of uninsured,
    budget, and existing health care structure
  • Evaluating changes needed

Health Care Housing Are Human Rights
7
Medicaid Expansion
  • Expands Medicaid to 133 Federal Poverty Level
  • 14,400/year for individual (in 2010)
  • 24,300/year for family of 3
  • Allows for 5 MAGI
  • Expect 16 million to 23 million new enrollees
  • Federal reimbursement to states for newly
    eligible
  • 100 2014-2016
  • 95 2017
  • 94 2018
  • 93 2019
  • 90 2020 and thereafter

Health Care Housing Are Human Rights
8
Medicaid Expansion (contd)
  • Maintenance of Effort states cannot reduce
    Medicaid or CHIP eligibility, increase premiums
    or enrollment fees, or otherwise restrict
    enrollment
  • Violations Lose all federal matching funding
    for the entire Medicaid program until corrected
  • Benefit Package Unknown how benefits for newly
    eligible will compare to those available to
    currently eligible
  • Option for Early Expansion (even at incremental
    levels)
  • Early Implementers to Date
  • Connecticut
  • DC

Health Care Housing Are Human Rights
9
Medicaid Expansion (contd)
  • Benefits of early expansion
  • Reduces administrative burden in 2014 (ramp up)
  • Extends health care to those most in need
  • Reduces use of emergency departments and other
    high-cost venues
  • Early expansion factors for states to consider
  • Current eligibility/participation
  • Balance cost of newly eligible with previously
    eligible
  • Expansion States
  • Different considerations for Arizona, Hawaii,
    Delaware, Maine, Massachusetts, Vermont, New York
    due to existing waiver for single adult coverage

Health Care Housing Are Human Rights
10
A Brief Mention of the State Exchanges
  • Online marketplaces designed to help individuals
    and small employers obtain private-market
    coverage Focused on individual and small group
    markets does not apply to self-insured plans
    (typically those offered by large employers)
  • Must be implemented by January 1, 2014
  • Subsidies and credits, based on income (which can
    fluctuate) 100-400 FPL
  • Must contain insurance with Essential Health
    Benefits (yet to be defined), which may be less
    than current state requirements

Health Care Housing Are Human Rights
11
Medicaid Expansion (contd)
  • State challenges in planning for 2014
  • Handling large influx of enrollment
  • Determining newly eligible from previously
    eligible
  • Ensuring state Exchange and Medicaid are able to
    integrate and provide seamless transition
  • Boosting provider availability
  • Budgeting for rate increases
  • Unknowns Impact of Medicaid expansion on other
    mainstream funding programs (e.g., block grants)
    specifics behind enrollment procedures breadth
    of required services

Health Care Housing Are Human Rights
12
Remaining Uninsured
  • In 2016 21 million non-elderly left uninsured
  • Medicaid eligible, but un-enrolled 10-11
    million
  • Undocumented 7 million
  • Non-participating 4 million
  • Penalty Individual penalty payments are based
    on the income of the tax return. Those below
    filing threshold are exempt from penalty.
  • Sources Congressional Budget Office (CBO),
    March 20, 2010. Letter to Speaker Pelosi.
  • CBO, Payments of Penalties for Being Uninsured
    Under the PPACA, April 22, 2010.

Health Care Housing Are Human Rights
13
Advocacy Opportunities
  • Encourage your state to consider advance
    implementation of the Medicaid expansion (even at
    the lowest FPL levels), greater benefits
    ongoing services for those remaining uninsured
  • Implement assertive outreach and enrollment,
    reach as many as possible to minimize the
    uninsured population establish best practices
    for teams
  • Participate in State Implementation Task Forces/
    Councils/Committees attend meetings, provide
    comments, educate policymakers about needs of
    individuals experiencing homelessness
  • ? Conduct site visits!! ?

Health Care Housing Are Human Rights
14
Health Center Funding
  • Allocates 11 billion in health center funding
    over 5 years (in addition to annual
    appropriations)
  • Operations Funding 9.5 billion total
  • FY2011 1 billion
  • FY2012 1.2 billion
  • FY2013 1.5 billion
  • FY2014 2.2 billion
  • FY2015 3.6 billion
  • Capital Funding 1.5 billion
  • National Goal Increase number of health center
    patients from 20 million in 2010 to 40 million in
    2015

Health Care Housing Are Human Rights
15
Anticipated Funding Opportunities
  • New Access Points
  • New service delivery site for the provision of
    comprehensive primary and preventive health care
  • New Starts
  • Satellite Applicant
  • Expanded Services
  • Medical
  • Behavioral Health
  • Enabling

Health Care Housing Are Human Rights
16
Maximizing Funding Opportunities Be Ready!
  • Have a clear organization-wide plan
  • Whats your long range vision?
  • How have you identified your priorities?
  • What are your strategic objectives?
  • What will your outcome measures be?
  • How will you evaluate your programs?
  • Whats the process for continuous improvement?
  • What constitutes success?

Health Care Housing Are Human Rights
17
Readiness Target Population and Community
Landscape
  • Who is homeless in your local area?
  • What are the most prevalent health care needs?
  • Who is un-served or underserved?
  • What makes up your health safety net?
  • What are the gaps?

Health Care Housing Are Human Rights
18
Readiness Key Relationships
  • Examine your current partnerships
  • Local hospital
  • Discharge planning sources
  • Referral sources
  • Emergency responders police fire
  • Political leaders
  • Business community
  • Continuum of Care
  • Dont be afraid to step out of the box!

Health Care Housing Are Human Rights
19
Readiness Patient Centered Medical Home
  • Current Status of
  • Team functioning
  • Consumer voice
  • Comprehensive services
  • Certification processes

Health Care Housing Are Human Rights
20
Readiness Meaningful Use
  • EMR Status
  • Outcomes Development and Management
  • Clinical Measures

Health Care Housing Are Human Rights
21
Readiness Stating Your Case
  • Document your ideal service delivery model and
    identify what you need to get to that goal
  • Integrated care model status
  • Implementation of Evidence Based Practices
  • Staffing Needs
  • Facility
  • Utilization Trends
  • Finances

Health Care Housing Are Human Rights
22
Readiness Quality Improvement/ Quality Assurance
  • How are you collecting data?
  • How are you using data to improve?
  • How are you doing in terms of HRSAs Clinical and
    Financial Performance Measures?
  • How are you measuring consumer satisfaction?

Health Care Housing Are Human Rights
23
Readiness Governance
  • 330 compliance
  • Board membership
  • Board functioning
  • Consumer input

Health Care Housing Are Human Rights
24
Readiness Finances
  • Financial Management
  • Policies and procedures
  • Billing and collection systems
  • Systems for collecting, organizing and tracking
    key financial performance data
  • Payment Reform
  • Global payments
  • ACOs

Health Care Housing Are Human Rights
25
Grantee Response Anticipating Funding
Opportunities
  • Updated Needs Assessment Local School of Public
    Health Student Project
  • Safety-Net Initiative (4 FQHCs Public
    Hospital) Supported by Local Foundations
  • Access to primary care formal assessment
    School of Public Policy
  • Creation of new open access clinic to divert
    emergency room visits and refer patients to
    patient centered medical home
  • Possible Accountable Care Organization (ACO)

Health Care Housing Are Human Rights
26
Grantee Response Anticipating Funding
Opportunities (contd)
  • Capital Campaign Expansion Project
  • Purchase of new mobile coach ARRA funding
  • Addition of diagnostic services
    (radiology/ultrasound) ARRA funding
  • Addition of vision services private funding
  • EMR in all clinics and EDR recently installed

Health Care Housing Are Human Rights
27
Grantee Response Maximizing Funding
Opportunities
  • New Access Point Application December, 2010
  • After-hours/weekend clinic - partnership with
    local public hospital and homeless womens
    service provider
  • Diversion from ED, walk-in and outreach
  • Patient navigator Referral to medical home
    (private funding)
  • Expanded Services Application January, 2011
  • Behavioral health (integrated model) two
    clinics
  • Add 4 new mobile clinic locations with new coach
  • New Ryan White Funding Expand Early
    Intervention Clinic

Health Care Housing Are Human Rights
28
Grantee Response Readiness Community
Landscape, Target Population Key Relationships
  • Launching strategic planning process 1st
    Quarter, 2011
  • Build on needs assessment - new five year plan
  • Expanded relationships with public hospital
    (NAP), other FQHCs and Morehouse School of
    Medicine (behavioral health services)
  • New relationships for mobile clinics sites
  • Transitional and supportive housing
  • Evening clinics at shelters

Health Care Housing Are Human Rights
29
Grantee Response Readiness Patient Centered
Medical Home, Meaningful Use Quality Improvement
  • Initiated medical home education program
  • Clinics sites
  • Outreach activities
  • Collaboration with other homeless service
    providers
  • Service Area Competition Application (November,
    2010)
  • Clinical Performance Measures focused on criteria
    related to Patient Centered Medical Home
  • Financial Performance Measures focused on
    Meaningful Use

Health Care Housing Are Human Rights
30
Grantee Response Readiness Patient Centered
Medical Home, Meaningful Use Quality
Improvement (contd)
  • Patient navigators Two-Three Clinics
    (Americorp)
  • Linkage to partner agencies for referrals (public
    hospital, other service providers)
  • SSI and patient assistance programs
  • Referrals for other services
  • Enabling services
  • Discussion with PCA to move into IT network
  • Support all EHR applications/Meaningful Use
    requirements
  • Lower cost
  • Health Information Exchange with public hospital
    other FQHCs

Health Care Housing Are Human Rights
31
Grantee Response Readiness Governance Finance
  • Bylaw changes December, 2010
  • New 330 governance requirements
  • Term limits and some change in leadership
  • Expanded activities for Client Advisory Committee
  • Focus groups
  • Expanded volunteer and staffing opportunities
  • New Market Tax Credit
  • Participation in all managed care programs
    proactively communicating with patients on
    medical home

Health Care Housing Are Human Rights
32
Grantee Response Medicaid Expansion
  • Status of Georgia NOT GOOD
  • Current eligibility does not include most
    homeless
  • Participating in federal lawsuit/new Governor on
    record as opposing expansion
  • Other opportunities
  • SSI benefits Patient navigators
  • Expanded FQHC access/collaboration - ACO
  • Other advocacy efforts mental health funding
    incarceration discharge planning
  • Future programs Readiness activities in Blue
    states

Health Care Housing Are Human Rights
33
More Information
  • The National Health Care for the Homeless
    Council is a membership organization for those
    who work to improve the health of homeless people
    and who seek housing, health care, and adequate
    incomes for everyone.
  • Additional health reform materials at
    http//www.nhchc.org/healthcarereform.html
  • NHCHC offers free individual memberships at
    http//www.nhchc.org/council.htmlmembership
  • Sign up for advocacy-related Mobilizers at
    http//www.nhchc.org/mobilizer.html
  • Next webinar Meaningful Use on January 26 at
    200 EST. To register http//www.nhchc.org/Webin
    ars/DMUwebinar.html

Health Care Housing Are Human Rights
34
Questions Answers
Claire Goyer, M.Ed
Tom Andrews, BS
Barbara DiPietro, PhD
  • Director of Policy, National Health Care for the
    Homeless Council
  • Director of Policy, HCH of Baltimore, MD
  • Technical Assistance Program Coordinator,
    National Health Care for the Homeless Council
  • Executive Director (Retired), Duffy Health Center
  • President, St. Josephs Mercy Care Services
  • President, Board of Directors, National Health
    Care for the Homeless Council
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