P7 ORW Presentation - Work Supports Strategies

January 5, 2018 | Author: Anonymous | Category: Business, Management
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North Carolina Department of Health & Human Services

NC FAST and Work Support Strategies

Operational Readiness Workshop July – August 2013

1

Agenda Time

Agenda Topics

Presenter

9:00-9:15

Welcome & Introductions

Workshop Team

9:15-9:45

NC FAST Project Update

Readiness Team

9:45-11:15

P7 Ecosystem & Division of Responsibilities

P7 Liaisons

11:15-12:00

DMA Update

DMA

12:00-1:00

Lunch: Work Support Strategies Update

WSS Team

1:00-2:00

Managing Applications & Cases

P7 Liaisons

2:00-3:30

Break-Out Discussion: Communications Strategy

All

3:30-4:00

Questions & Answers

Workshop Team

2

North Carolina Department of Health & Human Services

NC FAST Project Update July 2013

3

Project Update         

ePASS Document Management Deployment Update Help Desk Schedule Update Training Update County Security Configuration Project 7 Update Project 3 Update

4

ePASS – Statewide Volumes 2010

2011

2012

2013 – through July

FNS Screenings

40,687

72,323

68,946

34,372

FNS Potential Eligibility

28,212

51,545

49,433

25,391

FNS Applications

3,333

37,505

51,870

23,487

FNS Electronic Apps

0

0

0

10,689

MA Screenings

0

0

12,211

16,478

MA Applications

0

0

9,955

10,803

Quick Screens

28,071

56,999

57,468

29,846

EA Screenings

13,765

22,710

20,188

9,758

EA Potential Eligibility

3,835

5,438

4,488

2,087

Transaction

The number of FNS Electronic Apps has gone up over 4,000 in a month

5

Document Management Update        

Completed functional and detail design documents (integration with NC FAST) Completed County Guidelines document Completed development and testing (integration with NC FAST) FileNet production architecture is readied for configuration Deployed document management capability as part of Project 2&6 Pilot rollout Working on County Sync Guide Working on draft functional and detail design documents for county sync piece Preparing to initiate development of county sync capability

6

Document Management Update   

Document management design document has been posted in FAST Help A webinar will be scheduled to discuss the design document A job aid has been posted providing guidance on what should be scanned

7

Deployment Update 

     



Upgraded NC FAST to P2&6 version of code; a significant upgrade to the base NC FAST system Working through identified defects; continuing build activities and defect fix activities Continue to identify and prioritize Cúram tickets Refining data conversion approach in preparation for Hard Launch Continue submitting test conditions, scripts, and test data sheets for Business team review Respond to Business team comments and receive sign-off for test conditions and scripts Continue to plan and execution of Cycle 3 – Day in the Life execution cycle and Frequency 1,2,3,4,5 scripts Refining internal team communication protocol to streamline getting updates to the counties

8

Help Desk Update       

Significant increase in call volumes last week Identified limitation with current phone system causing some calls to roll to voice mail; new phone system on order If users call the Help Desk and are unable to speak to someone or cannot leave a voicemail message, send your issue via email. Agents work to resolve tickets in the order in which they are received NC FAST Help Desk can be reached at [email protected] or 919855-3200, Option 3 Help Desk is available Monday – Thursday, 8:00 a.m. – 6:00 p.m. and Friday, 8:00 a.m. – 10:00 a.m., 11:00 a.m. – 6:00 p.m. Please report only one incident/issue per email.

9

Help Desk Metrics Open Tickets (as of date) Tier 2 Tier 3/Config/User Setup Tier 3 Dev/Other Total Tier 2/3

7/22/2013 741 4 249 994

7/23/2013 797 8 265 1070

7/24/2013 818 5 276 1099

7/25/2013 859 6 293 1158

7/26/2013 914 6 293 1213

Tickets Resolved (daily) Tier 2 Tier 3/Config/User Setup Tier 3 Dev/Other Total Tier 2/3

7/22/2013 93 2 5 100

7/23/2013 91 4 3 98

7/24/2013 92 3 2 97

7/25/2013 79 1 1 81

7/26/2013 76 3 3 82

10

P2&6 Schedule Update Alleghany

Northampton

Ashe

Surry

Stokes

Rockingham

Caswell

Gates

Warren

Person

Hertford Halifax

Forsyth

Avery Caldwell

Davie

Madison

Iredell

Swain

McDowell

Rutherford

Lincoln

Graham

Martin

Chatham

Dare

Pitt Johnston

Lee

Cabarrus

Harnett

Stanly

Tyrrell

Wilson

Rowan

Gaston

Polk

Nash Wake

Randolph Catawba

Bertie

Franklin

Davidson

Burke

Buncombe

Guilford

Orange

Yadkin

Alamance

Wilkes

Watauga

Beaufort

Hyde

Greene Wayne

Moore

Lenoir

Craven

Macon

Cherokee Clay

Union

Hoke

Anson

Duplin

Scot land

P2&6 Soft Launch Key Pilot August 5

Phase 1 August 12

Phase 2 August 19

Phase 3 September 9

Jones

Sampson

Onslow

Carteret

Robeson Bladen

Pender

Phase 4 September 30 Columbus Brunswick

11

P2&6 Training Update         

Over 40 trainers have gone through Train-the-Trainer Launched the NC FAST Learning Gateway Posted web-based training (WBT) content into Learning Gateway Exposed Pilot counties to preliminary version of classroom training Delivered WBT and instructor-led content to Pilot counties and state office Initiated training of southeast counties Wrapping up development of final classroom training activities Feedback from Pilot and state office delivery has been quite positive Expectations:  Use of Captivate simulations  Training scenarios  Sandbox availability  Availability of program subject matter experts

12

County Security Configuration County

Reception Unit

Eligibility Unit 1

Eligibility Unit 2

Reception Supervisor 1

Eligibility Supervisor 1

Eligibility Supervisor 2

Reception Worker 1

Eligibility Worker 1-1

Eligibility Worker 2-1

Reception Worker 2

Eligibility Worker 1-2

Eligibility Worker 2-2

Reception Worker 3

Eligibility Worker 1-3

Eligibility Worker 2-3

User Role: Inquiry Only

User Role: Eligibility Worker

13

Project 7 Update 





Business team continues to work closely with DMA to:  Finalize Project 7 requirements  Complete documentation for State Plan Amendments (SPA), elected state options, targeted enrollment strategies, and federal hub waiver Design team completed joint design sessions for functionality needed to be ACA compliant; finalizing review and sign-off  Intake and assessment for Medicaid/NCHC  Integration with federal data hub for account transfers and verifications  Eligibility determination/redetermination under MAGI and non-MAGI rules  Coordination of appeals processing with FFM  Implementation of federal and state mandated reports and notifications Interfaces team began federal data services hub Wave 4 testing with CMS

14

Project 3 Update      

Team is composed of Services Business Lead Tracey Duncan, an NC FAST Business Analyst and 3 SMEs from DCDEE Continue to reassess the business requirements Reassessment of the Child Care Subsidy business requirements should be complete in August Requirements for Energy Assistance (CIP and LIEAP) will then be addressed with a SME from Economic Services Fit gap analysis is planned to begin in August, with the goal of beginning functional design in October Deployment is targeted for late 2014

15

North Carolina Department of Health & Human Services

Project 7 FFMI P7 ‘Ecosystem’ & Division of Responsibilities

16

The New P7 Ecosystem MA

Application

FDSH PATHWAYS Electronic In-person, by phone, mail-in Database Interface

State Verification Systems 17

The New P7 Ecosystem  New Streamlined application for MA  Additional questions required for an MA eligibility determination under current rules and/or FNS  Depending on programs for which the applicant is eligible, benefits may begin at different times  Additional electronic verifications from federal sources may be used  Ineligible applications will be transferred to the FFM/Health Insurance Marketplace for potential Advanced Payment Tax Credit (APTC) or Cost-Sharing Reduction (CSR) eligibility

18

The New P7 Ecosystem What is New? • •



• • •

What has changed?

Potential for increase in applications with roll-out of ACA May need to refer customers to the FFM/Health Insurance Marketplace



Caseworkers will ask new questions when customers are applying for MA

Potential for new work queues for Streamlined applications submitted via ePASS



MA applications completed on ePASS may now be submitted electronically A link will be added to ePASS to allow applicants to connect directly to the FFM/Health Insurance Marketplace

Entirely new web-based access point for customers Potential for new work queues for Streamlined applications submitted via FFM Applications may be transferred from the FFM to NC FAST and vice versa





‘One-Stop shop’ now available for customers; whether looking for Medical Assistance or shopping for insurance plan

19

MA Applications Completed via the DSS Streamlined Application keyed by caseworker

MAGI Notice Generated and Held by NC FAST.

Traditional determination/ additional program requested?

Enroll in MAGI program

Benefits under MAGI programs will not begin until January 1, 2014.

Send application to FFM

Answer additional questions for traditional MA (and FNS, if requested)

Enroll in Traditional MA and/or FNS

If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates. 20

MA Applications Completed via ePASS Streamlined Application keyed by applicant

Applicant registers for NCID

MAGI Notice Generated and Held by NC FAST.

Traditional determination/ additional program requested?

Enroll in MAGI program

Benefits under MAGI programs will not begin until January 1, 2014.

Send application to FFM

Answer additional questions for traditional MA (and FNS, if requested)

Enroll in Traditional MA and/or FNS

If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates. 21

MA Applications Completed via the FFM Streamlined Application completed through FFM

Seeking Financial Assistance ?

Enrolled in QHP of choice

Potentially MA eligible?

Calculate APTC/CSR

Full determination requested?

Application transferred to NC FAST

22

Key Points  Beginning October 1, 2013 – the Streamlined Application will always be completed FIRST when applicant is seeking Medical Assistance.  To receive a determination based on ‘traditional’ rules (between 10/1/2013 and 12/31/2013) and/or to apply for FNS in addition to MA, additional questions will need to be answered.  Regardless of the entry point, the Medicaid/NCHC determination will ultimately be done in NC FAST.  Benefits under MAGI programs will not begin until January 1, 2014  As of January 1, 2014 – MAGI rules become the standard for most Family & Children’s MA programs.  Applicants who do not qualify for Medicaid/NCHC may still be eligible for APTC/CSR (federal subsidies) to help pay for insurance and should utilize the FFM/Health Insurance Marketplace.

23

North Carolina Department of Health & Human Services

P7 Division of Responsibilities: DHHS/FFM/FFMI

24

Health Insurance Marketplace

25

Health Insurance Marketplace

26

Customer Assistance

If a customer requires assistance completing the streamlined application for Medicaid/NCHC while at the local DSS, they are assisted by the caseworker.

If a customer requires assistance completing the streamlined application for Medicaid/NCHC while using ePASS, they are advised to call the DHHS Customer Service Center.

If a customer requires assistance completing the streamlined application for Medicaid/CHIP while using the FFM, they are advised to call the Federal Call Center and/or Navigator.

27

Customer Assistance Provide customers with information that assists with the following: • submitting the eligibility application • clarifying distinctions in QHPs • making informed decisions during the health plan selection process Can assist in all different types of marketplaces • State-based Marketplace • State Partnership Marketplace • Federally-facilitated Marketplace Funded through State and Federal grants

Must complete comprehensive training to become a navigator.

28

Customer Assistance Serve many of the same functions as Navigators including: • Providing education to customers • Assistance completing applications Organizations can apply online to be designated by the Marketplace to certify application counselors. Some examples of organizations include: • Social service agencies • Hospitals • Community health centers No funding mechanism available for this program Must complete comprehensive training to be a Certified Application Counselor.

29

Customer Assistance

Navigators

Non-Navigator assistance personnel

Certified application counselors

Agents and Brokers

State-based Marketplace

Yes

Optional for states

Yes

Optional for states

State Partnership Marketplace

Yes

Yes

Yes

Yes, if state permits it

Federallyfacilitated Marketplace

Yes

Not applicable; Navigators provide this assistance

Yes

Yes, if state permits it

*Source: cms.gov

30

Navigators  Role: To assist the customer in applying for an insurance affordability program  



Can be a person or organization May assist with Streamlined application completion, or complete on behalf of the applicant Explaining APTC/CSRs or insurance options to customers

 Navigators are not responsible for:   

Assisting customers with ‘Traditional’ MA applications Explaining North Carolina DMA policy Contacting the DSS

It has not been determined if Navigator’s will be assisting customers with ePASS (Streamlined) applications 31

DSS Caseworkers  Role: Take applications for Medical Assistance (and FNS/SNAP, if applicable) 



Will manage integrated cases in NC FAST (Income Support and/or Insurance Affordability) May refer ineligible applicants to the Health Insurance Marketplace as an alternative to Medicaid/NCHC

 Caseworkers are not responsible for: Helping customers navigate the FFM/Health Insurance Marketplace  Helping customers complete the application on the FFM/Health Insurance Marketplace  Explaining specific details regarding APTC/CSRs or insurance options to customers Consider having the website and/or phone number for the Health Insurance Marketplace to give customers a place to start. 

32

NC FAST  Role: Provide an eligibility determination for MAGI and non-MAGI programs and issue benefits when applicable 



Will notify case worker via a task in a designated work queue when an application is received from ePASS or the FFM Will notify applicant of eligibility result and/or when their application is transferred to the FFM

 NC FAST is not responsible for:   

Providing an eligibility determination for APTC/CSR Notifying customers of insurance plan options Enrolling customers in QHP

33

North Carolina Department of Health & Human Services

DMA Update

34

North Carolina Department of Health & Human Services

Lunch and Work Support Strategies Update

35

North Carolina Department of Health & Human Services

P7: Managing Applications & Cases Streamlined App / Multiple Dispositions & Integrated Cases / The Evidence Broker / Impacts to the Universal Worker

36

North Carolina Department of Health & Human Services

Streamlined Application Demonstration Note: The following includes preliminary screen shots which are subject to change.

37

Streamlining the Process What is the Streamlined Application? 

 

A simplified application used to apply for all Insurance Affordability programs Used whether applying via the FFM, ePASS, or the DSS Will be the first application used when the customer is seeking Medical Assistance

38

Getting Started with the application.

Customer must agree to privacy statement before continuing.

The first page of the streamlined application gathers details about the primary applicant.

The second page gathers additional details about the primary applicant.

Are there any other people in the household?

Enter details about the additional household member.

Enter additional details about the household member.

Review the household member summary. Are there more people to add?

How are the household members related?

Identify the tax filers in the household.

Identify the tax dependents in the household.

Review the Household Summary. Make changes if necessary before continuing.

Indicate household members who earn income.

Enter income details.

Are there any income deductions that can be deducted on an income tax return.

Review expected annual income.

Similar income information is collected for additional household members (if applicable).

Additional household information is collected, beginning with details on medical bills.

Indicate household members who are tobacco users or are incarcerated.

Additional questions are asked to determine if household members qualify under MAGI.

Review the summary screen and make necessary changes before continuing to next screen.

Documentation needed from the customer displays before the application is submitted.

North Carolina Department of Health & Human Services

Streamlined Application Demonstration Q&A

61

MAGI vs. Non-MAGI MAGI

Non-MAGI

Streamlined application

Non-MAGI Medical Assistance application

Eligibility determination and enrollment can begin as early as October 1, 2013

Eligibility determination and enrollment are on-going currently

Coverage begins as early as January 1, 2014

Coverage begins on the day indicated by policy

MAGI becomes the new standard for most Family and Children’s Medicaid programs after January 1, 2014

Non-MAGI-based programs continue to use Non-MAGI Medical Assistance application

62

Potential for Multiple Dispositions The application process for all MA programs will start with the streamlined application after October 1, 2013.  

Coverage for the MAGI based determinations does not begin until January 1, 2014 Customers should be given the opportunity to see if they currently qualify for a MA program under the traditional (non-MAGI based) rules

Result: During the single application process, an Authorization/Disposition will need to be completed for the Streamlined and ‘traditional’ MA and/or FNS application(s). Streamlined Application

MA and/or FNS Application

MAGI

Non-MAGI Identical information prepopulates on the Non-MAGI application

63

Potential for Multiple Integrated Cases ‘Streamlined’ Medical Assistance Application

Submit

Insurance Affordability (Integrated Case)

Product Delivery Case

Identical information populated from MAGI application

Income Support Application (P26 Interview Questions)

Evidence

Submit

Income Support

Evidence Broker

Evidence

(Integrated Case)

Product Delivery Case 64

The Evidence Broker  The Evidence Broker is the functionality within NC FAST that allows evidence to be transferred from one integrated case to another  With multiple integrated cases there will be two types of evidence, identical and non-identical 



Identical evidence is evidence that is used in the same way and is the same evidence type in both integrated cases Non-identical evidence is evidence that is not used in the same way in both integrated cases

 Once enabled, the Evidence Broker will broadcast the identical information so that it can be then used on the other “target” integrated case  Caseworkers will be able to accept or reject the evidence in the target case either manually piece by piece or in bulk at once  When evidence is entered in one case that could be broadcast to the other integrated case, the caseworker will receive a task informing them that they have evidence to accept or reject 65

Incoming Evidence: Identical

Note: These screens are subject to change

66

Incoming Evidence: Non-Identical

Note: These screens are subject to change 67

Impacts to the Universal Worker  One Case Worker 

Customers will still have the ability to apply for multiple programs at the same time with one caseworker, whether there is a MAGI-based program involved or not.

 Reception, Tasks, Work Queues 

Other universal worker functionality associated with P2&6 such as work queues, reception, and tasks will remain essential to the NC FAST process.

 Potential Multiple Dispositions 

After completing the MAGI application, the customer may continue on to the Non-MAGI (and/or FNS) questions to see if he or she is eligible for Medical Assistance (or FNS) prior to 1/1/14. Therefore, a caseworker may have two dispositions to complete.

 Potential Multiple Integrated Cases 

One caseworker will be able to manage both integrated cases through the use of the evidence broker, which will allow identical information to be shared amongst these cases.

68

North Carolina Department of Health & Human Services

Breakout Discussion: Communication Strategies

69

The “Woodwork” Group  Increased awareness of the Affordable Care Act is expected to bring potential customers out of the woodwork. 





Those who are currently eligible but not enrolled: DMA research suggests that 69,683 individuals will gain coverage in 2014. Those who would potentially be eligible under a Medicaid expansion: Approximately ½ million additional applicants who will not be eligible may still want to apply. Expect an impact, not only to numbers of Medicaid applicants, but to other programs as well.

70

Estimated Medicaid Expansion Population in 2014

71

North Carolina Department of Health & Human Services

Breakout Session Report Out: Communication Strategies Highlights

72

North Carolina Department of Health & Human Services

Questions and Answers

73

North Carolina Department of Health & Human Services

Thank You for participating today! You will receive an email shortly with a link to a survey. Your comments & suggestions will help us plan future workshops.

74

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