SignUpNow Outreach
Communities Connecting Kids with Health Coverage 
Winter 2011-2012

Welcome to the Winter edition of the SignUpNow Outreach eNewsletter. SignUpNow (SUN) is an initiative of the Virginia Health Care Foundation (VHCF) that is focused on increasing enrollment of eligible uninsured children in Virginia's FAMIS programs.  Please forward this newsletter to colleagues and encourage them to register via the "Join Our Mailing List" button to receive the SignUpNow Outreach eNewsletter themselves.

In This Issue
Legislative Session
DMAS Updates
SignUpNow Training Opportunities
Faces and Facts

Legislative Session

 

A new legislative session began on January 11th, and deeper, more difficult cuts will be considered for those needing healthcare. Right before Christmas, Governor McDonnell submitted his budget for the FY13/FY14 biennium to the General Assembly. It cut state funding for Virginia's health care safety net in half as of July 1, 2013. That amounts to nearly $5 million: $3 million for free clinics and community health centers, and $2 million for the Virginia Health Care Foundation.

 

Cuts are also being considered that would eliminate state funding for all SignUpNow education and training initiatives and most outreach and enrollment activities.

 

In an effort to reclaim the funding and avoid cuts, the Virginia Health Care Foundation, in partnership with the Virginia Community Healthcare Association and the Virginia Association of Free Clinics, is holding a Health Safety Net Legislative Day on January 18, 2012, in Richmond. If you think the health care safety net is important to the parents and children you serve, it is critical that you take the time to come and tell your legislators about the huge need for the health care safety net and to ask them to keep money in the state budget for free clinics, community health centers and the Virginia Health Care Foundation. Register here for Health Safety Net Legislative Day. If you cannot attend Legislative Day, please call or write your legislators and urge them to avoid these cuts. Fact sheets and other information are available through VHCF.  Please contact Kim Bemberis at kimb@vhcf.org.

 

During this Legislative session, the Virginia Poverty Law Center, Healthcare for All Virginians, and others will advocate for coverage for pregnant legal immigrants. Currently, low income, pregnant legal immigrants are barred from Medicaid and FAMIS Moms for the first 5 years they are in the US. This bar greatly affects their ability to access medically necessary prenatal care. Advocates will encourage the General Assembly to adopt the federal option to provide Medicaid and FAMIS to pregnant women legally residing in the US during their first 5 years in the US.

 

Agreeing to adopt the federal option would provide prenatal care to about 450 pregnant legal immigrants with income below 200% of the Federal Poverty Level. Women who receive no prenatal care are 3 times more likely to have a low birth weight baby and nearly 3 times as likely to give birth prematurely as other pregnant women. Although Virginia's estimated cost to implement the federal option would be about $1 million, matched by federal dollars, state government accounting experts have determined that the cost would largely be offset by the savings from improved birth outcomes.

 

The General Assembly will also be considering various options for creating a Health Benefit Exchange, as part of the implementation of the Affordable Care Act. The Virginia Poverty Law Center and the Commonwealth Institute have released a two-page overview of the key priority areas that must be addressed when implementing Health Benefit Exchange authorizing legislation during the 2012 session. 

DMAS Updates

Teen Health Week Update

As part of the Robert Wood Johnson Foundation's Maximizing Enrollment initiative, DMAS launched Teen Health Week on November 7th, 2011. The goal was to focus more attention on the more than 34,000 teens in Virginia who are eligible, but not currently enrolled in FAMIS or FAMIS Plus.

 

DMAS created a "toolkit" for school nurses and their partners to help promote Teen Health Week and teen awareness, including: an online postcard, a flyer, announcements for school newspapers/online newsletters and overheads, and logos for linking to the FAMIS web site from school web sites. Toolkits were distributed by email, through the Department of Education and through community networks, and 14,000 teen flyers were made available for order by schools.

 

An online postcard launched Teen Health Week and provided a direct link to the updated FAMIS Teen web page at www.famis.org. During Teen Health Week, DMAS also launched a Facebook page (to find it log on to your Facebook account and search for FAMIS Programs). They also introduced the new teen spokespersons, twins Shytece and Serece, who are featured on the Teen page of the FAMIS website.

 

Thanks to the many organizations and individuals who helped promote Teen Health Week. Many of you worked with the schools in your area, sent out Letters to the Editor, and more. Because of all of the work behind Teen Health Week, the views of the Teen page at www.famis.org increased by 151%, and there were 469 hits on the Teen web pages. 564 people viewed the FAMIS Facebook page.

 

Don't stop now! Teens need special attention and Teen Health Week was just the beginning. Make concerted efforts to reach out to teens and their families. Remind them that FAMIS covers sports physicals, dental care, visits to a dermatologist, mental health services and many other health care services that teens might need.

 

Expansion of Managed Care Services in the Roanoke and Alleghany Regions

This article is being reprinted because many of you are now receiving calls and inquiries from families who have gotten notification of the expansion of Managed Care into the Roanoke and Alleghany Regions. The article contains key dates and information that may be helpful to you and the families you serve.

 

DMAS announced that it has contracted with six managed care organizations (MCOs) to expand the availability of managed care services in the Roanoke and Alleghany Regions.

 

These MCOs will provide coverage for medical services to eligible Medicaid and FAMIS individuals in the counties of Alleghany, Bath, Craig, Bedford, Botetourt, Floyd, Franklin, Giles, Henry, Highland, Montgomery, Patrick, Pulaski, Roanoke, Rockbridge, Wythe and the cities of Bedford, Buena Vista, Covington, Lexington, Martinsville, Radford, Roanoke, and Salem.

 

Effective January 1, 2012, Medicaid and FAMIS eligible individuals in these localities will access health care services through one of the following MCOs: Amerigroup Community Care, Anthem HealthKeepers Inc., MajestaCare - A Health Plan of Carilion Clinic, CareNet-Southern Health, Optima Family Care, and Virginia Premier Health Plan.

 

Individuals in MEDALLION transitioned to Fee-for-Service Medicaid on November 1st. Letters were mailed at the end of November to all Medicaid managed care eligible individuals in Fee-for-Service in the Roanoke/Alleghany region. These pre-assignment letters will place the individual in a health plan. If the individual (FAMIS Plus and Medicaid for Pregnant Women) wants to change health plans, he/she needs to call the Managed Care Help Line (800-643-2273) for assistance. If the individual wants to remain where he/she has been pre-assigned, nothing needs to be done. However, enrollees may call the Helpline for any questions. FAMIS and FAMIS MOMS enrollees should call the FAMIS Central Processing Unit (866-873-2647) for assistance in selecting a health plan. Individuals enrolled in Virginia Premier received an open enrollment notice at the end of November showing all the plans that will be available to them as a result of the expansion. They can stay with Virginia Premier or call the Managed Care Helpline if they would like to change MCOs.

 

Verification of Self-Employment 

Verifying self-employment income can be one of the trickiest parts of helping families apply for state-sponsored health insurance coverage. Not only are there many different forms of self-employment (independent contractors, S-Corporations, LLCs, etc.), there are many different forms of verification.

 

Generally speaking, if you are trying to verify self-employment, it is best if you can attach the most recent tax return, along with any applicable Schedules (the most commonly filed for self-employment are C, E, F and K1). Make sure to send all pages of the schedules. If the business was established less than one year ago (either started or purchased), you should request the applicable number of months of profit and loss statements (normally from the first month the business was started or purchased) to attach to the application. In addition, you should feel free to attach additional information or notes that will help the eligibility workers get a better understanding of what is happening with the family, in terms of income. 

SignUpNow Training Opportunities

Start the New Year with a FAMIS refresher! You no longer have to sit through an entire SignUpNow training to learn about specific policy updates or get a refresher on one of the many components of FAMIS. From the comfort of your own home or office, try our on-line, on-demand training. Consisting of nine 25-30 minute modules, valuable information is available on-line so that you can access it anytime that is convenient for you. You don't have to complete the entire training, if you just need a refresher on a particular module or two. Each module contains:

  • Learning objectives;
  • Detailed user-friendly content arranged in a format that allows the customer to complete the entire training or pick sections they are interested in learning more about;
  • Links to attachments, documents, web sites and a glossary of terms that can be of further assistance; and
  • A post-test to help you determine if you have grasped the most important information or if you should repeat the module.

 The on-line, on-demand training is available at http://tinyurl.com/SUNOnDemand.

 

Faces and Facts - Partnering to Help Families

John was a full-time student with a wife who taught school, and two small children. He had applied for FAMIS coverage for his children, but was denied because, based on the information provided, the family was determined to be over-income. He called a Project Connect Outreach Worker (OW) to see if there were any other resources available for his children. The OW started asking questions about his application.

 

After several conversations and a review of the materials that he submitted, she recognized a potential error in the determination. Like most teachers, John's wife taught 10 months of the year. Her contract, however, allowed for her annual salary to be paid over the full 12 months including the months she was not in school. An initial view of her pay stub showed her annual salary divided over 10 months. This monthly income would have been too high to qualify for FAMIS.

 

 The OW called the CPU and explained the situation. Workers at the CPU asked the OW to work with the family and get a copy of the form the wife completed for the school system, requesting that she be paid over twelve months. The family obtained the form and faxed it to the CPU. Within two days, the CPU had reprocessed the application and both children were approved for coverage?

This is a great example of why it is so important to attach supporting documentation to the application, which clearly explains the family's situation. It also illustrates the power of outreach and eligibility professionals working together to help cover families. The OW's willingness to ask the family additional questions and then raise issues with the CPU, along with the CPU's willingness to hear what the OW was saying, proved to be a true gift for this family.

 

As of December 1, 2011:

  • 62,835 children are enrolled in FAMIS (including 331 in FAMIS Select);
  • 519,226 children are enrolled in FAMIS Plus (including the CHIP Medicaid Expansion);
  • 1,355 pregnant women are enrolled in FAMIS MOMS;
  • 14,787 pregnant women are enrolled in Medicaid for Pregnant Women;
  • 12,745 men and women are enrolled in Plan First.
If you have colleagues who would benefit from receiving SignUpNow Outreach, please forward this email to them and encourage them to subscribe to our mailing list. We look forward to providing additional information on children's health insurance in the near future.

Sincerely,
Polly Raible 
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