Using Food Stamp Data to Implement ELE in Louisiana
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Transcript of Using Food Stamp Data to Implement ELE in Louisiana
Using Food Stamp Data to Implement ELE in
Louisiana
New CHIPRA Opportunity:Express Lane Eligibility
NASHP WebinarMay 14, 2009
J. Ruth KennedyLa. Dept of Health & Hospitals
The department, upon enactment by Congress of legislation allowing the same may utilize income determinations made by the Food Stamp Program, WIC, or National School Lunch Program for determining income eligibility for the Louisiana Medicaid program or LaCHIP.
La. R.S. 46:977.8
ELE is the Law in Louisiana!
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Why We Believe ELE is Important for Louisiana’s Kids
Highest % of state’s uninsured kids are from 50% to 100% FPL Literacy issues “Simplicity” of enrollment is relative Complicated lives
Different agencies determine Medicaid/CHIP and FS, WIC, and School Lunch eligibility Parental priorities Maslow’s hierarchy of needs
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Ex Parte Renewals Using Food Stamp Data Since 2001
High level of confidence in Food Stamp income data
Match with FS system identifies & flags children due for renewal with active FS case
Caseworkers still play major role in decision making
Income in FS system for Medicaid/CHIP income unit members is cross walked
~ 2/3 of Medicaid children are in active FS case Has resulted in dramatic reduction in procedural
(paperwork) closures
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Why Move from FS Ex Parte to FS ELE Renewals? Further reduction in administrative costs No longer a need for caseworker action Reduces our exposure to eligibility errors
True ELE cases excluded from QC and PERM Regardless of age kids over/under 100% FPL
eligible for Medicaid With Medicaid stimulus, higher FMAP for
Medicaid than CHIP thru 12/31/10! Performance bonuses based on Medicaid
increase
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Draft Plan for Automatic Enrollment Using ELA Data File of children <19 received from ELA We do file match with Medicaid and CHIP & remove
children with coverage File match through TPL contractor and remove
children with private insurance Mail required info about Medicaid and “call toll-free
number to activate” card During call, obtain any additional information to
certify case & certify case if eligible mother’s maiden name to verify citizenship via Vital Records Current income information
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State Plan Amendment is Required to Implement ELE
Cannot develop SPA without CMS guidance
Will CMS issue a template? What degree of detail will be
required? Once submitted, how quickly
can we expect approval?
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Decisions States Must Make
Selection and prioritization of Express Lane Agencies
ELE for Medicaid only or Medicaid and CHIP
ELE for applications, renewals, or both
Definition of ‘reasonable period” Eligibility components to be verified
via ELA Medicaid “screen and enroll”
threshold amount
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Express Lane Agency Issues
ELA application and renewal form must be revised Can addendum to application be used?
Willingness and capacity to modify their intake process
Additional ELA costs Forms revision Staff training System changes
Execution of data sharing agreement or MOU
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Coding Requirements and Implications CMS responsible for establishing
coding guidance Adequate data is essential for monitoring What we need to know--
Application or renewal? ELA classification/identity Demographics of ELE enrolled child Previously enrolled in public coverage? Automatic Enroll or something less? Number who “opt out
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Planning Ahead for the Mandated Evaluation Law requires evaluation of ELE to Congress by
9/30/12 $5 M (they’re serious about this) Lessons learned about evaluations
Keep notes of planning meeting Administrative cost data—traditional as well
as ELE Data, coding, back end reports
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Early ELE Implementation Hurdles in Louisiana
Only School Lunch application currently contain “opt out” language
Discovery of potential ELAs’ reliance on other program eligibility, rather than collecting income
SPA submission requires administrative rulemaking
Administrative rule making requires fiscal impact analysis
Fiscal impact analysis cannot be completed without CMS guidance
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ELE “Readiness” Activities in Louisiana
Request to FS agency for opt out language revision to forms
Identifying public agencies “capable” of determining income eligibility at 97% or higher rate of accuracy Collecting application forms Reviewing income policies
Determining data fields from ELA needed for fully Automated Enrollment
Annual volume estimates for both renewals and applications
Planning for eligibility review of ELE sample 13
Our Wish List from CMS (Sooner Rather than Later)
State Plan pages template Data and coding requirements Model language Guidance on full review for
statistically valid sample Definition of “prompt follow up” for
children temporarily enrolled in CHIP ELE-specific call with states (after
guidance is released)
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Ruth KennedyLaCHIP Director & Medicaid Deputy DirectorLouisiana Department of Health & HospitalsP.O. Box 91030 Baton Rouge, LA 70821-9030Telephone: 225 342 3032Blackberry: 225 241 1437Fax: 225 342 9508E-Mail: [email protected] www.lachip.org
Never doubt that a small group of thoughtful, caring people can change the world Indeed, it is the only thing that ever has !— Dr. Margaret Mead