Health Reform Resources: Enrollment Support and Marketplaces

As the start of open enrollment (October 1, 2013) draws closer, there has been a flurry of resources concerning how to help consumers screen for eligibility and enroll in Marketplace plans and Medicaid. Below you will find several new resources relevant to the Philadelphia region. Community-based providers and AIDS service organizations are encouraged to explore all the resources and opportunities available to assist with the transition to the era of health reform and new coverage options. You can explore our

other blog posts about health reform here.

Stakeholder Call with HHS and CMS about the Health Insurance Marketplace in PA - July 31, 2013

This second in a series of three calls is intended specifically for stakeholders in Pennsylvania. HHS and CMS regional officials will give brief updates on the operational execution of the Marketplace including systems readiness; consumer support and outreach.   

Certified Application Counselor Organizations

There are going to be opportunities for organizations to be trained and certified to provide counseling to enrollees. As a CAC organization, your staff and volunteers will help people understand, apply, and enroll  for health coverage through the Marketplace. There are three official trainings on how to become a Certified Application Counselor Organization over the next couple of weeks. Register at the links below.

Date	Time	Webinar Link
July 31, 2013	1:30 – 3:00 pm ET	https://goto.webcasts.com/starthere.jsp?ei=1020077
August 6, 2013	1:30 – 3:00 pm ET	https://goto.webcasts.com/starthere.jsp?ei=1020167
August 7, 2013	1:30 – 3:00 pm ET	https://goto.webcasts.com/starthere.jsp?ei=1020171

Kaiser Family Foundation Issue Brief -- Helping people with HIV Navigate the Transition to ACA Coverage.

This issue brief is a summary of a roundtable discussion convened by Kaiser Family Foundation in March 2013 concerning planning for the coverage transition, helping people with HIV choose and enroll in coverage and troubleshooting during coverage transitions.
Key passages:
Pg. 5 - HIV community needs to plan for changes in the role of the Ryan White HIV/AIDS Program 
Pg. 5 - HIV community stakeholders need to be aware of their state's organizational structure and work to inform state policymakers about the needs of people with HIV and standards for HIV care.
Pg. 6 - HIV service providers may need to consider business re-design options to maximize their engagement with the health system.
Pg. 6 - Best practices and lessons learned from states and organizations that have begun navigating through HIV-related policy changes will help inform how to better plan for challenges that may occur
Pg. 8 - It may be important to differentiate between types of HIV enrollees in ACA coverage
Pg. 9 - While HIV providers and clinic staff are poised to play a central role in supporting coverage transitions, they may require specific training and support

Insurance Marketplace Pre-screening Tools and other Resources at HIVhealthreform.org

There are too many great resources on hivhealthreform.org to list here. One of the most interesting is the pre-screening tools (for both Medicaid-expansion states and those not currently expanding Medicaid coverage) from Duke Law Project.

Health Reform To-Do List

This presentation was designed specifically for people living with HIV/AIDS (PLWHA) who are uninsured or in need of affordable insurance options. Most of the information is general to PLWHA in the US, but some Pennsylvania information is included because the state is not expanding Medicaid coverage to low income adults (not at this time anyway). These slides are adapted from content developed by the Target Center. I highly recommend providers and consumers of Ryan White services check out the Target Center for great resources about Health Reform and so much more.

I created this interactive presentation in an effort to help more people understand how the Affordable Care Act, or "Obama Care" may affect them. It's intended to be used as a starting-off point to explore resources to help you make the best decisions for yourself and your family. Anything that is underlined is a link to something to help you understand your options or help plan for your new coverage in 2014. Please take time and explore the links.

If you have questions or comments, please be sure to leave comment here or email me. I will do my best to answer your question or lead you to a good resource.

Summer 2013 Update: Priorities and Funding

I shared this Prezi with the Positive Committee at their July 8, 2013 meeting, to give them an update on the Planning Council's activities over the last couple of months. A couple things for you to know/consider before viewing the Prezi:

• You can read more about the priority setting process, including the factors and scoring process here. The Comprehensive Planning Committee is responsible for facilitating the priority setting process at lest once every three years, or whenever there is a need to update the list due to policy or other changes to the care system. Priority setting just means putting the Ryan White care services in order of importance/need according to certain factors, based on information about community need and impact on the continuum of care. 

• The Philadelphia EMA received less of a decrease in the Part A funding than we were told to expect. The grant award was a little more than 6% less than the 2012 award. The Planning Council already developed a plan for a decrease, and this plan is represented by the 2013 pie chart in the Prezi. the 2012 pie chart is how the money was budgeted for last year. You will notice that the most significant differences are in Early Intervention Services and Care Outreach, which were ended as of the first quarter of this grant year (June 30, 2013), due to the funding decreases. Other services will receive less money too, because Early Intervention and Care Outreach Services couldn't absorb all of the cut.

• The Regional Allocations meetings where the community decides how to budget our Ryan White Part A funds will be at the Office of HIV Planning. Everyone is welcome to attend and participate. The Office of HIV Planning plans to provide meeting materials to participants before the meeting. If you would like to attend a meeting, please call 215-574-6760.
• PA Counties (Chester, Bucks, Delaware and Montgomery)- 
• Tuesday, July 23rd from 1-4pm
• NJ Counties (Camden, Burlington, Salem and Glouchester) - 
• Thursday, July 25th from 1-4pm
• Philadelphia - 
• Tuesday, July 30th from 1 - 4pm

Stephen Handlon, OHP Staff Member Introduction

Stephen Handlon, OHP Staff

Tell us about yourself

I recently graduated from Haverford College with a B.A. in History. I have always had an interest in public health and am excited to be the new administrative assistant at the Office of HIV Planning. So far, I have had the opportunity to meet great people and see how policy impacts the lives of those affected by HIV/AIDS. I currently live in Northern Liberties and in my free time, I enjoy exploring new restaurants and hang outs in the city. I have been to Paris, France a few times and am obsessed with French films and almost anything related to the language or culture. Another fun fact is that I’m from Minnesota… and no, I do not have an accent like in the movie Fargo.

What made you get involved in the HIV/AIDS community?

Because of the work that has been done by advocates, community members, policy officials and scientists, those in the gay community in my generation have a greater awareness about issues related to HIV/AIDS than previous generations. However, there is still a lot to be done in terms of erasing the stigma surrounding the illness, providing adequate care to those affected and working towards a cure.

Who do you look up to or admire?

I admire all the hardworking people in the world who are so essential to our everyday activities, but who almost always go unnoticed. I try to remember to thank the driver when I take the trolley to work in the morning.

What do you think is the biggest challenge for people living with HIV/AIDS?

I think some of the biggest challenges are related to larger challenges disproportionately faced by people from marginalized groups, such as stigma and a lack of access to things such as quality food, housing and education. 

Health Reform Resource Update

Over the last few days I have come across a few health reform resources I thought worth sharing. This post is one of a series of blog posts about health reform and the Affordable Care Act. You can read see all the previous posts by clicking on the label "ACA" at the bottom of this post.

Healthcare.gov or  Cuidadodesalud.gov

Want to learn more about the insurance marketplaces and what options are available to you or your clients? The first place you should go is healthcare.gov, the federal website set up to share information about insurance eligibility and enrollment. You can also call 1-800-318-2596 or TTY/TDD 1-855-889-4325 for more information about buying health insurance through the state marketplaces. Enrollment will begin October 1, 2013, but you can call and get your questions answered today. Translation and interpretation services available in 150 languages over the phone.

Potential Impact of the Affordable Care Act on the Ryan White HIV/AIDS Program

This report from Mathematica provides an in depth look into how the ACA impacts the Ryan White program and Ryan White clients. The report was released in November 2012, but still offers valuable insight and recommendations to Ryan White grantees and providers. 

NASTAD Essential Health Benefits Brief

This issue brief describes the essential health benefits (EHB) and how they impact people living with HIV/AIDS and viral hepatitis. Four of the EHBs are highlighted: preventative services, prescription drugs, mental health and substance abuse services, and chronic care management.

Engaging Safety Net Providers in Expanded Coverage: Tips on Enhancing Billing Capacities

A new fact sheet from NASHP (National Academy for State Health Policy) offers action steps and advice to safety net providers to expand billing options. This fact sheet will be a good companion to my policy updates for providers: here and here.

As I type Kaiser Family Foundation is hosting a briefing on Medicaid Managed Care in the Era of Health Reform. The video should be available this week.

Everyday there are new resources for helping us navigate the new landscape of health reform. I'll keep sharing what I find useful. Please share questions, comments and links in the comments or on our Facebook page.