LOCAL OUTREACH & ENROLLMENT EFFORTS TARGETING HOMELESS INDIVIDUALS Yakima Neighborhood Health Services Rhonda Hauff, Chief Operating Officer

The Affordable Care Act Requires Most People to Have Insurance by January 2014 You are insured for through a combination of any of the following sources: ▪ Medicare ▪ TRICARE or veteran’s health program ▪ An employer-provided plan ▪ Medicaid/Apple Health ▪ Insurance you buy that is at least at the Bronze level ▪ A grandfathered health plan in existence before the health reform law was enacted 2 No Penalty

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*Urban Institute 4

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6 For additional benefits (TANF, SNAP, etc, customers will apply here in Washington Connections - a “virtual handoff” from the HPF ▪ SSI Recipients ▪ SSI related clients ▪ Medicare Savings Program ▪ Nursing Home clients ▪ Alien Emergency Medical (AEM )

Eligibility ▪ Real-time eligibility decision ▪ Federal-state interfaces for verification ▪ Internal Revenue Service ▪ Immigration and Naturalization Service ▪ Employment Security ▪ Automated verification ▪ Provisional Eligibility (90 days ) 7 Key Point

PEOPLE WHO DON’T WORK / DON’T FILE TAXES ▪ Self Attestation of Income accepted ▪ MEDS unit looks at ACES (SNAP, cash, Medicaid eligibility system). ▪ Random sample will be reviewed ▪ According to Health Care Authority, the focus will be on: ▪ Data matches showing income over Medicaid standard. 8

9 How to Apply - Consumer Entry Points Website Agent Broker Navigator In-Person Assister Self- Directed (website) Partner Call Center

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1 Neighborhood Connections Health Care for the Homeless 3 Housing 2 Homeless Respite 4 Homeless Resource Center, HEN & Basic Needs Assistance Healthplanfinder Opportunities

Homeless Service Providers -- Opportunities

Inreach – Patient Registration

54% of our Homeless are Uninsured

Post Visit Inreach – Mining the Data

Outreach Likely & Unlikely Outreach Venues ▪ Project Homeless Connect ▪ Latino Expos/Business Fairs ▪ Cinco de Mayo Celebrations ▪ Treaty Days / Yakama Nation events ▪ Central Washington Rodeo ▪ Employment Fairs ▪ Sunday Farmers’ Markets ▪ County Government – Employee Benefits Fairs ▪ National Night Out ▪ Veterans Stand Down ▪ Back to School Events ▪ Food Banks ▪ “Hoop Fest” 3 on 3 Basketball Tourneys

Point in Time / Project Homeless Connect

DSHS CHIPRA II Grants ▪ Provided PCs, laptops, printers, and scanners ▪ Used at satellite locations, mobile sites ▪ Plan for HCH team to take “to the streets” 18

Coming Prepared Not as Hard as it Used to Be

Once They Have Coverage… ▪ Picking a health plan and a primary care provider (PCP) ▪ Understanding how to use the local health care system ▪ Annual Recertification ▪ Verifying information ▪ address updates 20

In the End, it’s all about THEM ! 21

Medicaid Outreach Planning for People Living Homeless in King County John Gilvar July 29, 2013 Public Health- Seattle and King County

Safe Harbors and DSHS Data 23 Adults in King County HMIS below 135% federal poverty level, FY 2011

Adjusted Estimate of Target Population Size 24

Potential Barriers to Successful Enrollment for Eligible Homeless Adults ▪ Lack of computer, internet, , phone ▪ Cognitive impairments ▪ No mailing address ▪ Difficulties navigating application processes while coping with housing and other crises

King County Homeless Enrollment Strategies ▪ Education and brainstorming meetings with housing and homeless services providers ▪ Strategically stationing grant-funded in-person assisters ▪ Locations visited frequently by unsheltered and other high risk groups ▪ Street outreach ▪ Collaborating to build in-person assister capacity within housing and homeless services agencies