West Virginia Process Improvement Collaborative Learning Session 2 Chattanooga March 30 – April 1, 2004 Sharon Carte, CHIP Director Marla Short, Director, Nicholas County Starting Points Patty Martin, Eligibility Director, Nicholas County DHHR Renate Pore, Co-Chair Healthy Kids and Families Coalition

AIM Reduce the number of CHIP enrollees closed at the end of enrollment period.

Changes Tested Tested best time of day to call CHIP families re renewals Telephone calls to CHIP recipients who have not returned re-enrollment form in test site in January and February Telephone calls to CHIP recipients statewide in February (through Automated Health contractor). “Passive” Enrollment where parents sign and return form indicating nothing has changed; no additional documentation required.

Results – Reminder Calls Follow- up calls at local test site produced a 68 % return of renewals within two weeks (and prior to end of enrollment period) Test site (Nicholas County) no response rate in February was 14% Results from statewide follow-up calls in February were inconclusive

Results – Partial “Passive” Renewal Some parents returned income documentation with “passive” renewal form; this created some confusion at reenrollment centers where renewals are processed. Reenrollment centers held up renewals when parents submitted income verification. Solution: Reenrollment centers sent income renewals with income verification to CHIP office; CHIP office contacted family to fill out new application. Test site had few calls about partial passive renewals

Summary Reminder calls produce desired results and increased retention rate in test site. Evening calls are better. Reminder calls are not 100% successful because some phone numbers/addresses no longer valid. (20% in small test) Reminder calls are good strategy for CHIP because it is a relatively small program; may not be feasible for Medicaid.

Next Steps We are not sure yet about next steps; team needs to discuss the following –Continue statewide follow-up calls for 5 more months to test impact. –we believe that we can address majority of retention problem in CHIP through follow-up calls and “passive” (easy) renewal. –How do we address changes in addresses/phone numbers? (notice on CHIP card?) –How do we translate lessons from CHIP to Medicaid? –What about initial enrollment hassles - We are still working on getting right data out of RAPIDS