1. 1 Healthy Maryland! September 2010

2. The Challenge…

3. 3 Clinics Health Plans Hospitals ER & Outpatient Schools Social Services Access Food Bank

4. 4 Clinics Health Plans Hospitals ER & Outpatient Schools Social Services Maze of Referrals Food Bank

5. 5 Clinics Health Plans Hospitals ER & Outpatient Schools Paper Forms Social Services Food Bank

6. 6 Clinics Health Plans Hospitals ER & Outpatient Schools Manual Data Entry Social Services Food Bank

7. 7 Delayed and missed support for families Lost revenue for providers and local economy More paper and manual data entry Impact

8. 8 Social Interest Solutions  Independent, mission-driven non-profit organization  Software development, implementation, maintenance and enhancement  Policy analysis and advocacy  Leadership and staff with long history and experience in automation and systems reform  ~ 60 staff maintaining systems for AZ, CA, IN, MD

9. 9 One-e-App Technology  Web-based system accessible from many locations  Assisted and unassisted (public access) pathways  Offers a secure single point of entry  Provides simultaneous preliminary and/or final eligibility determination across multiple programs  Submits applications, signatures and documentation electronically via Internet  Application and case management tools for all users (assisted and unassisted applications)

10. 10 Implementations  Arizona: Health-e-Arizona (assisted and unassisted)  Indiana: Ind-e-App  Maryland: Health-e-Link  California: (assisted and unassisted) –One-e-App - 15 California counties –Statewide Kaiser Permanente Child Health Plan and CalKIDS in California

11. 11 Who Uses  Community-based organizations  Hospitals and Clinics  Call Centers  County Agencies (Social Services, Health Services, Public Health)  Schools  Health Plans  Food Banks  Public Consumers

12. 12 One-e-App Stats  Screened over 3.5 million people for potential eligibility across 4 states  Roughly 6 million applications to programs  Speeds determination – in some cases by 50% or more  Reduces need for follow-up with applicants ~78% as compared with paper  90% of public user survey respondents in AZ found the application “easy to use.”

13. 13 Examples of Features  Interview style data collection  Error checking and validations  Storage of documents and signatures  Application tracking tools  Management report generation  English / Spanish real time toggle  Notification and client communication tools (e.g. text messaging)

14. 14 Health Programs  Medicaid  SCHIP  EPSDT  County Indigent Care Programs  County Sliding Fee Programs  Adult and Child County Expansion Programs  Kaiser Permanente Child Health Plan and Kaiser Bridge  Express Lane Eligibility (school lunch / MC linkage)

15. 15 Social Services and Support Programs  Food Stamps (SNAP)  Earned Income Tax Credit (EITC)  Child Tax Credit  Supplemental Nutrition for Women, Infants and Children (WIC)  TANF (Temporary Aid to Needy Families)  Voter Registration  Low Income Energy Subsidies  Low Income Auto Insurance

16. 16 Referrals to Other Programs  Family Planning  Cancer Detection and Treatment Programs  General Assistance  Medicare Cost Sharing  Drug and Alcohol Rehab Program  Homeless Assistance  Others

17. 17 Electronic “Interfaces”  State eligibility systems in Arizona: Department of Economic Security (DES) and Arizona Health Care Cost Containment System (AHCCCS)  State of CA for Children’s Medicaid, S-CHIP, EPSDT  State of Maryland (Spring 2010)  County Automated Welfare Systems  Health plans  Patient Management Systems and Electronic Health Records  Pacific Gas and Electric (PG&E)  US Postal Service for address verification

18. 18 Data & Document Storage Case Management Tools Health Plans County Systems Process and Data Flow Rules Engine Universal Interface Determine Preliminary Eligibility Submit Application Home Community Based Organization State Systems - USPS - PMS - EHR - Others applicant consent

19. 19 Snap Shot – San Francisco  Fully integrated with county and state systems  Developed and running 16 weeks  Persons Screened: 112,772 (since 9/2007)  Persons Currently Enrolled in Healthy San Francisco: over 50,000  User satisfaction with enrollment process: 86% found the process “easy” or “very easy”  Reduced Emergency Room use through enforcing use Medical Home (managed via One-e-App)

20. 20 Snap Shot - Arizona  Fully integrated with state systems  190,000 Public Applications Submitted in year one (12/28/09 – 12/31/10)  54,000 Assisted Applications Submitted  230,000 households applied for Food Stamps  95% of the FS households had a least one person eligibile for Medicaid  90% of survey respondents in Arizona found the public application “easy to use” and would use it for renewals

21. 21 One-e-App in Maryland  Launched October 1, 2008 in Howard County  Programs: –MCHP –MA for Families –Healthy Howard –PAC –Kaiser Bridge  Interface in process with CARES to support MCHIP and MA for Families  Plan to begin UAT in November and hope to be live and in pilot in December.

22. 22 The Center and One-e-App: Unique  Unprecedented data integration (only non-state or county system to interface with state and county systems)  More than an electronic application  Verification document storage and management  Robust communication capabilities with notices, email, text messaging  Self-service and supported assistance  Reporting (data mart support for ad hoc reports)  Case and outreach management

23. Demo