1. Get America Covered: Planning for Open Enrollment 3 November 4, 2015

2. What We’ll Cover Thank You! HRSA Strategy for Open Enrollment 3 Key Dates and Messages Successful Practices & Lessons Learned Grantee Experiences –North Carolina Community Health Center Association –Mountain Laurel Medical Center How You Can Help Resources

3. Thank You! HRSA grantees and stakeholders played a major role in ensuring the successful implementation of the Affordable Care Act during the first two Open Enrollment Periods. To date, 17.6 million Americans have gained coverage and the uninsured rate is at its lowest level ever.

4. HRSA Strategy for Open Enrollment 3 Provide resources and support that will help grantees have the greatest impact and help meet three goals: –Facilitate the enrollment process among new and re-enrolling individuals eligible for coverage through the Health Insurance Marketplace –Improve health insurance literacy –Promote the benefits of preventive services

5. Key Dates for Open Enrollment 3 November 1, 2015: Open Enrollment for 2016 Marketplace coverage begins. December 15, 2015: Deadline to enroll for coverage starting January 1, 2016. January 15, 2016: Deadline to enroll for coverage starting February 1, 2016. January 31, 2016: Last day of Open Enrollment for 2016 Marketplace coverage.

6. Key Messages for Open Enrollment 3 It’s time to get covered. This year’s Open Enrollment runs from November 1, 2015 through January 31, 2016. Don’t miss your chance to get covered. Sign up by December 15 and start the New Year with coverage. If you want coverage to start January 1, the deadline to enroll is December 15. Financial help is available. Over 8 out of 10 people who enrolled in health coverage through HealthCare.gov qualified for financial help. If you choose not to buy health insurance this year, you may need to pay a tax penalty of $695 or more.

7. Key Messages for Open Enrollment 3 Getting covered is easier than ever. Every year, the process of signing-up for coverage gets simpler. You can even apply on your cell phone. Free help is available. Get answers to your questions by contacting our trained professionals for free and confidential assistance. Call 1-800-318-2596 or find free in-person help in your community by visiting LocalHelp.HealthCare.gov.

8. Successful Practices of HRSA Grantees during the First Two Open Enrollment Periods

9. Successful Outreach and Enrollment Practices Build partnerships. Work with the media to get information out about assistance events. Play enrollment-focused videos in waiting rooms. Provide a group enrollment option for consumers who require less assistance to enroll. Provide classroom-style assistance, with assisters floating among consumers to respond to questions.

10. Successful Outreach and Enrollment Practices Highlight successes and events on social media platforms (e.g., YouTube, Instagram, Facebook, and Twitter). Mail postcards or personalized letters to provide education and information about upcoming events. Encourage consumers to refer friends and family by using word-of-mouth. Appoint a project manager to handle open enrollment. Make Certified Application Counselors (CACs) as accessible as possible.

11. Outreach & Enrollment: Lessons Learned from North Carolina (NC) NC Community Health Center Association

12. NC Community Health Center Association & NC Community Health Centers NCCHCA Membership association of community and migrant health centers. NCCHCA’s mission is “to promote and support patient-governed community health care organizations and the populations they serve.” NC’s CHCs 38 community health centers in NC 32 health centers receive Outreach & Enrollment funding from HRSA. Staff are trained as Certified Application Counselors.

13. Outreach & Enrollment Landscape in NC 560,357 North Carolinians selected a plan during 2015 Open Enrollment 92% received financial assistance through premium tax credits NC uses the Federally Facilitated Marketplace No Medicaid expansion No state “lead” for Outreach & Enrollment Activities In addition to FQHCs, 4 organizations across the state funded as Navigators offer in- person assistance Active Enroll America presence in NC

15. Spectrum of Engagement

16. Outreach: Building Consumer Awareness & Connecting Them to Assistance Partnerships Are Key

17. Outreach: Building Consumer Awareness & Connecting Them to Assistance Partnerships will look different in each community. Activities that happen within partnerships are varied. For example: Offering on-site enrollment assistance at partner agency. Establishing referral systems to connect consumers to assistance.

18. FQHC Outreach Examples from North Carolina

19. In-reach: Helping Patients Understand Options Map out all points consumers interact with health center Train all staff on basic concepts Talk to patients again & again– the more contacts, the more likely people are to enroll

20. FQHC In-reach Examples from North Carolina

22. Application & Eligibility Goals of O&E Programs During Application and Enrollment Process Help consumers complete application, get eligibility notice, understand why they got results they did, and understand next steps. Help consumers understand what to do if their situation changes. Help consumers understand basic information about health insurance, understand their options, and feel confident in ability to pick a plan that works for them. Help consumers understand and make a plan for keeping coverage and accessing care. Specific Techniques Assisters Use Emphasis on up-front education about application process, potential results, PTC, and health insurance. Asking directive questions to assess needs and priorities. Checking for understanding using teach back or other methods. Rely on partners for questions assisters can’t answer (e.g. tax preparers). Providing education and take home information on next steps.

23. Activating, Maintaining, Using, and Renewing Coverage Goals of O&E Programs Help consumers understand everything they need to do to activate, maintain, and renew coverage, as well as access care. Help consumers understand what to do if situation changes. Help consumers address any barriers to completing next steps. Specific Techniques Assisters Use Outlining next steps during initial appointment and checking for understanding. Helping consumers identify and address barriers. Proactively following up with consumers to help them achieve specific tasks (e.g. remind them to renew coverage). Being available the entire year!

24. Collaboration and Sharing Across NC North Carolina has great collaboration among in-person assisters and other enrollment stakeholders. Share promising practices and ideas among IPAs. Get expertise and insight from many stakeholders. Tap into different networks of consumers. Collaborate on statewide and regional efforts.

25. Thank you! Alice Pollard, Health Care Access Coordinator Brendan Riley, Health Policy Analyst NC Community Health Center Association

26. Mountain Laurel Medical Center compassionate care in YOUR community 1027 Memorial Drive, Oakland, MD 301-533-3300

27. Mountain Laurel Medical Center RAEN Rural Action Enrollment Network

28. Mountain Laurel Medical Center Current RAEN Partners: Mountain Laurel Medical Center Tri-State Community Health Center Hyndman Area Health Center Healthy Howard (Connector Entity) Western MD AHEC Coming Soon: University of MD Extension Maryland Rural Health Association …compassionate care in YOUR community

29. OE 1

30. Mountain Laurel Medical Center RAEN was a response to:  Poor QHP Results  “Border Issues”  Lack of Attention to Rural  Fragmented Efforts  FQHC’s Feeling “Left Out” in MD Medicaid: the Notable Success

31. OE 2

32. Mountain Laurel Medical Center Network Planning Grant RAEN Started October 2014:  Study the System  Voice for Western MD  Voice for FQHC’s  Focus on Consumer Assistance Workers  Create the Right Partnerships  Capture Local Wisdom  Work Effectively Across the Borders  Educate Consumers

33. OE 3

34. Mountain Laurel Medical Center Rich Collaboration  Unfunded Partner MOU  More than Tripled # of Navigators  Certifying Staff for both MD & FFM  All FQHC’s Can Assist Across Borders  Rural Wrap-Up Meeting  Benefits Counseling Training  Need for Plain Language Materials  Starting Public Information Campaign  Radio Crosses the Borders Best

35. Local + Personal + Genuine + Ongoing = Trust Rural consumer expects more “personal touch” and wants ongoing relationship. Word of Mouth Trust is earned. Our assisters are facing a large trust burden with the ACA. FQHC’s have significant amount of trust to leverage. Perception that health insurance is unobtainable is still wide spread. Significant lack of knowledge about the ACA.

36. Charles Wilt, Chief Operating Officer Mountain Laurel Medical Center Charles@mtnlaurel.org 301-533-3300 David Stewart, Network Manager david@raen.org 240-979-1960 “This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number G09RH28757 and the Rural Outreach Benefits Grant Program for the grant amount of $75,000 which is 100% of the operational cost. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”

37. Take Action Alert consumers about Open Enrollment. Send a dedicated email to your networks and make sure they know now is the time to sign up. Include information about Open Enrollment in print communication. Materials are available at http://marketplace.cms.govhttp://marketplace.cms.gov Host an enrollment event. Display information in your office, business, or organization that alerts the public to open enrollment and how to get covered. Share information about Open Enrollment through your Facebook and Twitter accounts.

38. Just a Reminder November 1, 2015: Open Enrollment for 2016 Marketplace coverage begins. December 15, 2015: Deadline to enroll for coverage starting January 1, 2016. January 15, 2016: Deadline to enroll for coverage starting February 1, 2016. January 31, 2016: Last day of Open Enrollment for 2016 Marketplace coverage.

39. Marketplace Information and Enrollment o https://www.healthcare.gov/ https://www.healthcare.gov/ Provider and Partner Marketplace Resources o http://marketplace.cms.gov http://marketplace.cms.gov From Coverage to Care Resources o http://marketplace.cms.gov/c2c http://marketplace.cms.gov/c2c HIV/AIDS Bureau Affordable Care Act Website o http://hab.hrsa.gov/affordablecareact http://hab.hrsa.gov/affordablecareact Health Centers and the Affordable Care Act o http://bphc.hrsa.gov/about/healthcentersaca http://bphc.hrsa.gov/about/healthcentersaca Federal Office of Rural Health Policy Affordable Care Act Website o http://www.hrsa.gov/ruralhealth/affordablecareact/ http://www.hrsa.gov/ruralhealth/affordablecareact/ Resources