Note: This is only one agenda section of our complete September HAN meeting notes.
The CeltiCare transition
Outreach workers at community health centers have observed that some immigrant clients who received notices of the transition became concerned by the wording, and thought their present or future immigration status could be in question. Outreach workers are trying to clear up the misunderstanding. Some people are not seeking primary care, but waiting until their need is critical. People who used to bring family and friends in for care aren’t doing it anymore because they are concerned immigration is more closely involved with health care. There is concern about whether or not they will use free clinic services when the H1N1 flu arrives.
Meg Kroeplin reported that these AWSS immigrants in Western Massachusetts are scheduled to be enrolled in CeltiCare’s new program as of December 1. CeltiCare is currently working on developing a provider network. During the interim, AWSS immigrants will have access to either MassHealth Limited and the Safety Net or the Safety Net alone (click here for more information on how to help these clients.)
HSN pharmacies
Health center outreach workers noted that health centers with pharmacies on site can fill prescriptions for people who aren’t yet registered as their patients—but the pharmacy must be part of the health center, not just renting the site. Outreach workers should know this in order to give a good referral. Also, some clients are evidently calling the MassHealth Customer Service asking where they can get a prescription refilled are being referred to inappropriate pharmacies or hospitals.
New EOHHS email lists
Instead of sending outreach workers paper copies of all notices going to their MassHealth and Commonwealth Care clients, EOHHS has begun to send email lists of clients receiving notices. Many outreach workers had expressed concern about receiving lots of duplicate copies of paper notices—but the new system presents some hurdles as well. Evidently lists go to only one contact per organization, regardless of how many individual outreach workers are following clients or how many different sites the organization supports. It’s been very difficult for an individual outreach worker to track down current information on all his or her clients in order to do good follow-up work. One program manager now spends at least 45 minutes every morning sorting her case managers’ notices; including the case manager for each client on the emailed list would help.
Additionally, you can go into the MMIS and MAP systems within 5 minutes of each other to get information about patient eligibility or cost=sharing, and the information often disagrees. Current information is not getting into the two systems in a timely way, and this can keep eligible patients from getting scheduled care.
Medicare News
Regional SHINE directors Margie Ware and Lorraine York-Edberg reminded us to help clients get ready for Medicare Open Enrollment November 15 – December 31. It will be particularly important this year because some plans will be leaving the state. Look for letters in October advising members that the plan won’t be available. Tips: make sure you have a current list of clients’ medications so you/they can go onto medicare.gov, enter the drug list, press a button and learn which plan will be best for next year.
It’s going to be easier for people to qualify for “Extra Help” from the Social Security Administration in 2010. Resources such as life insurance policies and income from outside sources (family financial help, for example) will no longer be counted in determining eligibility. People whose resources used to be considered too high may now also be eligible for the Medicare Savings Program.
Community News/Resources
In November SHINE will offer a training on Medicare prescription drug coverage at the Northampton Council on Aging. Call 413-773-5555 for more information.
Healthy Connections has moved to 167 S. Main Street in Orange. The new telephone number is 978-544-8091.
Community Action’s First Call for Help program headquartered in Greenfield is launching a new mobile outreach program with sites in Hampshire County, Franklin County, and the North Quabbin. For more information, contact Brian Eno, beno [at] communityaction [dot] us.
The Caring Health Center in Springfield is offering a community-based wellness program that includes exercise, nutrition, dance, body/mind awareness and other programs requested by community members in focus groups. For more information, contact Christina Huebner at 413-693-1017.
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