here

Report
Access Health CT
Community Outreach
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Addresses Core Issues
• People are uninsured for many reasons, including:
• Inability to afford coverage
• Ineligibility for public programs
• Being denied coverage based on a pre-existing
condition
• The complexity of enrollment processes
• Living in remote areas
• Low literacy and health literacy
• Limited understanding of health insurance
• Cultural and linguistic barriers
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OHA – AHCT Partnership
• In order to address the challenges in implementing the ACA, Access
Health CT and the Office of the Healthcare Advocate created a unique
partnership.
• Designed to provide support through linguistically and culturally
appropriate community engagement initiatives and outreach
programs.
• Trusted community-based organizations help consumers enroll in
the health coverage plan that is best for their families.
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Access Health CT Consumer Assistance
• Through Access Health CT, different types of consumer
assistance entities are available to help consumers
learn about their health coverage options and enroll
through the Marketplace. These entities include:
• Navigators
• Non-Navigator assistance personnel (also known as
Assisters in CT)
• Certified application counselors (CACs)
• Certified Brokers
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AHCT Community Outreach Programs (NIPA)
• The state of Connecticut has been divided into six regions – each with a
Navigator and a number of Assisters based on the number of uninsured
in that region
• Federally-Qualified Health Centers (FQHCs), Hospitals, Municipal
Health Departments and other health care-related institutions provide
trained staff to assist consumers as Certified Application Counselors
• Trusted community-based organizations
• Linguistically and culturally appropriate community engagement
• Engage, educate and enroll consumers in health coverage and educate
consumers on how to use their new coverage
• Bring the health insurance marketplace to the consumer
• Connect to the public health infrastructure
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The Uninsured Marketplace
Source: Thomson Reuters
The Insurance Marketplace
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Process
Application
Complete
Enrollment
Enter
Applicant
Information
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2
5
3
Verify With
Data “Hub”
Display Plan
Options
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Select Plan
Simplifying Medicaid and CHIP
Modified Adjusted Gross Income (MAGI)
Tax-based concept of family size and household
income
No Asset Test
Elimination of current income disregards and
deductions
Standard 5% income disregard applied to
applicable coverage group
No longer considers household composition rules as we
currently know them
•
•
•
•
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What is a Qualified Health Plan?
an insurance plan that is certified by an Exchange,
provides essential health benefits, minimum
coverage
follows established limits on cost-sharing, and
meets other requirements
Navigator Organizations
• Work with Access Health CT to guide outreach strategies in the state
• Assign 2-4 Key Staff members (senior staff) who manage the program
• Organize regional and community-wide strategies, creating a structure for the
outreach work in each of six regions
• Support the work of the Assisters in their region by coordinating tactical planning,
answering questions, convening and training
• Support and conduct public education activities and enrollment events in each
region
• Link consumers to the Office of the Healthcare Advocate, DSS, 211 InfoLine,
Brokers and Agents, and other services
• Partner with Community Health Centers, Hospitals, City/Town Governments, School
Systems, Public Health Departments, Community Foundations, United Ways,
chambers of commerce and others
• Engage volunteers to promote outreach
• Contract runs from September 1, 2013 – June 30, 2014
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Navigators Across the State
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In-Person Assisters
• Community, faith, unions, social service organizations, health
departments and small businesses responded to an Request for
Proposals to receive $6,000 contracts
• Approximately 250 contracts given for existing staff to help community
members and their constituents learn about and enroll in health care
coverage
• Assisters in each community have developed their outreach programs
collaboratively and with their Navigators
• Assisters facilitate consumers’ enrollment in health coverage
• Each Assister is responsible for at least 100 enrollments
• Assisters present plan options but will not recommend a particular plan
• Will refer consumers to other sources if they need information
• Offer consumers the opportunity to register to vote
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Assister Organizations – Some Have Multiple Assisters
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Navigator Key Staff and Assister Certification Process
• Following selection of the Navigator and Assister
organizations, candidates must:
• Pass background check
• Sign Privacy and Security and Conflict of Interest
statements
• Sign contract and other documents
• Complete 34-40 hours of training
• Pass certification test with grade of 80% or better
• Receive photo identification badge and special laptop
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Certified Application Counselors
• CACs can be staff or members of community health centers,
hospitals, health care providers, and certain governmental entities.
CACs fulfill some of the same roles and responsibilities as Navigators
and Assisters, but aren't responsible for conducting outreach and
education.
• Their responsibilities include:
• Providing free information to consumers about insurance
affordability programs (e.g., Medicaid) and coverage options
• Assisting consumers in applying for coverage and insurance
affordability programs in the Marketplace
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Five Ways to Find an Assister or Certified Application Counselor
• Go to AccessHealthCT.com - use the “Get Help” tab
• Visit an Enrollment Center
• Come to an Enrollment Fair -- See the “Events Page” at
AccessHealthCT.com for dates and locations
• Call Access Health CT’s Toll Free Phone Number: 1-855-805-4325
• Use the AHCTCommunity.org website – for community groups
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NIPA Training Program
Phase One
Phase Two
Phase Three
ACA 101
Cultural and Linguistic Appropriate Access
Ethical Guidelines for Community
Engagement
Access Health CT 101
Eligibility and Enrollment
Access Health CT Web Portal
Achieving Health Equity
Health Insurance Literacy
Monitoring/Data Collection
Navigator and Assister Outreach Program
Overview
Outreach, Education and Enrollment
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NIPA Program Communications
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Assister Languages
American Sign Language (ASL)
Arabic
Bosnian
Burmese
Cantonese
French
Galician
German
Greek
Gujrati
up to $45,960
Haitian Creole
Hebrew
Hindi
up to $15,856
Italian
Jamaican Patois
Karen
Khmer
Laotian
Lingala
Mandarin Chinese
Polish
Portuguese
Punjabi
Romanian
Spanish
Swahili
Thai
Tigrinya
Ukrainian
Urdu
Vietnamese
Yoruba
up to $94,200
up to $43,567
Chithserey Ouk taking questions about ACA at Danbury Cambodian
New Life Evangelical Church.
September 29th, 2013
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Navigators, Assisters and CACs Serve Consumers
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People are already benefitting from some very real changes.
Thank You!
Kate Gervais
[email protected]
860-985-5580
www.ahctcommunity.org
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