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CHAMP-Net News
July
1, 2009 I Volume 3, Issue 7
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CHAMP-Net is a program
of the National Health Foundation (NHF).
Click here to visit NHF's
website.
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Have a question/ comment regarding CHAMP-Net or
CHAMP-Net News? Please share your suggestions by contacting
the CHAMP team at askthetrainers@champ-net.org
or 213.538.0774. We look forward to hearing from you!
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Spotlight on:
Policy Roundtables with The HSC Foundation
Each month CHAMP-Net News will highlight a current NHF
project.
Caregiving plays a key role in the long-term supportive services system
in our nation and is a burgeoning public health concern. Millions of
Americans provide unpaid care for spouses, partners, and other family
members or friends above the age of 18; thousands more care for
children with disabilities and chronic illnesses who will need lifelong
assistance; and a growing population of Americans is caring for wounded
service men and women returning from combat zones. Currently,
there is a lack of coordinated information sharing to bridge the lived
experiences of these caregivers and address their specific needs,
including the ways in which they are similar to and yet different from
each other based on the demographics and health needs of their care
recipients. To address the present knowledge gap, The HSC Foundation
has brought together National Health Foundation and The MayaTech
Corporation to host a Washington, DC-based expert roundtable to examine
the unique strengths, challenges, and needs facing a variety of
caregivers. In the coming months, NHF will work with these
organizations to host the expert policy roundtable and work to create
one voice around particular caregiving issues.
For more information about this policy roundtable, contact Danielle
Cameron at dcameron@nhfca.org
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 Welcome CHAMPers,
As a new month begins
and we start anew, the many proposed changes and uncertainties of the past
month are not easily forgotten. As our California
leaders come together to balance the state's budget for the future of California's
families, we remain connected! Our mission is to provide you with the
most up-to-date information to help you assist families during these
times of transition.
This month marks changes to some adult healthcare benefits. While these
changes will be challenging, we applaud your commitment and continued
efforts to ensure that eligible children and families have access to the
programs and benefits they need to stay healthy.
This issue of CHAMP-Net News highlights some important topics of
interest to health advocates including:
- 2010
CAA/Health Advocates Conference – Workshop Topics Survey
- First
5 LA- Summer Safety FunFest
- AskCHIS
Workshops
- California Budget
Update: Healthy Families Wait List
- Medi-Cal:
Reduction in Benefits for Adult Beneficiaries
- Medi-Cal:
Change allows U.S.
citizens and nationals to receive full scope benefits while
collecting documents
Best,
Jeanette Peņa, Program and Education Specialist
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News and Events
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2010 CAA/Health
Advocates Conference Workshop Topics Survey
The 2010 CAA/Health Advocates Conference is in the planning stages and
needs your input! We are currently seeking workshop topics for the
upcoming 2010 CAA/Health Advocates Conference and we'd like to hear
from you. Please take a few minutes to provide us with information
about possible workshop topics and if you complete the survey, you can
enter a chance to win a $100 Gift Card. Please click here to enter.
First 5 LA- Summer Safety FunFest
Join First 5 LA and EXPO Center on July 11, 2009 for a day of
fun and interactive safety activities for children and parents
absolutely FREE!
Location: Department of Recreation and Parks/EXPO Center
3980 S. Menlo Avenue, Los Angeles, CA 90037
Cost: Free
AskCHIS Workshops
The UCLA Center for Health Policy Research and its Health DATA
Program will conduct a free, in-person AskCHIS workshop for researchers
and staff of agencies and community-based organizations in Fremont and
Long Beach. Participants will learn how to access online data from the
California Health Interview Survey (CHIS) on a number of important
health topics. Additional workshop information, such as the
training site location, will be provided after your registration
has been processed and approved. To register for these workshops,
please click on the following locations:
Dates: Fremont on July 15, 2009
Long Beach on July 30, 2009
Cost: Free
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Healthcare Coverage Program Updates
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California
Budget Update: Healthy Families Wait List Effective July 17, 2009,
Unless Additional Funding is Found
California is currently facing a large budget deficit and the Governor
has produced its final proposal that has been under review in
Sacramento. Presently, the Budget Conference Committee has made
amendments and/or recommendations to the Governor's budget
proposal. A final proposal has yet to be passed into law;
however, some parts of the proposal have been accepted on behalf of the
Committee.
One of the proposals that has been adopted is the elimination of the
Application Assistance payments that would then allow the State to
save $2.7 million dollars in General Funds in the coming fiscal
year. Committee members remain hopeful that the other sources of
revenue will become available in the future that would then allow to
re-instate the Enrollment Entity reimbursements for Application
Assistors. The Healthy Families Program will continue to provide
support to Enrollment Entities and Certified Application Assistors with
the CAA Reference Manual, Web-based Training and the EE/CAA Help
Desk.
The Managed Risk Medical Insurance Board (MRMIB)has voted to freeze
enrollment and implement a wait list for the Healthy Families Program
(HFP) due to the current budget constraints. The Healthy
Families wait list effective date is July 17, 2009 and it is
unknown when additional funding will become available. If other
alternative funding options are obtained or reductions in program costs
become available, then MRMIB will remove the wait list and cover the
estimated costs of the HFP expenditures. Children that are already
enrolled in the Healthy Families Program prior to the enrollment freeze
will continue to receive services. To see the official notice on
behalf of MRMIB, please click here.
While these cuts will have a drastic impact on our communities, it is
important to help families stay insured by helping them to complete
their annual renewals on time and assisting them with new applications
for the Healthy Families Program as soon as possible. We commend
all of you for the great service you have offered to our children and
families. If you are interested in finding more information about
the budget proposal, please visit the following sites:
Health Access
California Budget Project
As always, check CHAMP-Net regularly for
program updates.
Medi-Cal: Reductions in Benefits for Adult Beneficiaries
Starting July 1, 2009, benefits for Adult Medi-Cal beneficiaries will
be reduced. Notices have been sent to all beneficiaries about
this change in benefits. This change will affect Medi-Cal
beneficiaries age 21 and older and includes the following services:
dental, speech therapy, podiatry, audiology, chiropractic, optometric
and optician, psychology, and incontinence creams and washes.
There are some exceptions to this change in benefits. For a full
list of excepted beneficiaries and circumstances, click here to view the
notice. For additional information about the cuts and to download
the notice in thirteen languages, visit: www.medi-calca.gov.
You can also download helpful flyers to use when working with clients
affected by this change on CHAMP-Net.
Medi-Cal: Change allows US
citizens and nationals to receive full-scope benefits while collecting
documents
While collecting the needed proof of citizenship or nationality
documents to apply for or renew Medi-Cal coverage, U.S.
citizens and nationals will receive full-scope benefits. These
individuals must submit proof of citizenship or nationality during a
reasonable opportunity period or their benefits will be reduced to
limited scope. This rule took effect on February 4, 2009.
Any US
citizen or national beneficiary who had limited scope benefits and
therefore paid for or was billed for services that would have been
covered by full-scope Medi-Cal after February 4th can receive
full-scope benefits retroactively back to February 4th. Click here to view the
notice sent to beneficiaries at redetermination.
If you have questions about these or any other program changes, please
contact us at askthetrainers@champ-net.org.
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CHAMP-Net's Tip of the Month: Know who's covered!
Beginning
July 1st, 2009 Medi-Cal will stop paying for dental care services for
most adults 21 and older. However, knowing who will and will not be
affected can help you assist families in determining whether they may
be eligible to receive dental services after July 1st. Help families
get informed and navigate though these change!
Some individuals will be exempt from cuts to their "optional
benefits" and will get continued dental benefits and services. For
detailed information about exempted individuals, please click here. Moreover,
individuals may be eligible to obtain continued dental treatment and services
if these services are needed to remedy another ailing condition and/or
needed for emergency treatment. As such, Medi-Cal may still
reimburse dental benefits and services for some non-exempted
individuals under certain conditions.
Medi-Cal WILL cover dental benefits and services, if any
of the following applies:
- An emergency
condition occurs and the service is required to treat the
emergency condition
- An adult (age
21 and older) began their course of treatment before July 1, 2009,
and is scheduled to continue on or after July 1, 2009
- Individuals
(under 21 years of age) whose course of treatment is scheduled to
continue after he/she turns 21 years of age (continuing services
for EPSDT-Early and Periodic Screening, Diagnosis and Treatment
recipients). Please note that orthodontic services are
excluded and will not be covered for individuals over 21 years of
age
- Pregnancy-related
services and services for the treatment of other conditions that
might complicate the pregnancy
- Individuals
under the Early and Periodic Screening, Diagnosis and Treatment
(EPSDT) program
The information above
and other additional information can be found in the Denti-Cal bulletin or their website. For questions
regarding changes to Medi-Cal beneficiaries, please contact the Denti-Cal Telephone Service
Center at (800)
423-0507.
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Ask The Trainer Question of the Month
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CONGRATULATIONS TO THE GEM PROJECT/CVHP OF WEST COVINA FOR ASKING THE FIRST
"ASK THE TRAINER' QUESTION" IN JUNE. IF YOU WOULD LIKE YOUR
AGENCY'S NAME AND QUESTION HIGHLIGHTED IN THIS SECTION OF CHAMP-NET
NEWS, MAKE SURE YOU ARE THE FIRST TO ASK A QUESTION IN JULY! Email us
at: askthetrainers@champ-net.org.
Good morning Trainer,
Do you have any information about reduction of dental benefits for
adults? When is the starting effective date for the reduction
dental services?
Sincerely,
GEM Project/CVHP
Hello,
The adult dental services under Medi-Cal are considered to be an
"optional" benefit and due to the budget crisis in the State,
this service for adults will be eliminated beginning July 1,
2009. Now there are some exceptions:
- Individuals
that are under current treatment plans and will require adults to
continue accessing dental services will still have dental
coverage. So if an adult is seeing the dentist for root canal and
has a follow up appointment after July 1st, those services
accessed will still be covered because it is necessary appointment
for a service that was given before the July 1st date
- If the
beneficiary is a pregnant woman and she is receiving
pregnancy-related Medi-Cal, she can still access dental services
if the condition(s) left untreated will affect her pregnancy (this
can include dental exams, cleanings and gum treatments)
- Individuals
receiving benefits through California Children's Services
- Individuals
receiving benefits through a Program of All-Inclusive Care for the
Elderly
If the exceptions are not met, individuals may access services if one
of the following:
- If
an emergency condition occurs and the benefit is required to treat
the emergency condition. Some medical and surgical services
provided by a dentist will continue to be covered. Check
with the dentist for more information.
- Some
of these benefits and services may be provided in hospital
outpatient clinics, Federally Qualified Health Centers, Rural
Health Clinics, Indian Health Services, adult day health care
centers, or through home health agencies. Check with the primary
health care provider for a referral.
- Some
of these benefits and services may be continued if they are
currently receiving them or if they move from an exempt group,
such as under 21 years of age, to a nonexempt group, such as
turning 21 years of age. Check with their primary health care
provider for more information.
- Their
county health department may be able to provide them some of the
benefits and services no longer covered by Medi-Cal.
We hope this information helps! If you have any further questions,
please let us know.
-The CHAMP Team
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CHAMP Training: Adult CHAMP Manual
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Attention all CHAMPers!
The new 2009 CHAMP Adult manual is hot off the press. During the last few
months, the CHAMP Team has been diligently working on updating the
Adult manual and the 2009-2010 manual has some great resources. If you
would like to download the new manual please visit CHAMP-Net. Remember, you can
also attend the CHAMP Adult Training and receive a copy. We want to
thank everyone that contributed to the manual and we look forward to
using our new manuals in the upcoming trainings.
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 CHAMP-Net's County of the Month: Santa Clara
The mission of the Public Health Department is to serve all people of
Santa Clara County by protecting health; preventing disease, injury,
premature death and disability; promoting healthy lifestyles, behaviors
and environments; and responding to disasters, disease outbreaks and
epidemics. The Department provides a number of programs and
services in the following areas: alcohol, drugs and tobacco prevention;
communicable diseases and sexual health; maternal, child and youth
health, chronic disease and injury prevention. For a full listing, click here. In
addition, Santa Clara
County offers two
local initiative programs to increase coverage for low-income children
and adults.
Healthy Kids offers comprehensive health insurance for uninsured
children who are not eligible for other existing programs and are
financially unable to purchase coverage. This program is
available to children under the age of 19, who are residents of Santa Clara County, whose families earn 300%
FIG or less, and are ineligible for Medi-Cal or Healthy Families.
For additional information on Healthy Kids, call 1-800-260-2055, or
visit www.scfhp.com.
Valley Care is a health coverage program offered at Santa Clara Valley Medical
Center. The
program is available for adults ages 19-64, who are residents of Santa
Clara County, have been uninsured for the previous 90 days, who are US
citizens or Lawful Permanent Residents for 5 or more years, and who
have a family income less than 200% FIG. Participants in the
program will have access to services including emergency, dental,
health education, outpatient visits, ambulatory surgery, required ER
visits, and inpatient hospitalization. There is a wide variety of
doctors and locations, and the low co-payments are based on
income. For more information about the program, call
1-888-363-3394 or click here.
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NHF is an independent, charitable, tax-exempt 501(c)(3)
corporation dedicated to improving and enhancing the healthcare of the underserved
by developing and supporting innovative programs that 1) can become
independently viable, 2) provide systemic solutions to gaps in healthcare
access and delivery and that 3) have the potential to be replicated
nationally.
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