Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
Date
December 09, 2014
Facilitator Richard
Chambers
Time
11:30 PM – 2:30 PM PST
Scribe
Location
Molina Center
200 Oceangate, Suite 100- Long Beach, CA 90802
Invited:
In Attendance:
James Cruz, MD
Richard Chambers
Yunkyung Kim
Deborah Miller
Jennifer Rasmussen
Megan Dankmyer
James Novello
Paul Stuessy
Rosa Hidalgo
Sabra Matovsky
Bertha Poole
Louis Frick
Liz Helms
Steven Soto
Paula Crano
Joy Bland
Tina Padron
Terrance Henson
Brenda Premo
Ruthy Argumedo
Mary Rios
Sergio Calderon
Janet Vadakkumcherry
Pete Benavidez
Cecilia Burch
Sal Pineda
Gina Semenza
Larisa Crossno
Danica Lusser
Julieta Rosales
Karla Gutierrez
Andrew Lacroux
Terrance Henson
Danica Lusser
Sal Pineda
Oscar Narro
Cecelia Burch
Pete Benevidez
Stephanie Buhir
John Nolan
Paul Stuessy
Gina Semenza
Martha Villar
Megan Dankmyer
Bertha Poole
Ruthy Argumedo
Brenda Maroney
Marjorie Benesh
Rosa Hildalgo
Gloria Hunter
Karla Gutierrez
Lisa Hayes
Julieta Rosales
Richard Chambers
Deb Miller
Jennifer Rasmussen
Yunkyung Kim
Jon Roohan
Isaac Valles
Larisa Crossno
Donald Brock
Liz Helms
Danica Lusser
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
Oscar Narro
Stephanie Williams
Denny Chan
Attachment:
Meeting PowerPoint Presentation
Janet Vadakkumcherry
Mary Rios
Sergio Caulderon
B2A
Presentations_12-09-2014.pptx
Time
Agenda Item
Discussion
Leader
11:30 12:17
Lunch & Mingle
All
12:17
Welcome, Call to Order Opening Remarks
1. Welcome by Richard Chambers, thanks all for attending
2. Called to order 12:17pm
Richard
Chambers
12:1712:23
Introductions
All
12:23
Approval of May 29, 2014 Minutes
Richard
Chambers
Motion to approve: Pete Benavidez
2nd Motion: Mary Rios (on phone)
Approved: Approved by Committee at 12:23pm
Richard then discusses the agenda and transitions to Molina updates
12:2512:45
Richard
Molina Updates
Chambers
1. Will talk about 2014 achievements - exciting year
2. Membership growth - MHC crosses 1/2 million member mark.
Nationally, 12 health plans exist, (Puerto Rico coming soon)
3. Launched Duals Demonstration plans (Molina Dual Options Cal
MediConnect)
4. Very exciting time for CMC, despite high opt-out rate
5. Later Deb and Jen will discuss how the California Coordinated
Care Initiative (CCI), is changing lives.
6. LIP transition in January was seamless -those previously
uninsured now get managed care services and this is progressing
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
successfully. Molina is meeting previously unmet healthcare
needs
8. ACA expansion meant lots of growth - 20% growth in 2016
9. Marketplace Plan taking off and looking to expand in the future
10. Amazing growth in the Molina’s California Health Plan itself:
a. Over 700 employees
b. In 2015 nearly 1000 are expected
i.
Resulted from Healthcare Services department hiring,
1. Needed more Case Managers & Community
Connectors
12. New Leadership in the Health plan – Finance, Rajeev Narula
13. Quality Improvement focus
a. Improved rates on HEDIS and CAHPs
b. Molina is the highest rated in the counties we serve (NCQA)
14. Expanding Provider network, including:
a. Scripps – In negotiation with their physician groups
b. In LA - Dignity
c. In SAC - Dignity
15. Medi-Cal Expansion: Goal is to serve and grow membership
a. “Choose Molina” initiative
b. DHCS CAL fresh transition. With second notice to Cal
Fresh recipients for Medi-Cal:
1. DHCS got 50% response rate
2. Second mailing just took place
3. Medi-Cal expansion continues into 2015
18. Medicare Expansion
a. Coachella Valley - Medicare plan available in 2015 - D SNP
Medicare Advantage Plan
b. Passive enrollment will take place throughout 2015
i.
We need to make sure that message is communicated
about enrollment options.
19. Looking Ahead
a. Autism & ABA benefits - Implementation is taking place; the
state is still trying to figure out the payment system
b. Quality
i.
Focused on improving scores
ii.
CCEPD - Molina agreed to commit to increase
employment rate of people with disabilities.
c. LTSS education
i.
Molina wants to improve quality of care and support for
caregivers
1. Sal comments - In our experience disability
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
employment rate is unacceptable, applauds Molina
for taking a step in this direction.
a. Richard notes very happy to implement this,
sometimes we need to step back and look at
the big picture to recognize what we’re doing
12:45Long Term Care Updates
12:55pm
John Roohan MD - Introduction
a. Family Doctor
b. Wants to implement CCI and help get members appropriate
care, at the right time, in the right place
1. Find out what services are needed and where access issues are
2. Megan Dankmyer – There are case managers for members in
SNFs
a. Case Manager (CM) does HRA in person at the SNF
b. One CM to one Facility
i.
When new Molina members are identified SNFs - SNF
staff will call Molina. This has become a very
collaborative effort.
c. SNF will also call Molina for help transitioning back into
community
i.
All CMs trained in CCT
d. Interdisciplinary Care Teams (ICTs) collaborate with SNF staff
Brenda Premo makes a comment - Language is important and the
term custodial members" is an issue
We should look at different way to describe this that encompasses
the whole individual.
Response: Jen R.
States that we can start making those changes at the
health plan level. Molina needs B2A committee members
to make recommendation to state also.
“Custodial” is a tech term that’s used for payment of
claims. Molina will start changing terminology, but will
need the state to do so as well in order for it to be fully
integrated.
Sal Pineda - Question – For Medi-Cal SNF, the health plan is
responsible for cost, but then the member is transitioned back to FFS
Megan
Dankmyer
John
Roohan,
MD
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
medical.
Response: John H.
States that now members will stay in the plan while in a SNF.
Paul Stuessy -How do you decide what level of care a member is
categorized as?
Response: John states this is a clinical determination based on
the needs of the care.
Sal Pineda - confirms his understanding
Sal Pineda - Question - Are interpreters provided at ICTs and other
meetings?
Treated the same way, members are provided with interpreter
Sal Pineda - who pays for the ASL interpreters
Molina: the health plan – we do.
12:55 1:05
Deborah
Autism Services Change for Medi-Cal
Miller
1. Deborah is standing in for Doris Doss
2. Discusses Molina’s Community Connectors
a. Staff living in the community and familiar with culture and
resources. They help find members.
b. Story – Community connector encounters a man with a gas can.
The man is a person with diabetes who was hungry and living
in his van.
i.
He was a Molina member by chance
1. Helped member in the moment and got his phone
number. Community Connector called next day and
now in touch with member to help solve issues.
3. Medi-Cal Autism Benefits
i.
ALL Plan Letter/Dual Plan Letter - gives instructions on
Autism benefits program
b. Autism training at Molina
i.
Training Member Service representatives
ii.
Training for Case Managers, Clinical staff, and others
iii. Physician training is also provided
iv.
Molina has weekly phone calls with DHCS and is always
revising training material with any new updates
d. Rates - still waiting to hear more on this topic from the state
e. Provider network - increasing ABA providers in the Molina
provider network
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
f. Regional Center Outreach - Training for transition plans
i.
All transitions will be completed by June 2015
Sal Pineda requests an email with more information on ABA
i.
Deb says she or Lisa will follow up with him
1:05 1:35pm
Healthcare Services Update
1. Meeting the HRA challenge - Jennifer Rasmussen
2. Overview of the HRA process
a. Identify members
i.
Each month there a wave of enrollments
1. Passive and Voluntary
2. 50 - 20 voluntary
3. Thousands passive
ii. Molina stratifies enrollees high risk and low risk
1. See PowerPoint for high
2. See PowerPoint for low risk type
3. If we don’t have enough information, we classify
them as high risk
b. Timeframes
i.
Depends on level of risk
1. Notes committee members/attendees can see this
in packet provided today
ii. Molina does more than just minimum to help identify
members
c. Outreach - Divide and Conquer approach
i.
Hired staff in the all communities we serve
ii. Member names go right to the staff in the community
and gets to member very quickly. Often next day face
to face in community
iv.
Staff knows the community in which they serve
1. Bus stops, languages, services, culture,
languages
2. Hired staff from sister organizations because of
familiarity with community
d. Low-Risk Outreach
i.
Done over the phone. The call is made and a face to
face HRA is offered in person
ii. Can do HRA over the phone if preferred by member
iii. Mail HRA is also an option
e. HRA challenges - finding the member
i.
We receive many files on a members
Jennifer
Rasmussen
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
1. Often receive wrong numbers
2. May get person who screens calls
3. We try to identify preferred language ahead of
time but this is not always possible.
f. What do we do to combat these challenges? – “Turning
over Stones”
1. Look at historical claims data
a. Contacts providers in history for more
recent contact info
b. IHSS can also help
c. Claims data once they start using Molina
2. When contacting members, we try different days
and different time of day.
3. If we are still unable to contact, we send a letter
that asks member to call us.
4. Have relationships with SNFs in place.
5. Will also refer to Community Connector team.
Community Connectors can:
a. Have a one on one connection with
member
b. Help navigate and show resources
c. Community connector program is based on
New Mexico model. Started with 11 staff
and now up to 54 staff members.
7. Calling from non-Molina identified phones,
getting leads, leaving cards/info
a. Will do assessment whenever and
wherever possible
b. Goal is to get them connected with care
they need
g. “What’s under the stones”
1. Some don’t want to be found
2. Some not in service area
3. Sometime BH can make this more difficult
4. Homelessness, or near homelessness’
5. Low on cell phone minutes
6. Sometimes shared family cell phones
7. Some don’t want case management (we respect
this choice)
h. Engaging members
1. Explaining why they’re in Molina
2. Offer resources
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
3. Give HCO if member wants it
4. Explain Continuity of Care (COC)
5. Explaining benefits (emphasizing that member
is not losing benefits but getting more with
CMC)
6. Offering HRA
7. Listening plays important part of role
a. Hearing member’s concerns
b. Using motivational interviewing
c. Prioritizing goals
Questions a. Sal Pineda – If the member does not speak the same language as
the person reaching out, how long is the wait to get an
interpreter?
i.
Jennifer Answers - If on the phone, just a few minutes. If in
person and it’s a common language, also a few minutes. If
it’s not a common language and in person, then the wait
time for an interpreter is longer. Molina is continuing to
update this process.
b. Sal Pineda - How do you deal with HIPAA compliance when
contacting third parties to find members? Like contacting doctors
to get a member’s new address.
i.
Jennifer Answers - Data comes from state and claims
contact with doctors. All of this contact is HIPAA
compliant because Molina is payer of claims.
c. Liz Helms - States there was a meeting in Sacramento she
attended where she met a met woman who has daughter in need
of services.
i.
Lisa will send HCO number to caller so they can provide
this to the individual. Lisa notes that plans can’t enroll
members Cal MediConnect (CMC) plans
ii. Lisa to call Liz off line.
1:35 2:15
Local CCI Advisory Committee Updates
1. Lisa discusses Inland Empire (IE) and Los Angeles county CCI Lisa Hayes
advisory committee updates
a. Advisory boards are required by CMS and the state
b. IE and LA advisory committees are collaborative groups
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
2.
3.
4.
5.
that include the health plans serving the area, consumers,
and community based organizations.
c. Meetings are monthly in LA.
d. Meetings are bimonthly in the IE.
Communications subgroups exist for each advisory committee.
a. Jan 2015 enrollment wave - continuing to working on
messaging
b. Cal Duals Cal MediConnect Toons have also been created
to increase awareness. [Lisa shows one of the several
cartoons to the B2A committee].
c. Need to provide feedback on accessibility and subtitles.
i.
Committee recommends subtitles/and colors be
changed
a. Lisa will share this at next communication
meeting.
ii.
Cecelia comments: says video was confusing.
Recommends cutting the acronyms and notes the
characters talk too fast.
iii. Sal Pineda comments: From a vision-related
disability perspective - I thought the ladies voice
was man’s neighbor and the video became
confusing. Suggests that people like him review
these videos
iv.
Brenda Premo- comment: states that video is not
accessible to people with sensory disabilities.
Concerned that people won’t watch.
v.
Sal Pineda – states that internet access is limited and
this could be sent out on DVDs.
There is a new video in the making by the health plans –
currently the script is still being finalized.
a. Looking into incorporating a signing interpreter circle for
the health plan created video
Lisa then discusses the contents of the gift bags presented to the
committee
a. Artwork was done by person with autism. As a child he was
hard to reach. However, art seemed to work for him. Now
the artist is 21 and doing art professionally.
b. Molina purchased the frames and cards from him for the
Bridge2Access committee.
Jan enrollment wave - see chart in the attached PowerPoint.
a. Molina D-SNP members will get cross-walked into our Cal
MediConnect plan (CMC)
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
i.
ii.
iii.
Letter goes out to member.
Very little change to member experience.
Matching networks – took a tremendous effort to
accomplish
iv.
Near or at 100% matching in the counties Molina
serves
b. Part D Reassignees
i.
These are member of a Medicare Advantage D-SNP
plan whose plan starts charging a premium or is
ending. These individuals will be cross walked into
a CMC plan.
c. Takeaway - this is the biggest enrollment wave we’ll ever
see in the duals demonstration. Committee members are
encouraged spread the word about choices to their
consumers. Resources include:
i.
The Health Plans - they are working to get
information out to the community
ii.
Calduals.org
iii.
HICAP
iv.
CMC Ombudsman
6. Los Angeles CCI stakeholder advisory committee updates
a. When this group meets in January, we will discuss how the
January enrollment wave is going and whether the meetings
can move to a quarterly schedule.
b. Communications subgroup meets every 3 weeks now and
big achievements include:
i.
TeleTown halls via PASC - 3000 callers for
Molina’s event, 6000 callers for all plans event
ii.
Recent Tele-forum
a. 24 people in a room answering calls,
different languages spoken.
b. Mailer sent out for people to call in
c. Got a chance to answer individual questions
iii. Continued plan outreach
7. IE CCI stakeholder advisory committee updates
a. Continued preparation for January enrollment wave
b. Currently conducts meetings on a bimonthly schedule, may
move to quarterly in 2015.
c. Communications committee has proposed a TeleTown hall
8. Lisa briefly discusses Molina Ombuds program and notes we
are continuing to gauge the IE population’s concerns.
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
9. Lisa invites community based organizations to contact Molina
about how we can better reach out and help their consumers.
2:15 2:20pm
2:202:25
Covered California Enrollment Update
1. Close to 7000 in CA for Covered California
2. Enrollment pathways include:
a. Online enrollment
i.
Note: There were issues with state site. As such, health
plans developed more methods for enrollment.
b. Phone enrollment
c. In-person enrollment
i.
Enrollment events
ii.
Offers to have person come to their home
d. Enrollment lead cards in contracted providers’ offices.
e. Enrollment at San Bernardino Inland Center Mall - Molina Info
Center
f. Enrollment at Molina clinics
3. In January 2015, Moreno Valley Mall Molina Info Center is
expected to open.
Ruthy
Argumedo
All
Future Meeting Dates/Times
1. Asking committee members to get consumers involved in our
advisory committee
2. Molina’s Disability and Senior Access Services staff is made up
of 75% people with disabilities
3. Lisa Reiterates CCEPD initiative Molina’s focus on it.
a. Sal Pineda - States interpreter process should be set up with HR
i.
Lisa yes and we are working on this
ii.
Sal also states that at job fair interviewers were asking
how deaf people communicate to deaf people
5. Lisa proposes quarterly meetings for 2015
a. Twice in LA and Twice in IE (inland Empire); Senior
Leadership will be present at both
b. To coincide with CCI meetings and bring that feedback,
i.
Sal Pineda -says that he likes this idea and has sister
agency in the IE that could become involved.
ii.
Brenda Premo. – says this is a good idea. Gets folks from
the IE involved so they don’t have to always sit on the
phone.
Bridge2Access Statewide Advisory Committee
December 09, 2014 Meeting Minutes - Approved
c. Lisa states that she will speak with Richard and get a
communication out to the group.
2:25 –
2:27
All
Open Forum/Agency Announcements
1. GLAD will host 1 Cal MediConnect event with the five health plans.
Starting with events in January. Will update the group soon.
2. No other announcements.
3. Meeting adjourned 2:27pm
Recommendations to Molina Senior
Leadership Team
Agenda Item
Use more appropriate word for
"custodial"
Due Date
Recommendation
By Whom
Find a more
appropriate word
and use it.
Brenda P.