Healthy Maryland! September 2010

1. Healthy Maryland! September 2010

2. The Challenge…

3. Hospitals ER & Outpatient Clinics Schools Health Plans Social Services Food Bank Access

4. Hospitals ER & Outpatient Clinics Schools Maze of Referrals Health Plans Social Services Food Bank

5. Hospitals ER & Outpatient Clinics Schools Paper Forms Health Plans Social Services Food Bank

6. Hospitals ER & Outpatient Clinics Schools Manual Data Entry Health Plans Social Services Food Bank

7. Delayed and missed support for families Lost revenue for providers and local economy More paper and manual data entry Impact

8. Social Interest Solutions • Independent, mission-driven non-profit organization • Software development, implementation, maintenance and enhancement • Policy analysis and advocacy • Leadership and staff with long history and experience in automation and systems reform • ~ 60 staff maintaining systems for AZ, CA, IN, MD

9. One-e-App Technology • Web-based system accessible from many locations • Assisted and unassisted (public access) pathways • Offers a secure single point of entry • Provides simultaneous preliminary and/or final eligibility determination across multiple programs • Submits applications, signatures and documentation electronically via Internet • Application and case management tools for all users (assisted and unassisted applications)

10. Implementations • Arizona: Health-e-Arizona (assisted and unassisted) • Indiana: Ind-e-App • Maryland: Health-e-Link • California: (assisted and unassisted) • One-e-App - 15 California counties • Statewide Kaiser Permanente Child Health Plan and CalKIDS in California

11. Who Uses Community-based organizations Hospitals and Clinics Call Centers County Agencies (Social Services, Health Services, Public Health) Schools Health Plans Food Banks Public Consumers 11

12. One-e-App Stats • Screened over 3.5 million people for potential eligibility across 4 states • Roughly 6 million applications to programs • Speeds determination – in some cases by 50% or more • Reduces need for follow-up with applicants ~78% as compared with paper • 90% of public user survey respondents in AZ found the application “easy to use.”

13. Examples of Features • Interview style data collection • Error checking and validations • Storage of documents and signatures • Application tracking tools • Management report generation • English / Spanish real time toggle • Notification and client communication tools (e.g. text messaging)

14. Health Programs • Medicaid • SCHIP • EPSDT • County Indigent Care Programs • County Sliding Fee Programs • Adult and Child County Expansion Programs • Kaiser Permanente Child Health Plan and Kaiser Bridge • Express Lane Eligibility (school lunch / MC linkage)

15. Social Services and Support Programs • Food Stamps (SNAP) • Earned Income Tax Credit (EITC) • Child Tax Credit • Supplemental Nutrition for Women, Infants and Children (WIC) • TANF (Temporary Aid to Needy Families) • Voter Registration • Low Income Energy Subsidies • Low Income Auto Insurance

16. Referrals to Other Programs   • Family Planning • Cancer Detection and Treatment Programs • General Assistance • Medicare Cost Sharing • Drug and Alcohol Rehab Program • Homeless Assistance • Others

17. Electronic “Interfaces” • State eligibility systems in Arizona: Department of Economic Security (DES) and Arizona Health Care Cost Containment System (AHCCCS) • State of CA for Children’s Medicaid, S-CHIP, EPSDT • State of Maryland (Spring 2010) • County Automated Welfare Systems • Health plans • Patient Management Systems and Electronic Health Records • Pacific Gas and Electric (PG&E) • US Postal Service for address verification

18. Process and Data Flow Home State Systems County Systems • USPS • PMS • EHR • Others Data & Document Storage Case Management Tools Health Plans Community Based Organization Rules Engine Universal Interface Determine Preliminary Eligibility Submit Application applicant consent

19. Snap Shot – San Francisco • Fully integrated with county and state systems • Developed and running 16weeks • Persons Screened: 112,772 (since 9/2007) • Persons Currently Enrolled in Healthy San Francisco: over 50,000 • User satisfaction with enrollment process: 86% found the process “easy” or “very easy” • Reduced Emergency Room use through enforcing use Medical Home (managed via One-e-App)

20. Snap Shot - Arizona • Fully integrated with state systems • 190,000 Public Applications Submitted in year one (12/28/09 – 12/31/10) • 54,000 Assisted Applications Submitted • 230,000 households applied for Food Stamps • 95% of the FS households had a least one person eligibile for Medicaid • 90% of survey respondents in Arizona found the public application “easy to use” and would use it for renewals

21. One-e-App in Maryland Launched October 1, 2008 in Howard County Programs: MCHP MA for Families Healthy Howard PAC Kaiser Bridge Interface in process with CARES to support MCHIP and MA for Families Plan to begin UAT in November and hope to be live and in pilot in December. 21

22. The Center and One-e-App: Unique   • Unprecedented data integration (only non-state or county system to interface with state and county systems) • More than an electronic application • Verification document storage and management • Robust communication capabilities with notices, email, text messaging • Self-service and supported assistance • Reporting (data mart support for ad hoc reports) • Case and outreach management

23. Demo