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Nov. 15, 2010
TOPEKA Starting next month, children who have been on HealthWave for a year and whose family circumstances haven’t improved will be renewed without their parents having to resubmit paperwork.
The procedural change is expected to speed the processing of HealthWave applications and help resolve a persistent backlog that has kept many eligible Kansas families from receiving medical services.
HealthWave in Kansas includes children eligible for Medicaid and the Children's Health Insurance Program.
“Going to passive review will be huge,” said Dawn Gelle, a regional vice president with Policy Studies, Inc., the Denver-based company that manages the application clearinghouse for the Kansas Health Policy Authority.
"Passive review," is the jargon for describing the procedural change.
“Seventy to 80 percent of those renewals will not have to have anything done on them,” Gelle said.
That should give clearinghouse workers more time to process applications requiring more substantive review.
According to health policy authority officials, more than 17,700 applications and renewals had been at the clearinghouse for more than 45 days as of Nov. 1.
Federal officials in April directed the agency to come up with a plan for reducing the backlog. The plan they subsequently developed calls for eliminating backlog by March 2011.
“That will happen,” said Gelle, who led a Monday tour of the clearinghouse for members of the Legislature's Joint Committee on Home and Community Based Services.
The clearinghouse, she said, receives between 700 and 1,000 HealthWave applications and renewals each day. It’s able to process between 500 and 750 a day.
Between 100 and 150 of the applications, she said, involve pregnant women.
Clearinghouse workers also field between 1,200 and 1,500 telephone calls a day. On Mondays, 15- to 20-minute waits to get a worker on the line are not unusual. On Thursdays and Fridays, the waits range between five to seven minutes.
The clearinghouse employs about 140 workers, most of whom earn between $12 and $14.50 an hour.
According to health policy authority officials, much of the backlog is due to increasing numbers of families turning to HealthWave after one or both parents lost their jobs. Also compounding the problems were stricter federal requirements for proof-of-citizenship, cuts in state funding and the fact that Policy Solutions Inc. in January took over from a previous contractor. That transition also caused some delays.
Plans for eliminating the backlog include several “simplification policies” aimed at streamlining the process and cutting down on the number of hard-copy forms.
Policy Solutions hired an additional 23 workers in October to help clear up the backlog.
Three legislators took part in the tour:
• Sen. Kelly Kultala, D-Kanas City;
• Rep. Bob Bethell, R-Alden;
• Sen. Laura Kelly, D-Topeka.
“The volume is remarkable,” Kelly said. “I’ll be glad to see passive renewal take effect. I think it makes a lot of sense.”
Bethell also welcomed the change but wondered why it wasn’t implemented earlier.
“I can see that a lot of work goes on here and that a lot of it’s repetitive – entering the same information more than once,” Bethell said.
“And I understand that we’re moving to a system that’s going to do away with a lot of that. But what I don’t understand is why we didn’t do this a long time ago. We’ve known about this for 18 months now.”
Health policy authority Executive Director Andy Allison said the change didn't happen earlier due to concerns that ineligible people might be enrolled in the program, driving up costs unnecessarily.
The agency, "was reluctant to make changes like passive renewal because they create the risk of driving up costs by enrolling people who may not actually meet the eligibility standards for Medicaid or CHIP,” Allison wrote in an email to KHI News Service. “Because simplifications can introduce error in the eligibility process I viewed this step as a last resort, especially in tight budgetary times. With passive renewal in place by December, I expect to see our progress in reducing the backlog accelerate as our enrollment and Medicaid costs increase.”
Child advocates said the change was long overdue.
“This is fabulous,” said Shannon Cotsoradis, chief executive at Kansas Action for Children. “Given what we know about the renewal process – that the vast majority of kids are eligible – this is a great opportunity for us to be making more effective use of our limited resources at the clearinghouse.”