Weeks before Obamacare marketplace launch, race is on to train navigators

1 | Health Reform

CORRECTION APPENDED

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Kansas City-area safety net officials met in the spring to talk about helping individuals sign up for health insurance through the new marketplaces established by the Affordable Care Act. The federal government recently awarded "navigator" grants to organizations that will help people sign up for health coverage through the exchanges.

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KANSAS CITY, Mo. - With open enrollment scheduled to start in about five weeks, the race is on to train workers to help residents around the region obtain health insurance through marketplaces established under the federal health reform law commonly referred to as Obamacare.

“Are we running fast? Absolutely,” said Cathy Harding, executive director of the Kansas Association for the Medically Underserved (KAMU). “I don’t feel like we are scrambling.”

KAMU, which is leading a consortium that is expected to deploy about 250 workers or “navigators” around the state, was recently awarded a grant of more than $520,000 by the U.S. Department of Health and Human Services. Harding said the navigators are expected to assist about 48,000 people.

Among the groups Harding said KAMU expects to work with in the Kansas City area are the Community Health Council of Wyandotte County and El Centro.

On the Missouri side of the Kansas City metro area, Shepherd’s Center Central in Midtown is part of another navigator consortium. The Shepherd’s Center serves middle age and older adults.

And officials at the Mid-America Regional Council said they expect to be involved on both sides of the state line through its Regional Health Care Initiative and its Department of Aging Services.

“The main thing all of us want is for a good job of enrollment to be done,” said Scott Lakin, director of the health care initiative.

In many cases, according to officials involved with the efforts in Missouri and Kansas, navigators will be specially trained staff members already working at social service agencies. But, officials said, the navigator teams also could include librarian or other community volunteers with ready access to the public.

The Affordable Care Act requires navigators to complete 20 to 30 hours of online training and pass a test before starting work.

A new state law in Missouri also requires navigators in that state to be certified by the state Department of Insurance.

The health reform law calls for the insurance marketplaces — sometimes called exchanges — to begin accepting enrollment applications Oct. 1 for coverage effective Jan. 1.

Under the law, families and individuals with household income between 100 percent and 400 percent of the federal poverty level will be eligible for subsidized premiums through the exchanges.

For individuals, according to the administration’s health reform website, that means they can have a household income of up to $45,960. For a family of four, the upper threshold is $94,200.

According to the Kaiser Family Foundation, approximately 44 percent of the Missouri adults that fall roughly within the subsidy parameters are uninsured; in Kansas, that figure is 36 percent.

HHS recently awarded $67 million in navigator grants to 105 organizations around the country

KAMU was one of three Kansas groups splitting about $890,000. About 60 percent of the funding went to the KAMU consortium.

The federal government awarded two navigator grants in Missouri totaling about $1.8 million.

The money was awarded to Primaris Healthcare Business Solutions in Columbia and the Missouri Association of Area Agencies on Aging in Jefferson City.

According HHS officials, Primaris is leading a coalition of 11 health care and social services organizations. Primaris has been a federal health services contractor for 30 years, offering free counseling on Medicare prescription drug and Medicare Advantage plans.

Founded in 1973, the alliance of aging agencies includes 10 organizations serving various regions throughout the state.

Jeremy Milarsky, navigator program manager for Primaris, said the consortium would deploy 55 navigators. And the plan calls for the Shepherd’s Center to have one full-time and one part-time navigator, he said.

He said the Primaris consortium would cover more than 80 percent of the state in areas that include about 630,000 currently uninsured people.

Details about how Primaris will work with the aging agencies and how its navigators will comply with state certification requirements remain under discussion, Milarsky said.

The Missouri Foundation for Health, through its Cover Missouri initiative, was scheduled to hold a day-long enrollment summit in Columbia today.

The Department of Insurance last week posted a licensing handbook for navigator testing.

It costs $41 to take the test in addition to the $25 application fee for individuals. Advance reservations are required.

According to the department, the testing sites in the Kansas City area are:

Harding at KAMU and Milarsky said they had been fielding phone calls from organizations hoping to collaborate with them.

A spokeswoman for the HHS Kansas City regional office said the agency also was talking with local government officials and groups about aiding the enrollment effort.

Nonprofit officials said they have also had discussions with health care foundations to see how philanthropy might play a role in signing people up through the marketplaces.

To a certain extent, Harding said, the playing field is shifting as the game moves along.

“Just as with any new program,” she said, “there will be adjustments and changes as we move forward and we learn … and until we have the absolute best approach and the best tools that we can.”

CORRECTION:An earlier version of this story failed to state the number of navigators that would be deployed by the consortium led by Primaris. The group plans to field 55 navigators, according to program manager Jeremy Milarsky.



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