Georgia Department of Community Health House Rural Development

Georgia Department of Community Health House Rural Development Council Bainbridge, GA - July 20, 2017 Andrew Johnson, Deputy Commissioner

Mission The Georgia Department of Community Health We will provide Georgians with access to affordable, quality health care through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia. 1

DCH Overview • Approx. $14. 5 billion dollars (combined Fed/State) • Nearly 1, 000 employees 2

DCH Programs and Enterprise Support • Programs – Medicaid – State Health Benefit Plan – Health Facility Regulation – Health Information Technology – Health Planning (CON) – State Office of Rural Health • Enterprise Support – Financial Management – Human Resources – Strategic Management/Vendor Management – Information Technology – Communications/ Legislative Affairs 3

State Health Benefit Plan • Jeff Rickman, Chief • 650, 000 covered lives – State Agency Employees – Public School Teachers – State Retirees • Over 800 payroll locations • Telemedicine benefit • Virtual Visit benefit 4

State Office of Rural Health (SORH) • • • Patsy Whaley, Executive Director Located in Cordele, GA Grants Administration Technical Assistance Facilitates Rural Hospital Stabilization Committee 5

SORH Grant Awards 2016 -2017 • FQHC Development and Expansion Grants • School-based Telehealth Center Grant • Rural Hospital External Peer Review Network Grant • Rural Swing Bed Grant • Rural Hospital Board Education Grant • Rural Behavioral Health Environmental Scan Grant 6

Medicaid • Two million Georgians enrolled in Medicaid – Aged, Blind, and Disabled (ABD) • Approx. 500, 000 – Low-income Medicaid (LIM) • Approx. 1, 400, 000 – Peach. Care for Kids • Approx. 128, 000 *100% Federally funded 7

Basic Medicaid Eligibility Individuals may become eligible for Medicaid if their income is low and they match one of the following descriptions: • Pregnant • Child or teenager under age 19 • Legally blind • Have a disability • Need nursing home care 8

Presumptive Eligibility Medicaid • Temporary, expedited enrollment process at the point of service • Requires basic information such as income and household size • Qualified Hospitals (47 participating hospitals) • Qualified Providers • 22 trainings in 2017 9

Presumptive Eligibility Medicaid • Authorized by the Affordable Care Act • Hospitals who meet the requirements of participation will be given the opportunity to become Qualified Hospitals (QH) by completing Presumptive Eligibility (PE) Medicaid training requirements • Has not been disqualified by DCH 10

Presumptive Eligibility Qualified Hospitals • A Qualified Hospital (QH) is a hospital that: – Participates as a Georgia Medicaid Provider – Notifies DCH of its election to make PE determinations – Agrees to make PE determinations consistent with DCH’s policies and procedures – Assists individuals in completing and submitting the full Medicaid Healthcare Coverage application and understanding any documentation 11

Right From the Start Medical Assistance Group • Located in all 159 counties • Located in Dept. of Human Services (DHS) Division of Family and Children Services (DFCS) offices throughout Georgia • Enrollment for Medicaid and related programs, such as Long Term Care, Katie Beckett, and Planning for Healthy Babies (P 4 HB) • RSM staff can conduct outreach events to assist with enrollments • Apply online at https: //gateway. ga. gov/ 12

Children’s Mental Health • Governor Deal appointed Commission • DCH reviewing Medicaid Fee-for-Service and Managed Care processes and services • Partnerships with Dept. of Behavioral Health and Developmental Disabilities, Dept. of Public Health, DFCS • Renewed focus on quality outcomes 13

Challenges and Opportunities • Workforce • Access • Medicaid Provider Application Process 14