Department of Health and Human Resources Story Archives - Page 16 of 16

Health care exchange begins enrollment in W.Va.

West Virginia’s Department of Health and Human Resources has been working for months to organize their federal-state partnered health insurance exchange beginning enrollment on October 1.

Likened to the travel website Expedia, the exchange will allow consumers to go online, compare plans from private insurance providers and choose the one that’s best for them, but the site will also determine your eligibility for coverage on state programs like Medicaid.
For the state of West Virginia, the passage of the federal Affordable Care Act meant new requirements, like establishing a health care exchange, but for consumers, Assistant Secretary for the state Department of Health and Human Resources Jeremiah Samples said the ACA means options. Options for insurance coverage and providers.

Those options, however, aren’t as abundant here as in many other states.

As West Virginians begin to navigate the healthcare exchange looking for insurance to cover themselves and their families, the plans they have to choose from will all come from one provider: Highmark Blue Cross Blue Shield.

“Private insurance companies made the decision to not proceed with offering coverage on the exchange and there’s a number of reasons for that. Our market is not very large so it’s not as attractive to many insurance companies, and there’s also challenges to the paradigm shift from the health insurance laws,” Samples said.

“That exposes insurance companies to risks that they’ve never had to deal with before and so there are a lot of challenges there that many insurance companies felt they were not in a position to precede.”

Samples said even though there is only one private insurance provider, Blue Cross Blue Shield will still provide a variety of plan options at different cost levels.

But some West Virginians will take a different path to coverage. Samples estimated more than 130,000 West Virginians will find through the exchange they are eligible for Medicaid.

The DHHR sent out eligibility letters to more than 118,00 of those West Virginians to allow them to enroll by simply checking a box to agree to the program and then mailing the form back in to the state.

“We already have about 45,000 folks that have sent those letters in,” Samples said. “That’s 45,000 people that didn’t have insurance before, 45,000 people that will not be coming in to the county office bogging down the systems using our resources. It will also be the most streamlined process by which that consumer can go through to have their eligibility determined.”

Those individuals became eligible for coverage when Governor Tomblin announced Medicaid’s expansion in May, covering individuals earning between 17 and 138 percent of the federal poverty level. Many of those are SNAP, more commonly known as food stamp, participants and parents whose children were already covered through the state.

But if you’re still not sure where you fall, whether you are eligible for Medicaid, or want to find an insurance plan to fit your budget, Samples said the process starts online at healthcare.gov, with a phone call to the federal call center, through a private insurance agent, or at your local DHHR county office.

“Each DHHR office will have an in-person assistor embedded into it. An in-person assistor will be trained on how to provide consumers information about private health insurance,” Samples said. “So, for example, if a consumer wants to know, what is a co-pay? What is co-insurance? What do these terms mean to me? Than that in-person assistor will be able to provide them with some support as they go through the exchange.”

Open enrollment through the health care exchange begins October 1 and ends March 31. Health insurance bought through the exchange goes into effect January 1.

The website to enroll is www.healthcare.gov.

DHHR Secretary stays focused on filling 600+ vacancies

In her first appearance before legislators, Department of Health and Human Resources Secretary Karen Bowling said the department is not yet prepared to release a detailed response to a performance review completed earlier this year. Instead, she shared some generalizations about major issues the department is trying to address. The biggest of those issues is hiring and retaining the necessary personnel to run the state’s largest agency.

Called a fragmented department with duplicative programs seeing little results and a lack of a strategic goal-setting vision, the performance review released in April of the Department of Health and Human Resources was less than positive.

Completed by Pennsylvania-based consulting firm Public Works, the report is still in review by the DHHR and its new secretary, Karen Bowling.

On the job since July 1, Bowling admitted she’s still trying to digest the 116 pages, but was called on by the Legislative Oversight Committee on Health and Human Resources Accountability for an update during interim meetings at the Capitol.

“I’m not sure that we would ever have enough hours to present 78 recommendations, but I think just the idea of just some of the most important points in that Public Works report,” Bowling said Monday, “I wanted to make sure I emphasized those and talked about those so everyone could understand the direction in which we were going.”

But moving any direction is proving to be a slow process for the state’s largest agency.

With more than 630 vacancies, Bowling said one of the department’s top priorities is trying to fill those positions. Public Works accounted those vacancies to an “unstable work environment,” which lead to a turnover rate of 30 percent and an additional $7 million in mandatory overtime pay last year.

“Part of the turnover rate and part of the vacancy rate and part of the overtime issues are not being able to fill the jobs quick enough. Part of it is getting qualified people into the jobs fast enough and getting them oriented and ready to go,” Bowling said.

“We, the DHHR, will have to work with other areas to make sure that we change the process to the extent that we can so we can move quicker on filling vacancies.”

So to address the problem, Bowling said the DHHR is beginning to work with the Department of Personnel and the Department of Administration to try to streamline the hiring process.

Senator Ron Stollings, the committee co-chair, said that high turnover rate comes down to those on the front lines—social workers in child protective services or other areas—being overworked and under paid.

“Unfortunately, we probably don’t pay these front line workers competitive salaries and we haven’t hired,” Stollings said. “There are so many vacancies so the ones that are working are working so hard and I’d say there’s a very early burn out. So when there’s something better that comes along in a private arena they leave.”

Aside from streamlining the hiring process, Bowling said they’re looking at other factors like mentor systems and managerial training to create a better work environment and reduce the turnover rate.

On other issues, however, Bowling responded with broader answers. She said the department isn’t prepared to talk specifics for many of the areas of the complex review until they complete an internal self-study.

That answer seemed to be acceptable for the committee and Bowling will return in December to present more concrete, specific examples of how the department is making changes.

There was one question, however, Bowling was prepared to take a stance on. A position brought up by Delegate Don Perdue, who serves as co-chair of the committee, to break the DHHR into separate entities, one dealing with human services, the other with Medicaid.

“That was one of two suggestions that have been made periodically over the last 16 years that I know of. Each time, each time the Department has said, no, we don’t want to cut it a part into health and human resources, we don’t want to take out Medicaid, we don’t want to do anything like that,” Perdue said during the meeting, “and yet, Madame Secretary, our statistics are not changing. They’re getting worse.”

“I am really concerned that if we continue to gather all these chicks into one nest, they are going to be some that suffer and that’s what’s happening now in my belief. I hope you can prove me wrong.”

Bowling said she believes she can. She stood behind her predecessors, but said the DHHR can be more successful than it is today under her leadership in the future. The Secretary said she can help the department achieve the outcomes Perdue wants to see.

“My belief is that actually further integration and breaking down silos. You know, bureaus can get stuck in silos and I think breaking those down will actually improve efficiencies and will give us a greater opportunity to make positive change in the state,” she said.

“My job will be to show statistically that I can make that happen through leadership and maybe through some changes in organizational structure and management and then maybe Chairman Perdue will see that change in years to come and agree with me.”

Most of those changes Bowling believes can be made internally without much legislative action needed, but Stollings said he stands firmly behind the department and is prepared to support any legislative action that may be necessary to help turn the DHHR around.

Integrated Behavorial Health Conference tackles drug abuse, other mental health issues

West Virginia’s substance abuse problem is one focus of the Integrated Behavioral Health Conference in Charleston this week. Professionals from health…

West Virginia’s substance abuse problem is one focus of the Integrated Behavioral Health Conference in Charleston this week. Professionals from health care, government and law enforcement are meeting to find the best ways to handle substance abuse and other mental health needs.

Department of Health and Human Resources Cabinet Secretary Karen Bowling said the idea of the conference began a couple years ago and that the goal is to combine resources in hopes of learning and progressing the field.

“Whether it’s medical professionals, policy makers, law enforcement –we all go at the idea of behavioral health services and substance abuse from a different angle. Bringing individuals together with expert speakers and continuing education credits and really making sure we’ve covered the full gamut of individuals who are dealing with our citizens who are in need of behavioral health services will help us think more collaboratively,” said Bowling.

Governor Earl Ray Tomblin outlined a few collaborative efforts to combat substance abuse in an opening keynote speech, which touched on regional drug task forces, prescription disposal centers, and the justice reinvestment act from this past legislative session. He also announced a $9 million grant from the Substance Abuse and Mental Health Services Administration that’s been awarded to the state.

“Over the course of five years these federal monies will help expand prevention services state-wide by focusing on prescription drug and alcohol abuse,” Tomblin explained

The Deputy Director of the White House Office of National Drug Control Policy, Michael Botticelli, participated in the opening panel discussion at the conference. He said the emphasis on prevention and other collaborative efforts can in some way be attributed to an evolution of perceptions surrounding substance abuse and addiction.

“I think under this Administration we’re really looked at and moved away from this 'War on Drugs' mentality and really focused this issue as a public health-related issue—acknowledging that substance abuse is a disease and that people can get treatment and do recover. One of the issues that is really important to us is how we make sure people are getting good care,” said Botticelli.

Clinical Assistant Professor of Marshall University’s Pharmacy School Brian Gallagher said getting quality care that combats substance abuse means all corners of the health care industry need to be involved, including pharmacists and pharmaceutical companies.

“Everybody has a component in this and I think the part in dealing with the pharmaceutical industry is that they’re recognizing that they don’t want their drugs taken off the market. They don’t want it to be so restrictive that the patients can’t get access to those drugs,” said Gallagher.

“We need to make sure we strike an appropriate balance: the patients who actually need the drugs are able to get them while we’re keeping them out of the hands of the people who abuse them. It’s striking that balance that’s important and working with the pharmaceutical industry and every body involved.”

Asked what type of costs might be associated with potential changes in policy, Secretary Bowling said the state will first look for other grant opportunities. But, she expects any spending in the short term will inevitably save the state money and hopefully will reduce health care costs for individuals.

“If we focus our attention on the right things for the people that we serve, in the long run it’s going to actually reduce costs to the system,” said Bowling.

“What we have to make sure we’re doing is thinking about the client in a holistic manner, that we are looking the physical and the behavioral aspect of care and making sure we’re doing the right thing, at the right place, at the right time.”

The West Virginia Department of Health and Human Resources is sponsoring the inaugural conference which runs through Thursday at the Charleston Civic Center.