HICAP presents LIS Strategies

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HICAP presents LIS Strategies

• The Health Insurance Counseling and Advocacy
  Program

Tatiana Fassieux, HICAP Program Manager Butte,
Colusa, Glenn, Plumas and Tehama Counties Anne
Kasper, HICAP Program Manager Riverside, San
Bernardino, Inyo and Mono Counties Margaret
Reilly, HICAP Program Manager El Dorado,
Placer, Nevada, Sacramento, San Joaquin,
Sierra, Sutter, Yolo and Yuba Counties Dori
Silveria, HICAP Program Manager Kings and
Tulare Counties
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L I S

• What is it?
• Why is it?
• Where is it needed?
• Can we get there from here???

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Background

• LIS Program is designed to help Low-income
  beneficiaries.
• Full or partial subsidies of premiums and
• Reductions in cost-sharing for the Medicare
  prescription drug plans
• Amounts in cost-sharing vary based on the income
  level and assets of the beneficiary.

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• Certain groups of low-income Medicare
  beneficiaries automatically qualify (are deemed
  eligible) for the LIS program.
• Full-benefit dual eligible individuals
• Medicare beneficiaries who are recipients of
• Supplemental Security Income benefits
  
• Participants in the Medicare Savings Programs
  (MSP)
• QMB - Qualified Medicare Beneficiaries, SLMB
  -Specified Low-Income Medicare Beneficiaries,
  QI - Qualifying Individuals

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• What about beneficiaries with low incomes and
  limited resources who do not fall into one of the
  automatic subsidy eligibility groups?
• That would be the targeted population CMS is
  trying to enroll
• with our help!

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• Congress asked that the Secretary (of Health
  Human Services) Leavitt shall report on best
  practices in the successful enrollment of
  low-income beneficiaries into the Medicare
  prescription drug benefit program (Part D).
• Which particular activities (outreach,
  partnerships, involvement of key organizations,
  or others) and at what level (federal, state,
  local) contribute to effectively enrolling and
  transitioning
• low income beneficiaries into Part D and the
  Low-Income Subsidy (LIS) program.

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Now that is a good question
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Whats in a name?
There is a reluctance to identify with the
Low Income label.

• Extra Help?
• Limited Income Subsidy?
• Extra Financial Help?

Would a rose by any other name still smell as
sweet?
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How does LIS work?

• Beneficiaries eligible for the full subsidy
  received 100 premium subsidy.
• For beneficiaries eligible for the partial
  subsidy, the law sets the sliding scale premium
  percentage (100-25)
• Cost sharing refers to the beneficiarys expenses
  (deductible and copayment or coinsurance) in the
  Part D plan, with the exception of the premium.
• Beneficiaries eligible for the full premium
  subsidy have no deductible or copayment amounts.

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How does LIS work?

• For beneficiaries eligible for the partial
  subsidy Deductible in 2009 is 60
  Coinsurance is 15.
• Copayment is a fixed dollar amount
• (2.40 for generic or preferred multiple source
• 6.00 for other drugs in 2009)
• Coinsurance is a percentage.

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Success Factors a k a Challenges and
Opportunities

• Identify and then locate - the target
  population
• Create appropriate messages
• Collaborate with CBOs and FBOs
• Facilitate Enrollment in LIS

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From the Inland Empire

• Target areas for outreach indicated as high on
  the zip code list for residents who are
  potentially eligible, but who havent yet
  applied.
• Target churches, organizations serving low-income
  clients (like public health clinics, nutrition
  sites, home-delivered meal programs, food banks).
• Do not discriminate make it a habit for
  counselors and outreach personnel to mention that
  extra help is available through Social Security
  if you fit into the guidelines.
•  Consider hiring volunteer counselor to follow up
  by phone with people given LIS info and an
  application during a counseling session. 
• After 6 to 8 weeks they would be contacted again
  to determine if they had gotten a reply about
  their eligibility.

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From the Capitol Region
Dedicated LIS On-Line Assistance 9-County
Outreach Effort began July 2008 limited
success
LIS mentioned in every Community Presentation

• New Counseling Session protocol
• Always ask income questions
• Make appropriate notations on Intake Form
• Follow-up with either
• Immediate on-line assistance,
• LIS packet, or
• Referral to central office for follow-up

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The University setting in combination with
vast rural areas

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• Beating the Bushes Campaign
• Phase 1 Design
• Have dedicated counselor for outreach and
  counseling
• Prepare unique flyers to target clients in
  non-traditional locations Laundromats, grocery
  stores, car washes, banks, homeless shelters,
  bars, beauty shops, etc.
• Identify partners
• Design data collection tools
• Different color intake
• Ask how client heard of us specifically, what
  outreach medium they say or heard

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• Phase 2 Outreach
• Mail outreach materials to partners
• Produce TV commercial to run during programs
  viewed by potential candidates
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• Phase 3 Data Collection
• Using existing reporting methodologies, track
  counselor and counseling time, number of intakes
  and outreach events accomplished with LIS/MSP
  funding.
• Evaluate results for future projects.

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Tools from Tulare

• Operating under the auspices of Tulare County
  Health and Human Services
• Affiliation opens doors
• Rural Service Area
• Health Fairs are important
• Churches
• Food Banks
• Mobile Home Parks

With surprising frequency, often this emphatic
comment is heard
Im not interested.
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COLLABORATION IS KEY

• Rely on Community-Based and Faith-Based
  Organizations to
• Implement Best Practices.
• CBOs and FBOs can
• Identify beneficiaries through Public Benefit
  Program lists.
• Identify and educate beneficiaries by reaching
  them during their daily activities.
• Provide insight into strategies most likely to
  work locally.
• Effectively tailor messages to their local
  communities.
• Time Community Outreach to coincide with
  activities already planned for specific
  beneficiary populations.

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The future is now

• The on-line LIS application (developed by SSA),
• Medicare Prescription Drug Plan Finder (developed
  by CMS),
• BenefitsCheckUp (developed by NCOA)
• The use of on-line application and plan-finder
  tools is impossible without a technological
  infrastructure, such as computers, Internet
  access, and printers.
• Technology investments are not one-time purchases
  but required regular funding to update and
  maintain.

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A chicken in every pot

• Still a good idea.
• But for effective enrollment in LIS
• A computer with internet access is mandatory.

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Our Goals

• Build collaborative partnerships that engage our
  mutual constituency
• Create a message to which our target audience
  can relate
• Enroll every eligible beneficiary, in every HICAP
  region, in the LIS program.

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The sweet smell of success
Can be found only with adequate planning and
collaboration