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HomeMy WebLinkAboutMINUTES - 05242005 - PR1 Contra TO: BOARD OF SUPERVISORS Costa FROM. John Cullen, Director icCountyEmployment and Human Serves ent DATE: April 19,2005 Kit SUBJECT: RECOGNIZE and ACKNOWLEDGE the Health Insurance Counseling and Advocacy Program(HICAP) and ACCEPT a 2005 Acts of Caring Award from the National Association of Counties SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDED ACTION_ 1. RECOGNIZE the work of HICAP volunteers who provided free individual Medicare and health insurance consultation to 2,454 residents, 66 educational presentations, and documented savings of $231,961 for clients in 2004. 2. ACKNOWLEDGE HICAP as a valuable service ensuring that seniors and the disabled have access to health care. 3. ACKNOWLEDGE that there is no more appropriate time than May,National Older American's Month, to recognize HICAP's valuable services to County residents. 4. ACCEPT the National Association of Counties Acts of Caring Award. CONTINUED ON ATTACHMENT: X YES SIGNATURE: ►ZRECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE L---' PPROVE OTHER r SIGNATURE(S):q4;., go�!�, ACTION OF BO ON 01q APPROVED AS RECOMMENDED OT ER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ��'� ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED A(q, G�* xz"o � JOHN SWT EN,CL&K OF THE BOARD OF SUPERVI RS AND COUNTY ADMINISTRATOR Contact: Mid ...MIMI, cc: EHSD(CONTRACTS UNIT)-TM COUNTY ADMINISTRATOR BY DEPUTY LL ...............ol INTERNAL OPERATIONS COMMITTEE STAFF NACo 2005 Acts of Caring Awards Health Insurance Counseling and Advocacy Program (HICAP) Employment & Human Services Department Contra Costa County, .California January 2005 NACo 2005 Acts- of Caring Awards Health Insurance Counseling and Advocacy Program (HICAP) Employment & Human Services Department Contra Costa County, California What is the "Tbe day that I got an appointrnent to talk to nature of the you was one of the best days ofmylife. Ifeltas though program? Iliad hit a brick wall..." "Out of desperation we called your agency for Help....77iere are no words that can express our feeling ofreliefand appreciation For all the work that HICAP did for us." The Health Insurance Counseling and Advocacy Program (HICAP) of Contra Costa County received these words of appreciation from clients for successfully appealing an HMO's denial of payment of$49,000 for a hospital stay, for getting a company to reinstate health insurance for a retired employee widi Alzheimer's, and for getting Medicare to pay for two denied ambulance bills. Since its inception in 1983, HICAP Volunteer Counselors have been dedicated to seeing that seniors and the disabled receive access to health care. HICAP volunteers provide free individual.consultation to Medicare beneficiaries. 'Ilie volunteer healdi.insurance counselors help seniors widi the following concerns: ■ Understanding Medicare ■ Choosing insurance to supplement Medicare 1 ■ Appealing denials of health care and payment for care ■ Deciding whether to purchase long-term care insurance ■ Preventing insurance fraud and abuse The program benefits seniors and younger, disabled Medicare beneficiaries who are denied care or are confused by complex regulations and changing policies. HICAP clients are given information to make wise choices in obtaining medical care and prescription drugs. Counselors meet with clients in 20 locations throughout the county and travel to the homes of clients who are disabled. Translation services are available without charge. NVhat are the In the past year, twenty-six HICAP Counselors basic statistics of the provided individual assistance to 2,454 people. In program? addition, HICAP offered sixty-six educational presentations attended by a total of 2,218 county residents. Counselors documented financial savings totaling$231,961 for clients due to HICAP's efforts in recovering payment for medical claims and in the cancellation of duplicative insurance policies. HICAP counselors provided 2,622 hours of volunteer service. At a value of$20 per hour, this professional level of service is worth$54,440. Two full-time staff and one half-tune staff are paid by the county to provide the training, supervision and recognition of the volunteers,to handle complex, difficult cases, and to manage program administration. HICAP staff reviews every case and meets with the volunteers monthly. . . .... .... .. ... ... ........ ............... .. ......... The total budget for the HICAP program for the past fiscal year was $184,037. Additional in-kind support carne from counseling site locations that provided room use and scheduled counseling appointments. NVhat role do Tlie county administration supports the HICAP county leaders play in volunteers by providing direction and encouragement. enhancing Tlie county sponsors several recognition events each year or facilitating the volunteer to honor the volunteers with special awards. HICAP leas received the program? "Contra Costa County Government Volunteer Program of the Year" award and was lionored at a special reception by the Chair of the Board of Supervisors. County leaders provide opportunities for HICAP to work- with other county organizations to address changes in the health care system to benefit seniors as well as for HICAP staff and volunteers to receive training to update their knowledge. For example, HICAP worked with the County Advisory Council on Aging to address the overcharging of Medi-Cal beneficiaries for the cost of prescription drugs. Recently, the County Training Unit assisted HICAP staff in presenting a seminar on"The New Medicare Law." Seventy-four providers of aging services attended the training. How has the HICAP is responsible for seniors receiving program had a physical therapy that was threatened with termination, significant, positive impact for seniors being able to remain in a hospital when faced on your community? with premature release, for seniors getting access to free prescription drugs that they couldn't otherwise afford, and for seniors getting their HMO to pay for emergency out-of-area care that had been denied. These are a few examples of the impact of the volunteers. I s Wien a Medicare HMO decided in the fall of 2001 to terminate services to ten thousand seniors in Contra Costa County, HICAP responded with a major educational campaign to notify residents of their rights and choices for continued health care. During the three-month crisis, HICAP received 3,445 related calls for assistance. HICAP gave presentations to 3,500 people, which is one-Hurd of those affected. HICAP counselors also prevent insurance fraud. In Contra Costa County, counselors found seven clients who were victims of financial abuse totaling more than $40,000 by one insurance agent. The agent sold duplicate and nonexistent policies and overcharged for premiums. What makes the HICAP is innovative and unique because it uses program innovative and the collective skills and creativity of the volunteers and unique? N'Vhy should the staff to respond to the needs presented by the 1, program by recognized as an community. For example, one volunteer found that the special rights "Act of Caring?" of the Medicare population with end-stage-renal-disease are complex. She researched the options for this special population and prepared a consumer handout on leer findings. Another volunteer developed a comparison chart of the premiums charged by companies offering Medicare Supplemental Insurance in Contra Costa County. She found vast differences in the prices charged by companies for the same products and wanted consumers to have this information. The volunteers are tireless in getting Medicare beneficiaries the health care they deserve and to which they are entitled. Many spend hours negotiating with HMO service representatives and case managers and the staff of medical offices to obtain needed care. The counselors also write many letters for clients to appeal denials of payment for such things as wheelchairs or ambulance trips. • , Contra Costa HICAP attributes the longevity of the commitments made by its volunteers to its use of counselors in all aspects of service. In addition to the traditional counseling role, the volunteers are utilized as conununity educators, as mentors for new counselors, as trainers at the monthly training updates, as reviewers of client cases, as research assistants, as representatives at community organizations,and as specialists in various areas of health insurance regulations. Volunteers are expected to function as professionals. Our Congresswoman, Ellen Tauscher,wrote to the volunteers, "I know that you have seen firsthand the difficulties that one can encounter when faced with illness. HICAP has been a fabulous resource for so many people struggling to make sense of their health care options. I know that HICAP has had a significant impact on the lives of many seniors and their families. It is with great confidence that my-office has referred many constituents to the HICAP Program for assistance. How can other Contra Costa HICAP is happy to provide communities replicate the inforination to other communities. HICAP staff has project? What obstacles might . presented the model it developed for the utilization of �4 others encounter :F volunteer skills at state conferences. Staff recently in replication? described the workshops it developed for facilitating access to Medicare's $600 prescription drug credit at the California Association of Area Agencies on Aging Conference. Contra Costa HICAP has a unique, interactive training program for new counselors, which has been replicated with success.