Covering Kids and Families Collaborative

1
Covering Kids and Families Collaborative

• Georgia

Addressing the issues of Medicaid ineligible
families transitioning to PeachCare for Kids and
newborns attaining and maintaining coverage from
birth through their first year by working with
eligibility workers, Dept. of Health, and local
hospitals.
Columbia County Dept. of Family and Children
Services Terry Greene
Georgia Dept. of Community Health Fran Ellington
Covering Kids and Families State and Augusta
Pilot Site Fran Yelton Robyn Freeh
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Goals

• Improve the transition from Medicaid to PeachCare
  for Kids
• Improve the time it takes to add newborn children
  to the Medicaid rolls.
• Improve the number of eligible children turning
  one year of age who remain covered by Medicaid or
  transition to PeachCare for Kids.

3
Changes Tested

• Completion of PeachCare for Kids application
  online by DFCS staff for all Medicaid ineligible
  children either at renewal or application.
• Staff trained on online process.
• Notification letters developed and tested.
• Ineligible children identified.
• Online applications completed (in test loads).
• Acceptance of PeachCare for Kids and Medicaid
  application information over the phone.
• Identified staff to accept phone calls.
• Advertised local phone number in community
  through Valentine and Pre-Kindergarten promotion.
• Monitored volume and source of calls.

4
Changes Tested

• Access actual practice of Presumptive Eligibility
  and Newborn Medicaid process.
• Interviewed Health Dept. and hospital staff.
• Mapped Process and compared to policy.
• Evaluated data to confirm stated process.
• Trained Health Dept. and hospital staff on
  desired process including provision of or
  elimination of new and/or unnecessary forms.
• Monitor use of new forms and transfer of data.
• Utilize information currently provided to DFCS
  concerning newborn births.
• Screen lists sent from state computer system as a
  result of hospital report of births to identify
  newborns.
• Input data in DFCS computer system as report of
  birth and residency status.
• Confirm case status in state computer system to
  transition newborn from temporary to ongoing
  status.

5
Results

• DFCS staff processing PeachCare for Kids online
  for all Medicaid ineligible children in 2
  caseloads.
• DFCS staff accepting applications over the phone.
• Health Dept. processing new applications and
  sharing correct policy information with clients

6
Results

• Hospitals reporting births, residency of newborn
  and pediatrician on state computer system and
  attempting to provide temporary Medicaid card
  prior to discharge.
• DFCS utilizing hospital birth report as
  notification of birth and converting from
  temporary to ongoing Medicaid case.

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Denials By Reason
8
Closed At Renewal
9
Closures By Reason
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Next Steps

• Complete testing related to retention of children
  turning one.
• Update Medicaid provider manual to clarify
  newborn procedures.
• Clarify newborn procedures for local eligibility
  offices.
• Make changes to PeachCare system to facilitate
  the transition from Medicaid to PeachCare.
• Do testing of provider selection fields in
  newborn process.