Georgia Department of Community Health: Providing Quality Healthcare Services in Rural Georgia

Georgia Department of Community Health House Rural Development Council Bainbridge, GA - July 20, 2017 Andrew Johnson, Deputy Commissioner 0

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 Rural Hospital Stabilization Grant Numerous others 6

Medicaid Two million Georgians enrolled in Medicaid Aged, Blind, and Disabled (ABD) Approx. 500,000 Low-income Medicaid (LIM) Approx. 1,400,000 PeachCare 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 (P4HB) RSM staff can conduct outreach events to assist with enrollments Apply online at https://gateway.ga.gov/ 12

Childrens 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