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From YouTube: KY Health & Human Services Delivery System Task Force
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A
C
A
Present
we
do
have
a
quorum
to
conduct
business,
so
we
will
proceed
first.
Let
me
thank
your
one
for
your
willingness
to
serve
on
this
task
force.
This
is
the
inaugural
meeting,
but
in
a
sense
it's
not
inaugural
meeting,
because
the
continuation
in
the
work
we
did
in
2022
with
our
task
force
for
reorganization
of
Health
and
Family
Services.
A
That
task
force
was
a
result
of
Senate
concurrent
resolution
20.
and
the
work
for
that
committee
resulted
in
Senate,
Bill
48,
which
we're
going
to
cover
in
some
detail
today.
So
this
is
actually
a
continuation.
What
we
realized
last
year,
almost
to
the
inaugural
meeting
of
the
committee,
was
it
was
too
big
of
an
animal
to
take
on
it
in
one
interim
session.
A
Personally
thank
secretary
Freelander
for
his
willingness
to
cooperate
with
us
and
and
this
he
was
instrumental
in
our
last
task
force
session
in
providing
information
providing
these
people
to
make
them
available
to
us
in
the
wealth
of
information
they
have
provided.
Unfortunately,
you
new
members
are
not
going
to
be
privy
to
a
lot
of
that
information.
What
we
try
to
cover
in
the
session
last
year
was
focus
on
the
organization
itself
and
again,
possibly
we
want
to
provide
you
with
those
organizational
charts,
because
it's
a
it's
a
massive
Department,
that's
grown
over
many
many
years.
A
We
think
that
this
session,
this
task
force
here
in
the
interim,
will
focus
more
on
operational
issues
again
trying
to
provide
a
means
to
improve
how
the
services
are
delivered
within
that
particular
cabinet
and
with
that
again,
I
want
to
thank
each
and
every
one
of
you.
We
want
to
participate,
it's
going
to
be
like
drinking
from
a
fire
host
a
little
bit,
but
just
ask
you
to
be
impatient
with
us,
but
with
that
I'd
ask
you
to
take
a
look
at
the
organizational
task
force
final
report,
which
we
provided
to
you.
A
A
As
you
see,
the
first
recommendation
was
that
we
continue
the
task
force
through
interim
2023,
which
we
have
done
By
Appointment
of
this
task
force.
Second
recommendation
dealt
with
child
support
enforcement
program
and
we
recognize
there
was
quite
a
deficiency
there
in
trying
to
collect
those
funds.
So
if
Senate
Bill
48
calls
for
those
functions
to
be
moved
to
the
office
of
Attorney
General
with
a
very
extended
timeline,
it
won't
happen
until
January
of
2025
to
give
everyone
plenty
of
time
to
prepare.
For
this.
We
also
took
the
office
for
children
and
special
Health.
A
Recommendation
four
was
to
take
the
Family
Resource
Centers
and
voluntary
services,
or
serve
Kentucky
and
move
those
to
the
educational
labor
cabinet
through
intensive
lobbying
and
negotiation
and
discussion.
That
recommendation
was
not
included
in
the
final
passage
of
Senate
Bill
48,
but
it
is
something
I
think
we
need
to
take
a
look
at
once
again,
because
what
we're
attempting
to
do
is
align
responsibilities
with
accountabilities.
A
You
know
I,
think,
there's
a
good
argument
to
be
that
those
could
be
better
served
through
the
education
and
labor
cabinet,
but
again
point
for
discussion
later
the
office
of
budsman
administrative
review
in
the
office
of
Inspector
General.
We
had
a
lot
of
discussion
about
this
during
the
last
session
after
the
bill
had
already
been
filed,
and
the
final
decision
was
made
that
we
would
not
act
on
that
at
this
important
time.
So
that'll
be
another
point
of
discussion.
A
This
year,
Recreation
six
was
required:
apartment
for
Medicaid
services
and
Department
of
Asian
independent
living
in
dbhdid
to
identify
and
eliminate
redundancy
barriers.
That's
a
challenge.
That's
gone
to
the
secretary
to
give
us
a
report
in
December
of
this
year.
It
require
the
human
office
of
human
resource
management
to
work
with
the
Personnel
cabinet.
Do
the
device,
systemic
barriers
and
redundancies?
I'll
talk
about
this
just
a
little
bit.
A
We
have
some
problems
of
trying
to
get
any
people
on
board
on
a
timely
fashion
and
we
kind
of
have
secretary
for
a
better
one
of
a
better
description
and
almost
like
two
Personnel
cabinets.
We
have
the
Statewide,
but
then
we
have
that
function
within
the
cabinet
itself
and
there
is
some
redundancy
there
so
we're
looking
at
how?
Maybe
we
can
now
eliminate
that
redundancy
and
get
people
hired
quicker?
A
We
suggested
that
those
should
be
in
the
jurisdiction
of
dcbs
and
last
but
not
least,
is
that
because
of
the
growth
of
the
Medicaid
Program
and
demand
for
public
assistance
that
we
need
to
reevaluate
the
committee's
structure
of
our
general
assembly,
which
we
did
and
quite
truth,
I
think
that's
one
of
the
most
impactful
recommendations
that
we
made
you
folks
know
before
this
bill
was
passed.
We
had
a
committee
for
Health
and
Family
Services
in
the
house
in
the
Senate.
We
split
that
function.
A
Now
we
have
health
services
and
we
have
family
and
children's
services
and
part
of
the
problem
for
our
new
members
was
that
so
much
legislation
has
come
to
that
committee
because
you
expect,
since
this
is
our
biggest
cabinet,
this
is
also
one
of
the
biggest
committees
in
terms
of
responsibilities.
So
we
wanted
to
buy
those
functions
out
and
I
think
the
success
we
saw
in
the
last
legislative
session
was.
It
was
indicative
of
the
need
for
the
split
of
that
within
our
legislative
bodies.
It's
worked
very
well.
A
Quite
candidly,
I
think
that
the
issues
of
Children
and
Family
Services
had
a
tendency
to
take
a
back
seat
to
Health
Care
issues
and
that's
where
we
gave
our
primary
focus,
and
that
was
not
intentional,
not
just
the
nature
of
the
beast.
But
now,
since
we've
divided
those
issues,
I
think
it's
going
to
make
us
much
more
responsive
to
the
issues
that
we
face
with
that.
Unless
it's
very
brief,
but
are
there
any
questions
or
discussions
about
any
of
those
recommendations?.
A
It
I
don't
believe
so.
I
think
there
were
some
last
one.
Okay,
all
right,
I
was
hoping.
I
was
first
you're
still
special
to
us.
Oh.
D
Thank
you
so
just
a
brief
update
on
implementation
of
Senator
48,
the
the
reorgan
at
the
cabinet,
so
what
we've
done
is
is
we've
met
with
first
Mr
Duke,
general
counsel
and
Mr
Maddox
for
Attorney
General's
office
have
met
and
talked,
and
we've
had
pretty
good
discussion.
D
Obviously,
there
there's
for
lack
of
a
better
but
I'm
just
gonna
my
firm
grasp
for
the
obvious,
with
what
would
probably
be
within
the
Attorney
General's
office,
a
new
attorney
general.
They
wanted
to
make
sure
that
we
had
a
transition
book
that
was
written
with
everything
that
will
be
in
about
the
transition
on
child
support
enforcement
and
hearings
coming
out
of
the
ombudsman's
office.
So
we
we
had
started
talking
with
County
attorneys
a
little
bit
and
they
really
wanted
us
to
slow
down.
D
So
we
have-
and
it
makes
sense
and
so
we're
going
to
coordinate
with
them
as
we
move
forward
and
talk
about
that
that
transition
and
so
know
that
that
that
initial
discussion
has
occurred,
and
that's
that's
pretty
much
where
we
are
and
we've
agreed
that
we
will,
we
will
move
forward
in
lockstep
with
them
secretary.
A
Let
me
let
me
interject
just
briefly
just
to
kind
of
bring
the
other
members.
E
A
A
The
County
Attorney
Association
was
very
instrumental
in
getting
this
legislation.
Finally
passed,
they
actually
hadn't.
Did
his
study
I.
Think
it's
back
in
2015
about
this
particular
issue
had
recommended
that
those
functions
go
to
the
Attorney
General's
office,
but
they
wanted
to
make
sure
that
we
did
it
in
a
very
stepwise
fashion.
They
were
the
ones
originally
threw
out
the
date
of
I,
think
I,
said
January
warm
I,
believe
it's
July,
1
2025
and
the
reason
they
asked
for
that
extension
was
because
that's
when
the
contracts
with
County
attorneys
are
written.
A
D
Absolutely
and
the
number
of
employees,
just
the
raw
number
of
employers,
is
actually
as
big,
if
not
bigger
than
the
current
attorney
general's
office.
So
it's
a
big
deal.
It's
a
big
deal,
it's
a
very
complicated
program
around
child
support
and
collecting
child
support
right
now
through
the
county
attorney's
office.
D
So
it's
it's
a
complicated
program
and
a
big
program,
and
so
absolutely
we
need
to
take
our
time
and
make
sure
we
do
it
right
relative
to
there
was
an
office
of
the
Ombudsman
recommendation
that
many
of
those
functions
move
to
the
auditor's
office.
We've
also
had
a
sit
down
with
folks
from
the
auditor's
office,
including
the
the
deputy
auditor,
and
also
had
a
similar
discussion
about
more
in
depth
around
the
functions
of
the
ombudsman's
office.
D
What
What
In
the
bill
we're
talking
about
to
transfer
it.
It
was
I.
Guess
it's
not
funny,
but
we
were
talking
about
all
the
programs
at
the
cabinet
and
one
of
the
folks
from
the
auditor's
office
said:
what's
this
about
radiation
and
are
like
well,
you
know
we
do
do
some
regulation
of
radiation
and
radioactive
materials
as
they
come
through
and
as
a
part
of
the
cabinet
program.
D
Somebody
could
call
into
the
ombudsman's
office
and
and
and
have
concerns
so
I
think
that
to
your
earlier
Point
chairman
Meredith,
the
breadth
of
the
work,
that's
done
in
the
cabinet,
including
Public
Health,
sometimes
is
surprising.
So
again
we
sort
of
ended
up
in
the
same
spot,
where
we're
going
to
make
sure
we
have
good
transition
documents
written
so
that
nothing
gets
lost
in
in
any
transfer
that
may
or.
D
Beyond
that,
there
have
been
numerous
meetings
between
our
department
for
public
health
and
the
office
of
children
with
special
Health
Care
needs
in
terms
of
what
that
might
look
like
we're,
still
not
in
complete
agreement
about
what
the
budget,
how
we
will
display
the
budget
in
the
next
budget
session
and
then
but
you'll
you'll,
see
we'll
we're
working
on
what
those
details
are.
We're
working
we're
going
to
begin
work
on
the
Personnel
crosswalk.
That
will
I
think,
because
some
of
that
reorg
language
is
interesting.
D
We'll
we'll
make
sure
that
we
present
that
that
rior
crosswalk
for
the
Attorney
General's
office
for
the
auditor's
office
and
then
internally
within
the
cabinet.
We
we
have
just
had
some
very,
very
even
more
initial
than
anything
else.
I've
described
between
Department
of
Aging
and
independent
living
and
our
dcbs
I
still
think
we'd
love
to
have
a
conversation.
But
we
started
that
discussion
around
what
that
would
look
like,
but
I'd
say
that's,
probably
the
the
the
least
full
conversation
we've
had.
D
If
I'm
being
straight,
we
we
have
started
some
of
the
work
and
some
of
the
other
recommendations
around
some
of
the
Medicaid
pieces
and
looking
at
what
that
might
look
like
and-
and
so
hopefully,
I'll
have
a
a
report
for
you
in
December,
and
we
can
go
through
some
of
that
when
we
get
to
the
to
the
legislative
piece
of
this
later
on
in
the
agenda
and
I'm
happy
to
take
any
questions.
C
Representative
Sarah
Stocker
Jefferson,
County,
District
34.,
clarifying
question
when
you
talked
about
child
support
payments
being
moved
over
to
the
attorney
general
office.
C
Is
that
just
do
those
payments
only
include
payments
from
one
biological
parent
to
another,
or
does
that
also
include
payments
that
biological
parents
might
be?
This
is
the
Assumption
I'm
under
that
biological
parents
if
they
have
lost
custody
of
their
children
and
they
are
in
foster
care
out
of
Home
Care
placement
that
they
are
being
billed
while
their
child
is
out
of
the
home
and
is
needing
to
pay
the
state
back
as
part
of
their
plan
to
get
their
child
back.
D
Know
and
I
don't
know
it's
okay
start
going
down
a
wrong
road.
Lisa
Dennis
is
going
to
come
up
here
and
correct
me,
which
is
why
I
have
everybody
here,
but
so
this
is
a
a
relatively
complex
piece
because
it
is
a
a
federal
piece.
D
So
court
ordered
child
support
if,
if
somebody
gets
in
arrears
or
or
any
kind
of
payment
for
children
right,
so
some
of
that
comes
to
us,
the
the
cabinet's
responsible
for
trying
to
figure
out
how
to
establish
paternity,
how
to
keep
up
and
and
sometimes
transfer
those
payments
from
from
non-custodial
parent
to
custodial
parent.
So,
yes,
all
of
that
occurs.
D
Oftentimes
people
get
in
arrears,
particularly
relative
to
the
population
served
through
through
child
support
enforcement,
and
that
can
cause
all
sorts
of
challenges,
particularly
people
as
they
re-enter
from.
If
they
happen
to
be
incarcerated,
it
might
be
why
they
were
incarcerated
it.
There
are
lots
of
levels
of
complexity
to
this.
Our
collections
are
are
behind
and
so
the
challenges
of
performance
of
different
county
attorney's
offices
that
all
of
this
comes
to
play,
and
so
it's
a
it's
a
hunger
answer.
D
A
Just
a
brief
comment
about
that.
You
know:
we've
made
a
Much
Ado
About
the
fact
that
1.4
billion
dollars
in
the
rear
and
just
like
to
caution
our
task
force
members
just
bear
in
mind.
That's
a
number.
What
we're
looking
at
is
to
improve
upon
that.
We
think
there's
opportunity
how
much
we
can
improve
I,
don't
think
anyone
can
speculate,
but
we
have
120
counties
and
each
one
has
different
situations
and
the
ability
to
protect
or
to
collect
these
payments
are
different
in
Jefferson
County
than
they
are
Estill,
County
Kentucky.
A
So
it's
a
challenge,
but
we
think
about
moving
it
to
the
Attorney
General's
office
will
be
a
better
communication
between
the
attorney
general
and
the
County
local
County
attorneys
and
possibly
what
we've
seen
in
the
past.
So
it's
established
just
trying
to
make
a
situation
better,
but
appreciate
that
exactly
you
know
the
questions
comments.
E
Thank
you,
Mr
chairman,
and
thank
you
secretary
for
being
here
today
appreciate
all
the
work
that
you
do
and
your
Communications
with
us
just
a
couple.
Quick
questions
with
that
transition
to
the
Attorney
General's
office,
with
the
child
support
I
know
that
initially
there
was
some
plans
on
on
making
some
changes
to
the
current
system.
Since
this
change
is
taking
place
and
this
move
is
taking
place
so
have
those
changes
been
put
on
hold
until
that
gets
moved
over
there.
D
The
system
is,
what's
called
a
green
screen
system,
it
is
a
Dos
based
system.
We
basically
have
to
go
to
retirement
communities
to
find
programmers
and
I'm
I'm,
not
I'm
a
little
funny,
but
I'm
not
really
funny.
It
is
the
back
end
of
the
old
unemployment
system,
so
we
feel
like
we
have
to
move
forward.
D
Any
system
that
will
will
move
towards
will
move
from
that
green
screen.
Dos
based
system
into
just
something
that
that
is
is
more
modern
and
so
I
think
I,
don't
think
we'll
do
anything
that
would
make
it
any
more.
Actually
I
think
what
it'll
do
is
make
it
easier
for
the
Attorney
General's
office
to
take
it
over
they're,
really
it's
ex
it's
expensive
being
on
the
Mainframe
from
a
cot
perspective,
and
so
I
I
really
think.
D
If
there's
data
transition
and
migration
issues,
it
might
be
good
for
us
to
try
to
deal
with
them.
So
so
we
are
still
trying
to
move
forward.
We
just
we
think
it's
the
right
decision
and
we
think
it'll
actually
be
helpful
for
transitions,
so
that
somebody
doesn't
have
to
try
to
transition
and
data
migrate.
All
at
the
same
time,
from
A
system
that
nobody
knows
how
to
write
code
for
anymore.
E
E
Okay
and
then
I
guess
I've
got
one
last
question,
so
how?
How
are
you
planning
for
the
impact
of
existing
mousse
with
business
partners
during
that
transition?.
A
F
D
So
this
next
presentation
is
really
about
the
impact
of
the
end
of
the
public
health
emergency.
We'll
we'll
go
through
some
slides,
there's
already
one
that's
changed,
but
we'll
explain
that
as
we
go
and
some
of
the
challenges
we're
seeing
as
we
move
forward.
So,
let's
begin
the
first
is
just
sort
of
a
representation
of
Medicaid
enrollment
over
the
years.
You
can
look
at
really.
This
is
basically
over
the
public
health
emergency.
You
can
see
a
pretty
big
dip
around
June,
June
and
July
of
20
21.
Isn't
that
right?
D
Okay
and
it's
when
we
really
stopped
the
major
presumptive
eligibility
piece
and
so
you'll
see
what
what
happened
there
was
we
just
we
rolled
presumptive
eligibility
folks
off,
primarily
so
the
ones
that
we
had
signed
up,
we
rolled
them
all
off
and
and
since
then
I
think,
we've
got
about
500.
D
We
had
gone
up
to
to
like
our
120
000
during
the
during
the
teeth
of
the
pandemic,
and
then
we
we
backed
that
off,
really
where
we
really
felt
we
were
coming
out
and
so
that
what
you
see
there
is
really
sort
of
just
the
the
hospital
presumptive
eligibility
and
Nursing
Facility
presumptive
eligibility,
and
that's
why
the
numbers
so
low
this.
This
is
a
caseload
distribution
and
at
least
I'm
going
to
let
you
talk
a
little
bit
about
this,
but
but
you
see
these
caseload
distribution
counts.
D
You're,
gonna,
see
in
that
may
number.
That's
one
number.
Your
slide's
got
another
number.
My
slide
has
another
number.
These
numbers
are
are
all
if
I
can
say
just
fluid.
D
These
are
projections,
as
we
run
our
systems
so
know
that
what
I'm
going
to
talk
about
today
is
today's
number:
that's
probably
going
to
change
as
it
goes
forward,
but
I
just
I
just
wanted
to
let
you
know
you'll
see
they're
all
within
range,
but
they're
all
a
little
bit
different
and
that's
just
kind
of
how
how
this
how
this
process
is
going
to
work
so
I
just
I,
want
to
say
that
up
front
and
and
you'll
see
as
we
move
forward
Lisa.
So.
F
Typically,
during
traditional
Medicaid
operations,
individuals
have
to
renew
their
eligibility
every
year.
They
have
to
do
a
recertification
packet
during
the
public
health
emergency.
In
order
for
us
to
receive
that
additional
6.2
percent
increase
in
our
funding,
we
could
not
disenroll
anyone
from
the
Medicaid
Program
beginning
in
April.
We
started
renewing
individuals
that
annual
recertification
period,
so
we
took
all
of
our
cases
and
we
have
12
months
now
to
get
individuals
recertified
in
that
year
period,
so
we
have
taken
all
of
our
cases
and
because
we
had
not
recertified
individuals.
F
During
the
past
three
years,
our
caseload
for
eligibility
workers
have
increased
by
about
20
percent,
so
the
caseload
distribution
count
that
you
see
on
this
slide
represent
about
a
20
percent
increase
in
workload
for
our
workers
and
as
we
go
forward
as
we
get
to
the
end
of
the
public
health
emergency
in
cases
are
recertified.
Those
caseloads
will
be
going
down.
D
So
typically
Medicaid
recertifies
folks
on
an
annual
basis.
We
had
several
years
where
we
didn't
so
we
now
have
case
workers
and
dcbs
who've,
never
done
a
Medicaid
recertification,
and
we
we
so
this
is
this
is
when
Lisa
says
it's
a
20
increase.
It
really
is
over
what
they've
been
doing
around
snap
and
child
care
and
tana
all
of
those
similar
kinds
of
programs.
So
this
just
gives
you
an
idea
of
the
number
per
month,
we're
essentially
re-enrolling
a
big
piece
of
Medicaid.
D
Okay,
this
is
the
one
right
all
right
and
you
all
have
a
copy
of
the
new
slide.
Hopefully
good
good.
Thank
you.
D
So
in
the
end
it
was
about
74,
000
renewals,
and
we
we
really
the
number
of
folks
who
were
reapproved
for
Medicaid
right
and
that's
those
who
have
applied
gone
through
the
entire
RFI
process
got
their
information
in
or
we
were
able
to
do.
Some
passive
enrollment
is
really
about
50
percent.
So
of
that,
well,
a
little
more
than
that,
but
of
that
of
that
74
000
we've
had
about
43
approved
43
000
approved
for
Medicaid.
So
that's
we
were
expecting
that
to
be
higher
I'll.
D
Just
be
frank:
we
thought
that
was
going
to
be
a
higher
number.
It
just
hasn't
been,
and
so
we
think
about
34
000
at
this
point
in
time
are,
are
going
to
be
terminated,
but
there's
another
about
6
000
that
are
eligible
for
qualified
health
plan.
On
the
exchange
we
don't
have.
The
number
of
that
group
that
is
signed
up
you'll
see.
D
We
shifted
that
data
I
thought
it
was
more
clear
on
this
slide
to
show
you
how
many
folks
actually
have
not
re-enrolled
or
are
not
eligible
to
be
enrolled
in
Medicaid,
and
that's
that
34
000
number
that's
about
46
percent,
so
I
just
I
want
to
be
clear,
they're
eligible
for
other
health
care,
but
they
may
or
may
not
sign
up
for
that
Health
Care.
They
know
they're
eligible.
D
We
get
them
with
a
connector
or
an
agent
to
be
able
to
sign
up,
but
it's
it's
not
Medicaid,
there's
going
to
be
a
cost
in
in
many
cases.
So
we
don't
know
that
number.
Yet
that's
one
of
the
numbers
that's
going
to
change
basically
every
day,
particularly
if
we
were
able
to
figure
out
how
many
of
these
folks
actually
signed
up
for
a
qualified,
Health,
Plan
you'll
see
we
have
like
about.
D
If
you
combine
a
couple
of
the
numbers
about
110
folks
who
wish
we
still
have
to
process,
but
that
was
as
of
last
Friday.
That
number
has
probably
changed.
There
are
about
another
2600
where
we
have
rfis
out,
meaning
we've
asked
them,
they
sent
something
in
and
we
needed
more
information.
So
we
sent
it
out.
D
We're
probably
going
to
have
to
give
you
a
couple
of
months
before
we
have
a
really
at
least
better
handle
on
it,
but
I
didn't
we
have
these
preliminary
numbers.
Please
take
them
as
preliminary
because
they
change
from
this
morning
to
be
frank
with
you,
so
it
these
are
just
this
is
this
is
going
to
be
close
right.
D
These
are
but
I
I
think
once
we
end
this
month,
you're
going
to
see
that
that
will
be.
We
won't
be
too
we'll
be
a
few
percentage
points
here
and
there,
but
but
we'll
be
really
close
to
this,
and
then
what
will
happen
and
what
I'm
afraid
is
going
to
happen
is
some
of
those
folks
who
dropped
off
are
going
to
go
to
the
pharmacist
they're
going
to
go,
see
their
doctor
they're
going
to
find
out.
D
They
don't
have
coverage
and
they're
going
to
re-sign
on,
and
we
saw
this
with
a
snap
when
we
started
doing
recertification.
What
happens
is
folks
will
drop
off
then
they'll
come
back
on
and
and
unfortunately,
these
first
several
months
and
we've
tried
to
be
really
clear
about
how
we
communicate
the
Managed.
Care
organizations
are
reaching
out,
the
hospitals
are
reaching
out
we're
reaching
out.
We've
had
the
experience
of
reaching
out
to
folks
who
said
stop
calling
me
too
many
people
are
calling
me
about
signing
up.
D
D
The
reason
we
have
about
110
is
everybody
kind
of
that
last
week
started
to
give
us
information
and
and
so
kind
of
swamped
us
a
little
bit
just
to
be
frank,
but
we've
really
I
mean
to
have
just
a
hundred
out
of
you
know,
thousands
and
thousands
and
thousands
that
we're
working
on
it's
not
great,
but
we're
learning
as
we
go
and-
and
we
are
that's
what
and
we'll
tell
you
what
we're
learning
as
we
go,
we're
going
to
see
who
signs
up
for
qualified
Health
Plans,
we're
gonna
see
if
we
can
figure
out
private
coverage,
we're
gonna
we're
gonna,
try
to
figure
out
where
we
are
in
terms
of
signing
Folks
up.
D
B
F
Thank
you.
The
secretary
touched
on
this
just
a
little
bit
on
the
previous
slide.
We
talked
about
passive
and
active
renewals.
Passive
renewals
simply
means
that
we
have
enough
information
in
our
system
or
we
have
enough
data
sources
that
we
can
determine
an
individual
remains
eligible
and
that
individual
does
not
have
to
take
any
action.
F
We
look,
for
example,
if
someone
starts
an
application
or
starts
to
logs
onto
our
connect
system,
that's
our
eligibility
in
enrollment
system.
If
they
log
on
to
connect
to
start
an
application
or
to
try
to
upload
their
information,
they
don't
complete
that
process.
We
give
them
a
little
nudge.
A
nudge
is
just
something
to
say:
Hey.
You
started
this
application
in,
but
you
didn't
finish
it.
We,
you
want
to
go
ahead
and
finish
it.
We
also
have
sent
out
alert
messages.
F
Just
saying
hey
it's
time
for
you
to
renew,
we
have
made
791
alert
calls
and
you
can
see
the
almost
17
000
nudges
that
we've
done
that
we
have
completed.
So
we
have
the
just
the
number
of
applications
that
we
have
send
out
the
renewal
notices.
This
is
just
to
engage
our
members
to
make
sure
that
they
respond
to
us
and
one
of
the
other
reasons
that
we
do.
D
And
you
all
know,
you
don't
often
hear
me
being
complicated
complimentary
of
our
mcos,
but
in
this
case
they
have
really
been
aggressive
about
reaching
out
working
with
their
providers
to
try
to
get
folks
signed
up
and
it's
it's.
It's
been
a
challenge.
F
F
Typically,
a
provider
enrolled
in
the
Medicaid
Program
has
to
revalidate
their
information,
no
no
less
than
every
five
years
or
so
so.
During
the
public
health
emergency,
we
did
suspend
those
those
provider.
Revalidations
will
now
have
to
be
completed.
We
are
no
longer
using
unlicensed
facility
as
alternative
locations.
Of
course,
that
was
a
flexibility
that
early
on
in
the
public
health
emergency.
We
thought
we
may
need
some
facilities
to
accommodate
overflow
of
individuals.
In
case
we
had
a
huge
increase
or
a
huge
surge
in
covid
individuals
who
needed
to
be
treated.
F
We
did
give
hospitals
a
20
add-on
for
their
diagnosis,
related
related
grouper
code,
that's
just
20
percent
add-on
to
their
payments
for
any
patient.
That
was
coveted,
19
positive
or
had
a
diagnosis
that
also
went
away.
May
11th,
our
Nursing
Facility
270
per
diem
add-on
also
for
covid
positive
patients
that
ended
on
May,
11th
and
the
second
presumptive
eligibility
period
in
a
calendar
year
also
ended
some
things
that
we're
extending
as
long-term
Long-Term
Care
Resource
disregard
during
the
public
health
emergency.
F
We
we
disregarded
some
in
resources
for
individuals
who
are
in
long-term
care
facilities
to
help
facilitate
their
application.
We
do
go
back
and
recheck
those
resources
later,
but
we
make
sure
that
individuals
who
are
in
long-term
care
facilities
can
get
their
eligibility
determined.
We
also
are
taking
implementing
our
90-day
period
for
individuals
to
file
an
appeal
and
for
the
state
to
make
a
decision
prior
to
the
public
health
emergency
that
was
60
days.
Telephone
Telehealth,
Audio,
Only,
We
Are.
Remaining,
we
are
keeping
that
in
place.
However,
non-hippo
platforms
have
been
extended
only
through
August.
F
F
Typically,
if
an
individual
disenrolls
or
does
exits
the
Medicaid
Program,
when
they
re-enroll
they
can,
we
will
assign
them
to
a
new
Managed
Care
Organization.
If
they
do
not
choose
one,
we
will
now
allow
120
days
for
them
to
re-enroll.
We
will
automatically
re-enroll
them
in
the
last
Managed
Care
Organization.
They
were
in
when
they
exit
the
program
some
permanently
implemented
flexibilities
include
our
nurses
aid
application.
Instead
of
using
a
social
security
number
or
requiring
a
social
security
number,
we
will
use
their
I-9
and
expansions
of
Telehealth
outlined
in
our
regulation.
F
So
in
during
the
public
health
emergency,
the
department,
as
all
state,
a
all-state
Medicaid
agencies,
received
an
enhanced
Federal
match.
We
call
this
our
F
map,
so
we
received
that
during
the
public
health
emergency
as
part
of
the
unwinding
Medicaid
directors
were
very
concerned.
That
elimination
of
the
public,
health,
emergency
or
termination
of
the
public
health
emergency
would
result
in
a
huge
fiscal
impact.
If
that
Federal
match
just
completely
went
away
on
the
day
that
the
public
health
emergency
ended.
F
So
this
just
tells
you
how,
where
how
we
will
be
transitioning
that
fmap
phase
down,
we
do
have
some
criteria
that
we
have
to
abide
by
in
order
to
get
that
enhanced
fmap
through
through
December
31st
of
2023,
which
is,
we
cannot
have
any
eligibility
guidelines
that
are
more
stringent
than
we're
in
place
before
the
public
health
emergency.
F
D
F
A
Let
me
start
if
I
could
you've
done
an
excellent
job,
as
always,
but
I'm
trying
to
figure
out
what
Medicaid
looks
like
in
the
future.
You
know
my
first
session
was
2017.
D
D
So
I
think
it's
going
to
take
time
for
us
to
to
realize
that,
because
the
number
of
folks
on
Medicaid
and
what
that
fmap,
that
those
impacts
go
like
this,
and
so
we're
really
struggling
with
figuring
out
how
to
give
you
an
accurate
projection.
It
is.
B
D
A
All
right,
I'm,
just
trying
to
figure
out
you
know
where
we're
going.
You
would
think
with
supposedly
the
largest
economic
expansion
we've
seen
in
in
this
state's
history.
A
We
would
see
more
people
within
the
private
sector
getting
their
insurance
and
that's
not
coming
to
a
fruition
at
this
point
in
time
and
is,
is
the
issue
is
that
these
are
jobs
that
aren't
providing
Health
and
Care
benefits
or
or
we're
not
getting
people
back
to
work
as
we
anticipated
or
is
Healthcare
just
so
expensive
that
people
have
no
other
alternative
at
this
point
in
time,.
D
It's
like
I,
say
these:
these,
these
numbers
are
surprising.
It
and
so
I'm.
Asking
the
same
question
to
you.
Just
asked
me
who,
on
this
transition
to
Private
health
insurance,
and
how
can
we
figure
that
out
or
can
we
figure
it
out?
How
many
folks,
who
are
eligible
for
the
qualified
Health
Plan,
have
actually
gone
on
ahead
and
signed
up
or
are
they
waiting
to
find
out
that
they
don't
have
any
and
that
this
is
their
only
option?
D
I
think
we're
going
to
see
some
of
that
I
can't
tell
you
how
much
so
most
people
on
Medicaid
well,
most
of
the
folks
on
the
expansion
piece
of
Medicaid
have
jobs
that
are
not
paying
them
enough
right
in
order
for
them
not
to
receive
Medicaid
or
they
have
a
number
of
children
that
makes
them
eligible
and
certainly
can
show
you,
those
numbers
I
think
we've
talked
about
it
before
so
so.
There's
that
piece
as
well
and
then
in
terms
of
increased
spending
by
Medicaid.
D
There
are
places
where
we
have
I
think
done,
a
great
job,
which
is
in
the
hospital
outpatient
program
and
hospital
inpatient
program
pay
an
average
commercial
rate.
The
hospital
is
paying
the
the
difference
in
the
general
fund
cost,
but
that's
that's
been
a
chunky.
D
Expansion
I
think
once
we
add
out
the
patient
and
inpatient
together
for
a
full
year,
I'll
bet
we
get
over
two
billion
dollars
flowing
to
our
hospitals,
which
keeps
the
small
ones
open
and
the
rural
ones
open
and
particularly
outpatient's,
going
to
make
that
the
outpatient,
a
trip
is
going
to
make
a
big
difference
there.
So,
as
we
have
discussed,
if,
if
somebody
and
I've
talked
to
other
provider
groups
about
this,
if
folks
want
to
provide
us,
the
general
fund
match,
so
it
doesn't
hit
the
general
fund
of
the
taxpayer
right.
D
Let's,
let's,
let's
figure
out
how
to
do
that.
Also
within
I
guess
it
was
my
first
session
back
was
the
Senate
bill
50,
the
single
PBM
we've
seen
some
savings
from
that.
So
it's.
D
A
Discussions
on
this
I
know
with
budget
reviews
coming
up
that
you
folks
will
be
testifying
numerous
times.
We
may
not
have
this
opportunity
to
go
into
details.
We
did
in
the
past
because
we
don't
have
Medicaid
oversight
any
longer.
We
may
have
to
do
within
Health
Services
committee
meeting,
but
that's
wonder
you
know:
are
there?
Are
there
any
goals
and
is
a
reasonable
goal
as
to
wherever
it
should
be
in
terms
of
the
health
of
our
population?
You
know
we
talked
in
in
nauseam
about.
We
were
47
forever
and
now
we're
I
think
around
44..
A
That's
still
nothing
to
brag
about
I
think
that's
the
direct
result
of
people
having
access
to
insurance
that
they
haven't
had
before,
but
we're
really
not
moving
that
needle
a
whole
lot.
Additionally,
getting
people
off
of
Medicaid
into
game
for
employment.
Do
we
have
any
Targets
for
that
because
you
know
taking
sick
people
is
not
a
good
economic
model
right
it
just
it
may
create
jobs,
but
there's
a
cost
associated
with
that.
So
again,
I
think
to
sustain
the
program
in
the
future.
A
D
The
the
two
pieces-
I'll
I'll
talk
about
and
commissioner,
that
you
can
chime
in
one
of
the
things
that
is
also
excited
about
that
a
trip
piece
right,
sorry
to
abbreviate.
The
additional
payments
to
hospitals
is
there's
a
quality
piece
to
that
and
I
talked
with
the
hospital
Association.
They
are
excited
about
how
how
quality
is
working?
I
I
really
want
to
well
before
now,
but
I
think
it
would
be
wise
to
bring
folks
together.
D
Fqhcs
I'll
put
this
to
you
all
fqhcs
hospitals
mcos
together
who
should
should
have
the
same
goals
of
getting
people
healthier
and
now
we
have
funded
right
in
hospitals
and
there's
certainly
more
funding
that
can
be
done,
but
within
the
hospital
structure,
a
quality
piece
that
I
hope
moves
us
forward.
I
think
in
in
terms
of
Medicaid
enrollment
numbers
we're
going
to
see
what
this.
What
unwind
us
to.