Arkansas Works Overview

Transcription

1 1 Arkansas Works Overview Mary Franklin, BA DHS Director of County Operations

2 Arkansas Works 2.0 New Elements 2 Elements of Arkansas Works 2.0: Actions to Implement: Cap Eligibility at 100% FPL Cap eligibility at 100% of the federal poverty level (FPL) rather than 138% FPL. Those between 100 and 138% FPL without affordable employersponsored insurance will then be eligible for federallysubsidized private coverage Establish a Work Requirement This would be similar to other federal assistance programs, such as SNAP Arkansas Law & CMS 1115 Waiver Arkansas Law & CMS 1115 Waiver Strengthen Employer-Sponsored Insurance Directs a study and analysis to develop recommendations for programs to help small employers offer more affordable health insurance coverage for employees Give Arkansas the option to be an Assessment State Return control to the state by ending the requirement that the federal government be allowed to determine the eligibility of Medicaid and Arkansas Works applicants Arkansas Law Arkansas Law & Notification to CMS

3 3 Cap Eligibility for Arkansas Works at 100% FPL

4 Arkansas Works Enrollee Count September 25, Eligibility Classification Based on Federal Poverty Level (FPL) Number of Enrollees Arkansas Works Over 100% FPL Eligibility Arkansas Works Under 100% FPL Eligibility 61, , ,946 Below 100% FPL Total 302,624 61, % FPL

5 Arkansas Works Above 100% FPL Transition 5 FFM Account Transfer AFMC Medically Frail and other Fee for Service AR Works clients FFM / Healthcare.gov Medicaid (traditional) Renewals Run 12/28/17 1/1/18 Client Receives Notice Carriers Brokers Direct Enrollment Carriers receive alert in weekly file beginning 10/1/17 AR Works Medicaid is closed Coverage ends 2/28/18 Eligible for health coverage to continue with no loss in cost share FFM / Healthcare.gov Clients who go on their own

6 Arkansas Works Above 100% FPL Phase In Once waiver approval is received from CMS, Arkansas Works eligibility will be capped at 100% FPL 6 Change will be phased in, not all at once Phase-in schedule will be revised when waiver is approved

7 7 Establish a Work Requirement

8 Arkansas Works Populations and Work Requirement 8 Arkansas Works enrollees will fall into three categories for work requirement Not Subject to Work Requirement Subject to Work Requirement 1 2 Exempt 3 Enrollees age 50 or older Work requirement does not apply during the month in which the enrollee turns 50 Not at risk for losing Medicaid coverage Enrollees age 19 49* Meet an exemption not required to report work activities Not at risk for losing Medicaid coverage Required to Report Work Activities Enrollees age 19 49* Do not meet an exemption Will lose Medicaid coverage at the end of the third month of non-compliance *Work Requirement will not apply to enrollees ages in 2018, but will apply in future years

9 2 Exemptions Subject to Work Requirement Exempt Enrollees age Meet an exemption not required to report work activities Not at risk for losing Medicaid coverage Information collection for catastrophic events to be handled on a case-by-base basis Criteria State Verifies Information Currently receiving a SNAP exemption Validation Approach Validated against state data every 30 days 9 Identify at Application or using State data? Receiving TEA Cash Assistance Validated against state data every 30 days Y Arkansas Works Application, Portal, or Change in Circumstance Submission Employed >80 hours/month Demonstration (income >AR min wage x 80/month) valid until renewal or change in circumstance Medically frail Demonstration valid until change in circumstance Y Living in home with dependent minor Demonstration valid until change in circumstance Pregnancy Demonstration valid until end of post-partum care Y Caring for incapacitated person Short-term incapacitation Participation in alcohol or drug treatment program Full-time education, job training, or vocational training Receiving unemployment benefits State to verify demonstrations for a sample of enrollees Demonstration required every 2 months or at renewal, whichever is sooner Demonstration required every 2 months or at renewal, whichever is sooner Demonstration required every 2 months or at renewal, whichever is sooner Demonstration required every 6 months or at renewal, whichever is sooner Demonstration required every 6 months or at renewal, whichever is sooner Y Y Y N (report on portal only) N (report on portal only) N (report on portal only) N (report on portal only) Y

10 Work Activities 10 3 Subject to Work Requirement Required to Report Work Activities Enrollees age Do not meet an exemption Will lose Medicaid coverage at the end of the third month of non-compliance Criteria Validation Approach Arkansas Works Application, Portal, or Change in Circumstance Submission Work <80 hours/month Education (less than full time) Job training (WIOA, refugee, etc.) (less than full time) Vocational training (less than full time) Volunteer Job search/job search training Demonstrate monthly Demonstrate monthly Demonstrate monthly Demonstrate monthly Demonstrate monthly Demonstrate monthly; must be less than 50% of reported hours each month Health education class Demonstrate monthly; cannot count for more than 20 hours per year Currently meeting SNAP work requirement Demonstrate monthly Currently participating in DWS job assistance activities Demonstrate monthly Information collection for catastrophic events to be handled on a case-by-base basis State to verify demonstrations for a sample of enrollees

11 AR Works Population 11 Current AR Works Population <100% FPL, years old Exempt 59,183 Required to report work activities 39,659 Total 98,842 Data Date: 9/25/2017

12 Exemptions and Work Activities 12 Client Applies Some exemption information is collected during application Exempt? No Client must log on to portal and report an exemption or work activities* Exempt? No Did client log sufficient work activity on portal? Case closes at the end No of the third month of noncompliance Yes Yes Yes Client receives approval notice with exemption information; no additional action is required for duration of exemption Client receives notice with exemption information; no additional action is required for duration of exemption Case remains open *Clients receive an interim period between their coverage start date and required compliance with the work requirement for Arkansas Works (e.g., clients who are approved in February must comply with the work requirement starting April 1)

13 13 DWS

14 Work Requirement Education Process 14 Client is years old and eligible for AR Works Some exemption information is collected during application Exempt? Yes N o Client receives approval notice with information about reporting work activities* AFMC conducts outreach activities to: Educate the client about the work requirement and reporting on the portal Connect the client to resources for meeting the work requirement Dept. of Workforce Services SNAP E&T Client-directed (on their own) Client receives approval notice with exemption information; no additional action is required for duration of exemption *Clients receive an interim period between their coverage start date and required compliance with the work requirement for Arkansas Works (e.g., clients who are approved in February must comply with the work requirement starting April 1)

15 2018 Work Requirement Phase In 15 Existing AR Works clients (<100% FPL, years old) will also be phased in to the work requirement once waiver approval is received, the schedule will be revised. Notices All existing AR Works clients below 100% FPL and between will receive a notice with information about the upcoming work requirement once waiver approval is received. Clients will receive a notice the month before they become subject to the work requirement in 2018

16 16 Communication Plan

17 AR Works 2.0 Work Requirement Communications Plan 17 Key Elements: Goal To ensure AR Works recipients who are required to report work activities: Know about the work requirement Take action to meet the requirements Retain their coverage Partners Private insurance carriers that offer coverage to AR Works enrollees DWS AFMC (provider engagement and enrollee engagement) Messages Don t lose your coverage Report any changes and update your status It s easy to do Job training is available Your health is important Actions: Communications Planning Committee On-going meetings with insurance carriers, AFMC, DHS, DWS Direct Correspondence Mail notices to notify enrollees about the new requirement; notices sent after enrollees fail to report work activity the first month and every month thereafter Social Media Websites, Facebook, Twitter of DHS and carriers Print and Collateral Materials Posters in county offices, flyers

18 18 Resource Map for Arkansas Works Participants

19 Arkansas Works Resource Map 19 DHS is collaborating with AFMC, Insurance Carriers, and various training providers to build a resource map unique to each county where Arkansas Works recipients reside. DCO has interacted with the leaders of local county offices in the Department of Field Operations to obtain up to date information in several categories: v Employment resources by county v Volunteer resources by county v Education/training resources by county v Quality of life resources by county v Medical providers v Homeless shelters v Food pantries v Substance abuse treatment centers v Community corrections transition houses v Other helpful local agencies

20 Arkansas Works Resource Map Example 20

21 Arkansas Works Resource Map Example 21

22 Arkansas Works Resource Map Next Steps 22 DHS is going to revise the resource map during October with the following updates from local agencies. Dental providers Public transportation Public housing SNAP E&T contractors Short narrative summary for each county indicating that top hiring industry, the top employers and most recently published labor surplus rates. DHS is currently working to have the resource map hosted on a public facing website as well as be attached to the citizen portal.

23 23 Rules Promulgation

24 Arkansas Works Promulgation Schedule 24 The Arkansas Works 2.0 policy was sent to the Governor s office for approval on September 8. It was returned with his approval on September 13. We are currently in the Public Comment period for the policy. The comment period started September 14 and will end on October 13. A Public Hearing was held on September 27 at the Central Arkansas Main Library. There were no members of the public in attendance. The Arkansas Works 2.0 policy will be reviewed by the legislature during the November Public Health, Rules & Regulations and Legislative Review committee meetings.