Agency Performance Oversight Hearing, Fiscal Year 2015, Department of Health Care Finance

We recently testified during the FY16 Performance Oversight hearing for the DC Department of Health Care Finance.  Read our full remarks here: 

Testimony of HyeSook Chung, Executive Director

DC Action for Children

Agency Performance Oversight Hearing

Fiscal Year 2015

Department of Health Care Finance

Before the Committee on Health and Human Services

Council of the District of Columbia

February 10, 2016

Good morning Councilmember Alexander and members of the Committee on Health and Human Services. Thank you for the opportunity to address the Council as it reviews the performance of the Department of Health Care Finance for Fiscal Year 2015. My name is HyeSook Chung, and I am the Executive Director of DC Action for Children.  

 

DC Action for Children (DC Action) provides data-based analysis and policy leadership on critical issues facing DC children and families, to promote policies and actions that optimize child and family well-being.

 

DC Action is the home of DC KIDS COUNT, which tracks key indicators of child well-being in the DC neighborhoods where children live, learn and grow. We work closely with city agencies, the school system and service providers to share the most accurate and timely data, along with clear and accessible analysis. Our advocacy agenda is based on these data.

 

The District of Columbia continues to be a leader in health coverage for children. The Department of Health Care Finance, under the leadership of Wayne Turnage, provides health insurance for over 98,000 children and youth through DC’s public insurance programs including Medicaid and the Children’s Health Insurance Program or CHIP.[1] This number represents approximately 70% of District residents ages 0 to 20.[2] Because of this, the agency plays a pivotal role in ensuring access to care and tracking utilization and health outcomes for the majority of DC children.

 

I have been a member of the DC Medical Care Advisory Committee (MCAC) and; serve alongside other advocacy organizations, Medicaid consumers, health care providers and other Medicaid stakeholders.[3] The MCAC provides support and guidance to DHCF on policies, rules and procedures related to the District’s Medicaid program. We thank Director Turnage and his staff for their collaboration and transparency in sharing data and information regarding enrollment and plan performance.

 

Department of Health Care Finance demonstrates a commitment to improving performance

 

In FY15, we saw DHCF illustrate a commitment to improving performance in multiple ways:

  • Enrollment in all health insurance programs serving children; 90% of children are in managed care programs.[4] Over the year, we saw total enrollment increase in Medicaid, CHIP, Health Services for Children with Special Needs (HSCSN) and the Immigrant Children’s programs. In total, these programs provided services to just over 98,000 children. Because of the District’s leadership and commitment to providing insurance coverage for children, only 2% of children are uninsured.[5] Furthermore, only 10% of children receive care of a fee-for-service basis. The 90% enrolled in managed care include children enrolled in the Immigrant Children’s Program (ICP). During FY15, the agency adjusted their application process for the ICP to enroll children in managed care to ensure that children had immediate access to care as soon as they are approved.
  • The agency implemented widespread training on EPSDT services. DHCF provided training to over 85% pediatric care providers on the depth and breadth of services covered through EPSDT/HealthCheck benefits.[6] With a 100% federal match for services, the District is able to provide children with access to comprehensive well-child visits that include medical, oral, and behavioral health care screenings. We are encouraged to see that the agency set a particular focus on EPSDT compliance rates for children in the fee-for-service program in their FY16 Performance Plan, which tends to include vulnerable subpopulations like children in the foster care system or children living in nursing homes/long-term care facilities.[7] Our Children’s Health Services Program in the District is very robust, but until all children can take full advantage of its various benefits, we will continue to see disparities in health outcomes. We commend the agency for their efforts to improve health outcomes by ensuring that providers are identified and well-trained to provide services.
  • DHCF implemented a passive renewal system to automatically renew coverage for eligible children and families. Through a data sharing agreement with the Department of Human Services, DHCF is able to identify children and families that maintain their Medicaid eligibility and renew their coverage automatically. This new system improved renewal rates and ensures that Medicaid participants maintain coverage. Although the passive renewal system is not perfect, DHCF continues to adapt to challenges with participants who cannot passively renew and it allows them to focus on obtaining information and renewal forms for a smaller number of individuals.

 

These accomplishments show that DHCF is committed to improving health services in the District. As the agency focuses more on care coordination and improving health outcomes, we hope they will engage the MCAC and other stakeholders in even more thoughtful and challenging discussions around access, utilization and improving health outcomes. For example, last year we discussed a potential opportunity to research Medicaid financing for case management through evidence-based home visiting programs. We are delighted that DHCF pursued an opportunity to learn more about this strategy and joined a national learning collaborative with nine other states. We hope to see the agency continue this type of leadership and commitment to improving children’s health and to embrace additional opportunities that leverage partnerships with other child-serving agencies in the District. We would be particularly interested to see innovation in early intervention and school health services that takes advantage of technology like telemedicine. We hope that DHCF will continue their role as a convener so the District can continue building the strength of the Medicaid program.

 

Thank you for the opportunity to testify today, Chair Alexander. I am happy to answer any questions that you may have.

 


[1] Centers of Medicare and Medicaid Services (2015). Annual EPSDT Participation Report CMS 416, District of Columbia

[2] Department of Health Care Finance (February 2014). Data Snapshot: The Role of Public Programs in Children’s Health Care Coverage in the District of Columbia. Accessed at: http://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/publication/attachments/Childrens%20coverage%20snapshot_021814%20%281%29.pdf

[4] Department of Health Care Finance (2016). Response to FY15 Performance Oversight Question 45.

[6] Department of Health Care Finance (2016). Response to FY15 Performance Oversight Question 19.

[7] Department of Health Care Finance (2016). Response to FY15 Performance Oversight Question 21.

 

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