DEPARTMENT: Health
DEPARTMENT HEAD: Dr. Thomas L. Schlenker
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Agreement with The Centers for Medicare and Medicaid Services for Certified Application Counselor Designated Organization
SUMMARY:
This ordinance authorizes an agreement with The Centers for Medicare and Medicaid Services (CMS) to establish the San Antonio Metropolitan Health District (Metro Health) as a Certified Application Counselor Designated Organization (CDO) in the Texas Health Insurance Marketplace (Marketplace) for a one year term, with the option to renew for four, consecutive one-year periods, and authorizes the Director of Public Health to execute all necessary documents. This designation will also allow Metro Health to certify staff members to act as Certified Application Counselors to improve access to quality health care and services for the Healthy Start Initiative by providing assistance to pregnant moms and families within the San Antonio community applying for health coverage through the Marketplace.
BACKGROUND INFORMATION:
The Healthy Start Initiative aims to reduce disparities in infant mortality and adverse perinatal outcomes by: 1) improving women's health, 2) promoting quality services, 3) strengthening family resilience, 4) achieving collective impact, and 5) increasing accountability through quality improvement, performance monitoring, and evaluation. Healthy Start has a key role in strengthening families and creating the foundation for optimal infant and young child health and development, including early learning. The Healthy Start Initiative includes activities and components that will build a ladder of opportunity for all children and families. Healthy Start will be the first rung of that ladder beginning before, during, and after pregnancy and serving families for the first two years of a child's life.
Since 2008, the Healthy Start Initiative has reached over 40,000 individuals in the community through outreach, health education, and case management. On January 16, 2014, City Council authorized a grant application to the U.S. Department of Health and Human Services, Health Resources & Services Administration (HRSA). Metro Health's Healthy Start Program was awarded funding in an amount up to $9,700,000.00 for the period September 1, 2014 to May 31, 2019. This provides for an increase in the population served to include pregnant and postpartum women, children and fathers with a minimum of 1,000 participants annually.
ISSUE:
HRSA grant deliverables require program staff to bring awareness of affordable healthcare coverage options. As a CDO, Metro Health staff will participate in community-wide Affordable Care Act (ACA) marketplace enrollment fairs as well as refer Healthy Start participants who do not qualify for ACA coverage to Medicaid, Family Faith Clinics, and/or Federally Qualified Health Centers. Metro Health will continue to ensure that all community health worker staff complete any required training, and that they comply with privacy, security, and administrative policies while assisting those who are in need of health coverage and other social services.
ALTERNATIVES:
If this agreement is not authorized, Metro Health will develop an alternate plan to assist Healthy Start participants and families with applying for health coverage. This would include identifying and collaborating with an existing CDO and referring participants to Medicaid, Family Faith Clinics and/or Federally Qualified Health Centers to receive the needed assistance in applying for ACA health coverage.
FISCAL IMPACT:
There will be no impact to the General Fund.
RECOMMENDATION:
Metro Health recommends approval of an ordinance authorizing an agreement with The Centers for Medicare and Medicaid Services in order to become a Certified Application Counselor designated organization.