April 24, 2017: DCPCA Testimony- DC Healthcare Alliance Program Recertification Simplification Amendment Act of 2017

Good morning, Chairperson Nadeau and distinguished members of the committee; my name is Patricia Quinn, Director of Strategy and External Affairs for the DC Primary Care Association (DCPCA).  DCPCA works to ensure that all residents of Washington, DC have the ability and opportunity to lead healthier lives – through increased health care coverage, expanded access, and high quality care. Our key partners in this effort include community?based safety net primary care providers and other key stakeholders who are committed to our mission of creating a health care system in the District of Columbia that allows for everyone to be covered and everyone to be cared for.  Today I am here to provide testimony on B22-194, the DC Healthcare Alliance Program Recertification Simplification Amendment Act of 2017 and share our recommendations.

First, I would like to thank you for your leadership and taking this powerful first step to address the issues that have long plagued consumers of the DC Healthcare Alliance program. Bill 22-194 addresses a chief obstacle for residents seeking to recertify for the Alliance program, which is that the office of ESA is not properly staffed to provide the language access services to ensure the re-enrollment process is a reasonable one for consumers.  In fact, the process is so onerous that too often; consumers decide to forgo recertification altogether; particularly if they feel they have no urgent medical need. 

Critics of this proposal have stated that the issues surrounding Alliance recertification have been addressed by embedding ESA staff at the two health centers with the largest Alliance populations. However, long lines at the ESA office persist, and there is still a significant population which fails to recertify in order to maintain their coverage. Another complaint is that by expanding the recertification authority, non-DC residents will be enrolled into this program. This bill as written only addresses the recertification process. If any non-District resident receives benefits, it would be due to policies not being addressed in this bill. Through the current process consumers face barriers of language and cultural competency which lead to barriers of communication, trust and time; none of these ensures the fidelity of the program for DC residents, nor otherwise increases the quality of the program.

Chairwoman Nadeau, as you know community health centers currently provide enrollment services for DC residents for Medicaid and qualified health plans within the DC Health Link portal. When health centers are asked to do their part and are provided the resources to do so, the results have been positive for the people of the District. We are proud of our part in making the District one of the jurisdictions with one of the highest rates of coverage in the nation.

To relieve disproportionate burdens on beneficiaries, streamline bureaucratic processes for multiple DC agencies, DCPCA would like to make the following additional recommendations for DC Healthcare Alliance recertification process:

1.Align with the application and recertification process for Medicaid. Meaning CHOs should be permitted to conduct recertification annually.

2.Consumers should have the option of renewing either in person at ESA offices, at community health organizations (CHO) i.e. through enrollment staff certified as in-person assisters), over the phone, or online via DC Health Link.

3.ESA should develop and implement a training program for enrollment agents which will educate them on the District’s desired process as well as all quality standards the state follows. This should include and escalation process to resolve application problems as they arise.

4.Community Health Organizations must be authorized to access appropriate systems/technology to complete the entire enrollment process rather than simply conducting the mandatory interview.

In closing, we want to highlight the role that in-person assisters play in getting residents across the finish line to enrollment in health care services. DCPCA and our health center partners have been privileged to provide support to hundreds of District residents—in times of general need or in crisis. Many people had almost given up hope that they could find any such help. We urge the Council to strongly support B22-194 with our recommendations as an investment in our collective effort to build a healthier DC.

We thank you for the opportunity to testify, and for your work and partnership. I am happy to answer any questions now or going forward.