2017-18 OHCA Tribal Partnership Action Plan

Topics identified by tribal partners at Oct. 17, 2017 Annual Tribal Consultation Meeting

 

Action Item:

Access to Care

Purpose:

Increased support for tribal health programs to address health care for tribal citizens.


Provide Feedback: If you would like to submit feedback on Access to Care, please click here.

 

 

 
Strategy
Conditions that favor success
 
  Objective
What does success look like? 
 
Activities
Who will contribute what? 
Resources Needed
Update

Freedom of Choice: SoonerCare PCP

Increase AI/ANs provider choice to include real-time selection of an ITU as a primary care provider (PCP).   

1. SoonerCare members have the ability to call the SoonerCare helpline to request and receive an ITU same-day primary care provider change.   

2. Inclusion of ITU primary care providers as an option for assignment in the SoonerCare enrollment application.
   

OHCA to modify internal processes that will allow SoonerCare members to choose
an I/T/U provider at any time. 

 

Tribal partners to continue assisting their patient census with
SoonerCare enrollment. 

OHCA to dedicate agency
resources (including IT and
administrative) and expenses
to modify current processes. 

 

Tribal partners to share and utilize
best practices for SoonerCare enrollment; and empower SoonerCare member’s freedom of choice by advising on the importance of PCP alignment. 

5/4/17: SoonerCare helpline is able to process same-day I/T/U PCP selection 

9/13/17: OHCA approved initial
plans & resources to modify the
online enrollment process to
allow for I/T/U PCP selection.


8/3/18: I/T/U PCP selection in real time with online enrollment

 

           
           

Provider Network: Grow OHCA provider network to increase culturally appropriate care.

1. OHCA and tribal partners to have increased communication about the potential for ITU specific provider types including Community Health Representatives, Public Health Nurses, Community Health Aides, etc.



 

OHCA to research non-traditional provider types and report findings from other state Medicaid programs.

Tribal partners to provide research and data about their provider types that are currently not recognized and reimbursed by OHCA.


OHCA and tribal partners to share information learned and communicate solutions for feasibility

Information from other state Medicaid programs with contracted Indian health programs 
OHCA has researched the option of a pharmacist provider type. Pharmacist is currently not a recognized provider type per CMS.

CHR and CHA provider types are being researched by OHCA.

Public Health Nurse services are allowable under the OHCA I/T/U policy.


           
           
Health Care Services Models:

Foster access for innovative service delivery models outside of the traditional clinical setting.

1. Increased and more efficient use of telehealth

2. OHCA to design a mechanism for allowable offsite services
 

Increased and more efficient use of telehealth

OHCA to design a mechanism for allowable offsite services




OHCA to consult with tribal partners, develop policy, and create contract provisions to allow for increased reimbursement for telehealth and offsite services provided by I/T/Us.

Tribal partners to respond to survey tool assessing tribal health service models in their community.

OHCA to utilize administrative agency resources;

Centers for Medicare and Medicaid Services (CMS) to offer guidance on policy

Tribal partners to participate in consultation and provide timely feedback 

1. 06/27/18: OHCA hosted telehealth training at Lawton IHS.    

2. 07/01/18: “4 Walls Policy” implemented.


           
           

Chronic Disease Management: Manage chronic disease in tribal communities through increased awareness of and collaboration with OHCA care management services.       

1. Increase tribal member awareness of OHCA care management.    

2. Establish a joint partnership between OHCA and tribal health chronic disease programs.


 

Increase tribal member awareness of OHCA care management.

Establish a joint partnership between OHCA & tribal care management.


OHCA to utilize administrative agency resources; OHCA Population Care Management team.   

Tribal partners to participate in consultation and provide timely feedback.

OHCA to utilize administrative agency resources; OHCA Population Care Management team.   

Tribal partners to participate in consultation and provide timely feedback.



1. OHCA population care management, has been an active member of the diabetes task force & tribal group.    

2. OHCA has identified at least one I/T/U provider for care management partnership to participate in a workgroup; meeting has not yet convened.

Action Item:

Elder Care

Purpose:

Create partnerships to successfully address the growing needs of the tribal elder population.       


Provide Feedback: If you would like to submit feedback on Elder Care, please click here.

 

 
Strategy
Conditions that favor success
  Objective
What does success look like? 
Activities
Who will contribute what? 
Resources Needed Update

Transportation: Successfully address the transportation needs in tribal communities and the tribal elder population. 

 

1. Increase from 1 to 4 the number of Tribal SoonerRide transportation provider contract agreements.  
  Increase from 1 to 4 the number of tribal SoonerRide transportation provider contract agreements.

OHCA to promote the SoonerRide benefit and offer facilitation between tribal partners and LogistiCare.      

Tribal partner(s) to complete and execute a SoonerRide transportation provider agreement with LogistiCare.
Tribal partners to contact LogistiCare Solutions to execute transportation provider contract and tribal addendum.  OHCA has visited with individual tribal partners in an effort to facilitate. There were no additional tribal agreements executed in SFY 2018.
           
           

Long-Term Care programs and services: Need for coordination of existing LTC and elder care services available to tribal communities.      

1. Increase from 0 to 2 the number of OHCA presentations to tribal partners focusing on long term care programs and services.
  Increase from 0 to 2 the number of OHCA presentations to tribal partners focusing on long-term care programs and services.

OHCA to create a tribal specific presentation and present to partners at appropriate venues.      

Tribal partners to share best practices and continued goals for the health care of tribal elders. 


 


OHCA to utilize administrative agency resources.    

Tribal partners; tribal elder care programs to show resources.



2/14/18 OHCA organized and hosted the first annual Elder Care Listening Session.

25 people attended; 7 tribes were represented.
           
           

SoonerCare Aged, Blind, and Disabled (ABD) population transition to managed care model: Inclusion of and consideration of tribal health care system upon design of state mandated model.       

Dependent upon funding.
  Dependent on funding
TBD TBD 6/14/17: RFP for SoonerHealth+ cancelled

Action Item:

SoonerCare Outreach, Education and Linkage

Purpose:

Effectively connect tribal communities to the SoonerCare program. 

Provide Feedback: If you would like to submit feedback on SoonerCare Outreach, Education and Linkage, please click here.

    

 

 
Strategy
Conditions that favor success 

  Objective
What does success look like?  

Activities
Who will contribute what?  

Resources Needed
Update

Uninsured tribal population: Decrease the number of uninsured adult AI/AN population through the Insure Oklahoma program.      

1. Increase from 0 to 1 a CMS approved 1115 waiver amendment for implementation of Insure Oklahoma Sponsor’s Choice. 
  Increase from 0 to 1 a CMS-approved 1115 waiver amendment for implementation of Insure Oklahoma Sponsor's Choice. OHCA in collaboration with the Oklahoma State Department of Health (OSDH); Centers for Medicare & Medicaid Services (CMS); and tribal partners to develop an implementation plan for the approved amendment. 

OHCA and OSDH administrative resources; tribal feedback and participation in workgroup activities; CMS guidance.


09/18 @NIHB; CMS tribal listening session, CMS stated the waiver was “still under review.”
           
           

Culturally appropriate outreach strategies: Create and implement new methods to increase information about the SoonerCare program to tribal communities.        

1. Increase from 0 to 1 the number of tribal specific SoonerCare member handbooks.   

2. Increase from 0 to 12 (monthly) TGR and tribal partner’s presence on OHCA social media platforms.
 

Increase from 0 to 1 the number of tribal-specific SoonerCare member handbooks.

Increase from 0 to 12 (monthly) TGR and tribal partners presence on OHCA social media platforms.


OHCA to develop and disseminate handbook to tribal partners.        

Tribal partners to send FAQs to OHCA, to help determine content. Once finished will disseminate handbook to members.

OHCA administrative resources, and

Tribal partner participation.

As of 08/13/18 Native American Medically Fragile brochure; anti-tobacco poster are available on the OHCA webpage.    

1. Due to consideration of resources available, a tribal handbook has not been created.      

2. OHCA has shared social media posts from tribal partners. 
           
           

OHCA engagement with tribal communities:

Increase participation among OHCA and partners to encourage open communication and information exchange.       

1. Increase from 11 to 15 the average number of tribal governments / organizations at OHCA bi monthly consultation.    

2. Increase by 20% the number of tribal community events attended by OHCA.
 

Increase from 11 to 15 the average number of tribal governments/organizations at OHCA bi-monthly consultation.

Increase by 20 percent the number of OHCA's representation in tribal communities.


OHCA to be available to attend tribal community activities as needed.    

Tribal partners will invite OHCA to community events.

OHCA administrative resources.

 

1. Tribal partner representation increased to 17.    

2. OHCA was represented at 15 tribal community events in SFY 17 and 10 in SFY 18; a decrease of 34%.

           
           

Tribal Medicaid Administrative Match: Support tribal SoonerCare outreach and linkage efforts.       

1. Increase from 11 to 15 the number of active TMAM partners.   

2. Obtain the maximum participation from all partners for each reporting quarter.  Of those who have an active contract.  
 


 

OHCA to provide increased promotion and technical assistance to all 39 tribal governments in Oklahoma.   

Tribes to execute OK TMAM agreements and submit timely & accurate invoices.

OHCA and tribal administrative resources. 

1. OHCA staff met with several potential TMAM contractors, including direct service tribes to discuss the program.  SFY 2018 increased from 11 to 12 active TMAM partners.       

2. 9 of 12 TMAM partners are submitting for every quarter of the state fiscal year.
           
           

ITU provider enrollment: Maintain the SoonerCare ITU provider network.

  Achieve 100 percent contracting for all Medicaid-recognized providers working at an ITU facility.

OHCA will offer onsite visits with individual tribes to discuss increased SoonerCare enrollment and revenue opportunities.

Tribal partners will host sessions and listen to suggestions on how to increase provider enrollment. Take action on suggested activities.

OHCA administrative resources.

In SFY 2018, the OHCA TGR and Provider Services teams conducted 23 ITU provider trainings and site visits; and presented 12 times at Southern Plains Tribal Health Board, Inter-Tribal Council of the Five Tribes, and THRICE meetings.
         

 

Action Plan Archive

  • To view the 2016 Tribal Partnership Action Plan, click here.    
  • To view the 2015 Tribal Partnership Action Plan, click here.   
  • To view the 2014 Tribal Partnership Action Plan, click here.