2017-18 OHCA Tribal Partnership Action Plan

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


Past Tribal Partnership Action Plans:

  • 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.          

 

 

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 members have the ability to call
the SoonerCare helpline to request and receive an I/T/U same-day primary care provider change.

 

Inclusion of I/T/U 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.
           
           
Provider Network        OHCA and tribal partners to have increased
communication about the potential for I/T/U-specific
provider types 

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 
 
           
           
Health Services Models
 

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 
9/27/17: "4 walls" policy was approved by OHCA board.
           
           
Chronic Disease Management
 

Increase tribal member awareness of OHCA care management.

Establish a joint partnership between OHCA & tribal care management.


Convene tribal / OHCA care management workgroup

Tribal partners to respond to survey tool assessing chronic disease management services and needs in their community

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

Tribal partners to participate in consultation and provide timely feedback


 

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   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


Mike Van Pelt, General Manager, LogistiCare Solutions; tribal addendum located at www.okhca.org/tribalrelations
 
           
           
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


 
           
           
SoonerCare Aged, Blind, and Disabled (ABD) population transition to managed care model
  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   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); 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
 
           
           
Culturally appropriate outreach strategies     
 

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.


Meet with OHCA Office of Media & Design to develop handbook. Once finished will disseminate handbook to members.

 

Send FAQs to OHCA to help determine content. Once finished, handbook will be disseminated to members

OHCA administrative resources and tribal participation
 
           
           
OHCA engagement with tribal communities  

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 will be available to attend any tribal community activities as needed.

Tribes will invite OHCA to any community activities.


OHCA administrative resources
 
           
           
Tribal Medicaid administrative match     

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


Obtain the maximum participation from all partners for each reporting quarter (of those who have an active contract).

Provide increase promotion and technical assistance to all 39 tribal governments in Oklahoma.


Tribes will sign OK TMAM contract and submit timely & accurate invoices.

OHCA and tribal administrative resources  
           
           
ITU Provider Enrollment   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