Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community...
Transcript of Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community...
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Provider & Partner Orientation
Bureau of Community Health Systems 1000 SW Jackson Street, Suite 340Topeka, KS 66612www.kdheks.govwww.ksfhp.org
Updated July 2018
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A copy of this PowerPoint can be found on the KSFHP website: www.ksfhp.org (Click on Provider Orientation)
Direct link to the PowerPoint:
http://www.kdheks.gov/olrh/download/KSFHP_Provider_Orientation.pdf
2MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Mission
Kansas Statewide Farmworker Health Program (KSFHP) works to provide comprehensive primary care services to address the unique health care needs of migrant and seasonal farmworkers and their families.
3MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Vision
Healthy, happy and productive farmworkers and dependents in Kansas.
4MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP FundingKSFHP is supported primarily through a grant to the Kansas Department of Health and Environment (KDHE) through the U.S. Health and Human Services, Bureau of Primary Health Care (BPHC). Since 1994 KSFHP has been a voucher/case manager model based on PIN 94-7- Migrant Health Voucher Guidance.
KSFHP is 1 of 18 voucher programs of the total 165 Migrant Health Centers (MHCs) in the nation. It is 1 of 3 statewide voucher programs.
5MISSION - To Protect and Improve the Health and Environment of all Kansans
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Definition of Agricultural Work
CROPS
Farms | Co-Ops | Nurseries | Orchards Greenhouses | Tree Farms | Cotton Gins
Agricultural Work Includes:
Aerial Dusting, Spraying on Farms, Harvesting, Cultivation, Pruning, Irrigating on Farms, Packing on Farms, Planting, Fertilizing on Farms, Farm Management Services, Operate Machinery, Cotton Ginning
6MISSION - To Protect and Improve the Health and Environment of all Kansans
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Definition of Agricultural Work (Cont’d)
ANIMALS
Aquaculture | Dairies | Feedlots | Ranches
Agricultural Work Includes:
Herding, Cleaning, Feeding, Milking, Transport, Boarding, Spraying, Reproductive Services
7MISSION - To Protect and Improve the Health and Environment of all Kansans
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Who is Eligible?1. Agricultural work within the last
two years making up a significant portion of a permanent job or as a full-time seasonal job.
- Self-employed Farmworkers can apply
- Retired and Disabled Farmworkers can apply
2. 200% of poverty and under
8MISSION - To Protect and Improve the Health and Environment of all Kansans
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Primary Care Services• Preventive and primary care visits—KSFHP will assist
with medical visits. A portion of prenatal care visits, labs and one sonogram are covered at Medicaid rate. Clients pay fee to providers at each visit.
• Mental Health—A visit for prevention, evaluation and/or treatment of a mental health issue or disorder, paid at Medicaid rate.
• Substance Abuse—A visit for alcohol or drug abuse services, including assessment and diagnosis, treatment or aftercare, paid at Medicaid rate.
• Dental—KSFHP covers 100% of dental services, up to a total of $300 per year per client. Each client is responsible for $10.00 fee per visit to be applied to his/her bill.
9MISSION - To Protect and Improve the Health and Environment of all Kansans
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Primary Care Services (Cont’d)
• Vision Care—A visit for a comprehensive eye exam performed for the purpose of early detection, care, treatment and prevention. Paid at Medicaid rate. Eyeglasses or corrective lenses are not paid by KSFHP.
• Pharmacy—Up to $150/year per person, up to $300 for people with diabetes and/or hypertension. Each voucher is limited to $50. Clients pay a $5 fee per prescription.
• Laboratory and X-Ray—Paid at Medicaid rate. All procedures over $150 must be preauthorized by regional case manager.
10MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Limitations
Program does not cover hospitalization, emergency room visits, or extensive diagnostic testing or treatment.
11MISSION - To Protect and Improve the Health and Environment of all Kansans
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Voucher Provider Infrastructure
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Type of Provider Amount
Primary Care (includescommunity health centers, other safety net clinics, rural health clinics and other private clinics)
238
Dental 85
Behavioral Health 28
Vision 68
Pharmacy 84
Laboratory & X-Ray 163
Specialists 125
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Voucher Procedures1. An eligible farmworker family fills out a registration at
an access point agency or through a Regional Case Manager or Health Promoter and receives vouchers for health visits there. (Access points are listed in KSFHP brochure.)
2. If the client has an appointment at the access point, the access point staff write up the voucher to accompany the appointment.
3. If the client has an appointment at a clinic other than an access point, at a hospital, or has a prescription to retrieve from the pharmacy, then the client takes the voucher with him/her to the health visit, hospital, or pharmacy. The provider returns a copy of the voucher along with their bill to the KSFHP for reimbursement.
13MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Voucher Procedures (Cont’d)
4. For specialized care, an access point or provider must call the Regional Case Manager assigned to their area for approval. (Case management regions are listed in KSFHP brochure.)
5. Farmworker funds are supplemental and are only available to pay for services not covered by any other private or public program for which the individual is eligible.
14MISSION - To Protect and Improve the Health and Environment of all Kansans
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TB Program Serviceshttp://www.kdheks.gov/olrh/FWTBOverview.htm
• Eligibility requires income of 200% of poverty or below, uninsured, and positive TB screening test—open to non-farmworkers.
• Program covers entire state with exception of Sedgwick, Shawnee, Ford, Finney, Saline, Wyandotte and Johnson Counties (they receive funds directly from state).
• Covers additional diagnostic and therapeutic services related to positive TB skin test, such as chest x-rays, office visits, hepatic enzymes, etc.
15MISSION - To Protect and Improve the Health and Environment of all Kansans
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TB Program Services (Cont’d)
• Does not cover TB medicine or TB-related hospitalization
• Does not cover if patient is asymptomatic and TB testing is because of work, school or adjustment of immigration status
16MISSION - To Protect and Improve the Health and Environment of all Kansans
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Coordination of Care• KSFHP enabling staff works with wide range of
providers and programs
• When assistance is not available through KSFHP, staff look to other programs or charitable care
• When other programs are not available staff help negotiate fee adjustment and payment plans
17MISSION - To Protect and Improve the Health and Environment of all Kansans
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Family Registration Form (Page 1)
18MISSION - To Protect and Improve the Health and Environment of all Kansans
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Family Registration Form (Page 2)
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List each individual who lives in the house
Please ensure all the questions are answered for each family member and all blanks are completed on both sides
MISSION - To Protect and Improve the Health and Environment of all Kansans
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Self Declaration Form
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Available in English, Spanish and Low German. Form is REQUIRED if client does not have a pay-stub.
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Voucher
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Filled out by provider – Basic information about the reason the client is there and what services the client receives.
Client Information
Date
Clinic Information- Name of Clinic- Address
“Referral information should be
documented on the voucher”
-Height & Weight
-Screening & Counseling
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HHS, BPHC requires that the following information is documented on the VOUCHER:
• Originating agency of the voucher
• Client identifying information
• Client signature
The following can be provided on the voucher or on a visit summary print out:
• Provider signature (with title)
• Reason for the appointment
• Treatment and/or referral
22MISSION - To Protect and Improve the Health and Environment of all Kansans
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HHS, BPHC requires that the following information is documented on the BILL:
• Resulting diagnostic test and procedures
– Include CPT codes for all services done in house and/or for which you will be billing
• Identified diagnosis
– Include ICD 10 codes
23MISSION - To Protect and Improve the Health and Environment of all Kansans
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HHS, BPHC requires that the following information is documented:
Please include the visit summary printout whenever possible.
(For Diabetes & Hypertension patients in particular.)
24MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Billing
Please notify your agency’s billing personnel to submit bills promptly to ensure payment. At the end of each year, any bills with a date of service of November 30 or prior need to be submitted by February 1.
25MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Fiscal Year
May 1st thru April 30th
Please note that bills with a date of service of April 30th or prior should be submitted to KSFHP with the appropriate documentation (voucher, codes, etc.) by May 15th in order to ensure proper payment.
26MISSION - To Protect and Improve the Health and Environment of all Kansans
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Who are Kansas’ Farmworkers?
27MISSION - To Protect and Improve the Health and Environment of all Kansans
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2017 Farmworker Profile• Of the 5,792 farmworkers and
dependents identified:
- 79% were Latinos
- 17% were Low German
- 3.7% were White/Black/Native American
- <1% were Chuukese
- 95% need interpreting
- 42% were under 100% of poverty
- 79% were under 150%
28MISSION - To Protect and Improve the Health and Environment of all Kansans
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2017 Farmworker Profile (Cont’d)
Of the 5,792 farmworkers and dependents identified:
- 51% were male & 49% were female
- 40% were 18 years of age and under
- 12% were over 49 years of age
- 72% were uninsured
- 79% were seasonal
- 21% were migrant
29MISSION - To Protect and Improve the Health and Environment of all Kansans
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There are Agriculture Workers in Almost Every County
30MISSION - To Protect and Improve the Health and Environment of all Kansans
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Identification of Barriers2014 Health Status Survey & Annual Focus Groups:
• High Cost (includes no insurance)
• Language translation and interpretation
• Literacy levels
• Transportation and isolation
• Lack of history of preventive services
• Mobility of clients and distance to clinic
• Difficulty leaving work to get services
• Clinic not open when available for appointment
31MISSION - To Protect and Improve the Health and Environment of all Kansans
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Enabling & Support Services
• Outreach and registration
• Screening of needs and identification of a medical home
• Education regarding preventive care
• Referral to resources (KanCare, Special Health Services, Migrant Education Program, preventive care)
• Support, follow up case management
• Language and culture
32MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Feedback & Evaluation
• Health Status Survey(done with clients every 5 years)
• Biannual Provider Survey
• Client Focus Groups
33MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Focus Groups
• Focus groups are held annually in each region to give farmworkers and their families a chance to express their needs, concerns, and suggestions regarding KSFHP.
• This time is also to used inform the farmworkers and their families about available services or changes to the program.
34MISSION - To Protect and Improve the Health and Environment of all Kansans
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Areas of Special Focus (Clients)
• Diabetes Quality of Care Initiative
• Planning Families/Prenatal Care
• Behavioral Health
• Oral Health
• Obesity
• Tobacco Cessation
35MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Service Areas Voucher/Case Management Infrastructure
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KSFHP currently has 114 Access Point Agencies in 85 Counties
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Staff
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Statewide
CynthiaProgram Director
Heather Manager
AshleyAdministrative
Specialist
Teri Clinical
Coordinator
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Staff (Cont’d)
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Regional Case Managers
Tina Mary Patricia Karla
Western Central Eastern
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Staff (Cont’d)
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Health Promoters
Helen Ana V Alicia Victor
Western Eastern
MISSION - To Protect and Improve the Health and Environment of all Kansans
Diana L
Central
RosieAnna H
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KSFHP Brochure
40MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Brochure (Cont’d)
41MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Regional Posters
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Contact the Regional Case Manager in your area to request poster(s) for your agency: http://www.kdheks.gov/olrh/FWContacts.html
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Newsletter
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Do we have your email address? Email Heather at [email protected] to be added to the list.
http://www.kdheks.gov/olrh/FW_Newsletters.html
MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Website
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Visit us at www.ksfhp.org
• Staff Contact Information
• Program Eligibility Information
• KSFHP Forms
• This PowerPoint
• Policy & Procedures Manual
• Federal Poverty Limits
• KSFHP Newsletters
• Health Education Resources
MISSION - To Protect and Improve the Health and Environment of all Kansans
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Health Education Resources
http://www.kdheks.gov/olrh/FW_health_resources.htm
• KSFHP Calendars
• Infant SleepSacks
• English/Spanish Comic Books about safe pesticide use
• English Coloring Books about nutrition
• Spanish Coloring Books about nutrition
• Harvest of Health
45MISSION - To Protect and Improve the Health and Environment of all Kansans
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Health Education Resources (Cont’d)
• English/Spanish Low Literacy Books
– We Like our Teeth
– We Like to Eat Well
– We Like to Move
– We Like to Read
• Brochures in English and Spanish on a variety of healthy topics, for example:
– Tobacco Cessation
– Behavioral Health
• Healthy Plate to a Healthy Weight
46MISSION - To Protect and Improve the Health and Environment of all Kansans
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KSFHP Calendars
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20
16
MISSION - To Protect and Improve the Health and Environment of all Kansans
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15
20
17
20
18
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Harvest of Health
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http://www.kdheks.gov/olrh/FWAudioEd.htm
MISSION - To Protect and Improve the Health and Environment of all Kansans
![Page 49: Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community Health Systems 1000 SW Jackson Street, Suite 340 Topeka, KS 66612 ... Manager or Health](https://reader036.fdocuments.in/reader036/viewer/2022062414/5ed86625b7394006ce601ed9/html5/thumbnails/49.jpg)
Healthy Plate to a Health Weight
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http://www.kdheks.gov/olrh/download/Summary_Healthy_Plate_Healthy_Weight.pdf
MISSION - To Protect and Improve the Health and Environment of all Kansans
![Page 50: Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community Health Systems 1000 SW Jackson Street, Suite 340 Topeka, KS 66612 ... Manager or Health](https://reader036.fdocuments.in/reader036/viewer/2022062414/5ed86625b7394006ce601ed9/html5/thumbnails/50.jpg)
Cultural Competency & Language Access
http://www.kdheks.gov/olrh/SpecialPopHealthResources.htm
• Guidance
• Data
• Health Education
• Partner Links
• Resources
• Training
50MISSION - To Protect and Improve the Health and Environment of all Kansans
![Page 51: Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community Health Systems 1000 SW Jackson Street, Suite 340 Topeka, KS 66612 ... Manager or Health](https://reader036.fdocuments.in/reader036/viewer/2022062414/5ed86625b7394006ce601ed9/html5/thumbnails/51.jpg)
Follow Up Questions
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www.ksfhp.orgOffice: (785) 296 – 6028
Fax: (785) 559 - 4278
Cynthia SnyderProgram Director
Office: (785) 296-8113Cell: (785) 207-2817
Heather DriverManager
Office: (785) 296-8656Cell: (785) 207-2525
Ashley TemplinAdministrative
SpecialistOffice: (785) [email protected]
WESTERN KANSAS
Case ManagerEnglish/Low German
Tina GuentherOffice: (620) 675-8191
Cell: (620) 290-0133Fax: (620) 675-2236
WESTERN KANSAS
Case ManagerEnglish/SpanishMary Marquez
Office: (620) 682-7949Cell: (620) 253-6104Fax: (620) 225-3731
CENTRAL KANSASCase Manager
English/SpanishPatricia Fernandez
Office: (785) 296-8983Cell: (620) 617-7428Fax: (785) 827-1544
EASTERN KANSASCase Manager
English/SpanishKarla Cervantes
Office: (913) 677-0100Cell: (816) 590-7577Fax: (913) 362-8513
MISSION - To Protect and Improve the Health and Environment of all Kansans
![Page 52: Provider & Partner Orientation - Kansas · Provider & Partner Orientation Bureau of Community Health Systems 1000 SW Jackson Street, Suite 340 Topeka, KS 66612 ... Manager or Health](https://reader036.fdocuments.in/reader036/viewer/2022062414/5ed86625b7394006ce601ed9/html5/thumbnails/52.jpg)
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www.ksfhp.orgwww.kdheks.gov
MISSION - To Protect and Improve the Health and Environment of all Kansans