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February 20, 2001

# Tour of Milwaukee County Health Program Information System

Background and History of Program:

The County of Milwaukee County Health Program is a General Assistance
Medical Program (GAMP), which last year served approximately 20,700
approved participants. Speakers Joseph Cooper and Bijoy Nair of the
County Health Program demonstrated their information system to CAP
grantees in a technical assistance call on February 20, 2001.

The system used by Milwaukee County was developed in 1998 as a
collaborative effort between five (5) Federally Qualified Health Centers
(FQHC) and eleven (11) hospitals and other private medical providers in
Milwaukee County who sought to create a system to facilitate processing
indigent individuals to receive medical care. System development took at
approximately a year with 2 consulting staff working on the prototype.
With annual updates, the estimated annual cost of running the system is
approximately \$250,000.

Developed with the capability of tracking internal demographics, the
main function of this system is to offer all related medical providers
information about the status of clients in the program. For example, if
a client has been removed from the program, the system will explain the
reason for disqualification.

Hardware and Software

Developed using the Oracle Form tool, the system uses Oracle software, a
database, and an application server running on Windows NT 4.0. A web
server, which is run separately from the database server, runs on HP4
with 1GB of RAM and an 18GB hard drive.

The System

The two major functions of the system are verification of the client's
qualification for the program and dates of eligibility for services.
Each user is assigned a role that defines which information and options
are can be accessed. These roles include: health care provider, selected
administrative personnel, and specialist \-- a county employee with the
specific job function of accepting applications, interviewing clients,
and determining eligibility for the program.

The GAMP database has a Soundex function that can search all the names
that sound like the name entered, making the exact spelling of the name
unnecessary. This function serves to avoid confusion due to
typographical errors and to minimize duplicate entries in the database.

The data seen by clinics and medical providers is limited to the
client's name, eligibility/dates of coverage, and, if ineligible,
reasons for ineligibility. For purposes of this demonstration, all
conference call participants logged-in as county workers interested in
reviewing applications.

The application allows users to check client addresses and delete or
restore relevant information as appropriate through the use of an
"Action" button that features 5 options:

-   Add a new family

-   Send to Wisconsin Physician Insurance (The claims processor)

-   Terminate segment

-   Edit segment

-   Close

Only county personnel authorized to change information can access the
Edit function. Within each option are additional tools. For example, a
"Comments" button changes color from gray to green to flag comments,
allowing users to see when a comment was entered and by whom. A family
detail "Go" flags additional information. A lightning button next to the
Social Security Number (SSN) generates a number that will not duplicate
when a patient does not have a social security number. The SSN is the
unique identifier in 99% of cases. In most cases, the SSN and the
billing number are the same.

Other features include a "Latest status" section that allows efficient
updating and a flag that turns red if a client exceeds income limits;
clicking on the flag provides the amount by which limits are exceeded.
An "Edit" function brings up the current segment for updating and
"Approve family" or "Deny family" functions approves or denies all
family members in cases where coverage is the same for each family
member. "Quick Approve/ Deny/ Pending/ Terminate" features are used to
input or update information for one member at a time.

Multiple safeguards exist in the system, such as providing a section for
an applicant's photograph, to protect the eligibility of each client and
enable participating health care providers to deliver services in an
efficient, timely and cost-effective manner.

To receive a CD, handbook, or screenshots of the system, send an email
directly to Bijoy Nair at <bijoyn@yahoo.com>

For Further Information Contact:

**Joseph Cooper**

<JECooper@admin2.chrp.milwcnty.com>

(414/257-5949)

or

###### Paula Lucey

<palucey@admin2.chrp.milwcnty.com>

414/257-5949

TOUR OF MILWAUKEE COUNTY HEALTH PROGRAM INFORMATION SYSTEM CALL
PARTICIPANTS:

+------------------+---------------------------------------------------+
| ###### Name      | ###### Organization                               |
+------------------+---------------------------------------------------+
| Abby Sears       | Oregon                                            |
+------------------+---------------------------------------------------+
| Allen Meyer      | San Francisco Community Clinic Consortium         |
+------------------+---------------------------------------------------+
| Amir Abrams      | LA CAP                                            |
+------------------+---------------------------------------------------+
| Audrey Smolkin   | HRSA Philadelphia, PA                             |
+------------------+---------------------------------------------------+
| Aurelia          | Aaron E. Henry Community Health Center, MS        |
| Jones-Taylor     |                                                   |
+------------------+---------------------------------------------------+
| Barbara Eyman    | Powell Goldstein                                  |
+------------------+---------------------------------------------------+
| Beryl Cochran    | HRSA Seattle                                      |
+------------------+---------------------------------------------------+
| Bob Harris       | Harlan Center, KY CAP                             |
+------------------+---------------------------------------------------+
| Brenda Theus     | CAP PD, Memphis, TN                               |
+------------------+---------------------------------------------------+
| Dave Fant        | WV CAP                                            |
+------------------+---------------------------------------------------+
| Debbie L. Nuss   | Community Health Council KS CAP                   |
+------------------+---------------------------------------------------+
| Dennis Williams  | NC CAP                                            |
+------------------+---------------------------------------------------+
| Edgar Brisbon    | PA CAP                                            |
+------------------+---------------------------------------------------+
| Fran Carlson     |                                                   |
+------------------+---------------------------------------------------+
| Irma Honda       | HRSA San Francisco                                |
+------------------+---------------------------------------------------+
| Jackie Lifer     | Lawyer                                            |
+------------------+---------------------------------------------------+
| James Burnosky   | RWJ: Communities in Charge                        |
+------------------+---------------------------------------------------+
| Jason Ladmer     | KS CAP                                            |
+------------------+---------------------------------------------------+
| Jay McGath       | HRSA                                              |
+------------------+---------------------------------------------------+
| Jennifer Dalton  | Ingham - MI                                       |
+------------------+---------------------------------------------------+
| Joanne Omi       | NYC CAP                                           |
+------------------+---------------------------------------------------+
| John Cragin      | Boston Medical                                    |
+------------------+---------------------------------------------------+
| John Prochaska   | Chicago                                           |
+------------------+---------------------------------------------------+
| Judy Szalapski   | MN CAP                                            |
+------------------+---------------------------------------------------+
| Julia Tillman    | Central CAP                                       |
+------------------+---------------------------------------------------+
| Kay Freeman      | CareNet Partners: Tallahassee, FL                 |
+------------------+---------------------------------------------------+
| Kristen West     | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Marika Bertolini | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Cynthia Walker   | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Lela Keyes       | Aaron E. Henry Community Health Center, MS        |
+------------------+---------------------------------------------------+
| Len Stewart      | MA CAP                                            |
+------------------+---------------------------------------------------+
| Linda Cundiff    | Somerville, MA                                    |
+------------------+---------------------------------------------------+
| Liz DiCarlo      | MA CAP                                            |
+------------------+---------------------------------------------------+
| Liz Whitley      | Denver Health                                     |
+------------------+---------------------------------------------------+
| Luanne Nyberg    | NC CAP                                            |
+------------------+---------------------------------------------------+
| Lynn             | Inova Health System                               |
| Evans-Riester    |                                                   |
+------------------+---------------------------------------------------+
| JoAnne Jorgenson | Inova Health System                               |
+------------------+---------------------------------------------------+
| MAC              | Management Assistance Corporation                 |
+------------------+---------------------------------------------------+
| Mark B. Wilcox   | Health Federation of Philadelphia                 |
+------------------+---------------------------------------------------+
| Mary Helen Mays  | El Paso CAP                                       |
+------------------+---------------------------------------------------+
| Michael Head     | Cincinnati                                        |
+------------------+---------------------------------------------------+
| Mike DeLucca     | FL CAP                                            |
+------------------+---------------------------------------------------+
| Paula Lucey/     | Milwaukee CAP                                     |
| Joseph Cooper    |                                                   |
+------------------+---------------------------------------------------+
| Phebe King       | Maine Health                                      |
+------------------+---------------------------------------------------+
| Richard Liniger  | San Francisco HRSA                                |
+------------------+---------------------------------------------------+
| Ruth Woolum      | SKYCAP-Hazard                                     |
+------------------+---------------------------------------------------+
| Seema Verna      | Indianapolis, IN                                  |
+------------------+---------------------------------------------------+
| Stacy Kelly      | Austin CAP                                        |
+------------------+---------------------------------------------------+
| Steve Dorage     | HRSA Atlanta                                      |
+------------------+---------------------------------------------------+
| Tammy Eberly     | Tiahoga CAP                                       |
+------------------+---------------------------------------------------+
| Tammy Stoltz     | PCAP Pima Community Access Program                |
+------------------+---------------------------------------------------+
| Ted Hanley       | Galveston CAP                                     |
+------------------+---------------------------------------------------+
| Tom Brown        | Palmetto Alliance, Columbia SC                    |
+------------------+---------------------------------------------------+
| Tom Irons        | NC CAP                                            |
+------------------+---------------------------------------------------+
| Tom Lewis        | MD CAP                                            |
+------------------+---------------------------------------------------+
| Tracey Bush      | New Orleans CAP                                   |
+------------------+---------------------------------------------------+
| Zandra Glenn     | Leon County CAP                                   |
+------------------+---------------------------------------------------+
| Synthesis        | Synthesis Professional Services                   |
| Writers          |                                                   |
+------------------+---------------------------------------------------+

Summary Developed By: Synthesis Professional Services, Inc.