CAREAssist Advisory Group Meeting Minutes April 15, 2015, 9:00 AM – 12:00 PM Portland State Office Building, Room 1- E In Attendance: Attending: Vic Fox , Jonathan Livingston, Oregon Health Authority (OHA), CAREAssist (CA); Brad Howell, Community Representative; Lorna Loomis, Chris Carter, and Margy Robinson, Multnomah County; Barbara Ries-Fahey, OHA, Clinical Services; Marilee Smith, Kaiser Permanente; Lauren Nathe, OHSU Partnership Project; Shelley Bailey, Central Drugs; Chris Hoem, Gilead Science By teleconference: Renee Yandel, HIV Alliance; Marshall Beatty, Multnomah County; Karen Fox, Linn Co Health Dept; Heidi Eidler, EOCIL; Zachary Helm, Cascade Aids Project Meeting Facilitator: Vic Fox , Jonathan Livingston, Oregon Health Authority (OHA), CAREAssist (CA); Recorder: Schneider, OHA, CA Agenda Items Discussion Summary Action/Result Item (A/R) On Point for Action Welcome – 9:00 Review Agenda – 9:15 modification & additions March 25, 2015 meeting minutes. ACA Update – 9:20 Topics: ACA preparation and future of assister services Contracts that are up for renewal and new solicitation are PBM, MBM and In-network pharmacy. OHP update and remarks provided by Barbara Ries Program Updates – 9:30 New CER Form It is time to renew our Pharmacy Benefit Manager (PBM) contract, which is currently Ramsell; we are starting the review process with Contracts and Procurement and DOJ. If a new RFP is going to be posted it will not happen before the early Fall. The new abbreviated CER will probably not be out until June. On the form it asks if the monthly income has changed 10% or more, if yes they are asked to contact CA. Lauren expressed concern that some clients may have difficulty calculating 10% of their income and suggests A – Will keep everyone posted on the income issue. A – Will run two different reports and look at which clients are receiving the Jonathan Jonathan
Raising eligibility to 500% FPL has been approved and will go into effect July 1, 2015 or shortly thereafter. The community will be notice for the official implementation date for this change. This is targeted towards those who have Medicare to help with the gap in coverage. The CA Advisory Group was asked for suggestions on what kinds of services we could provide. Smaller work groups will be formed and will focus on a specific subject. Four specific possible areas to explore were identified: 1) over the counter medications 2) enhanced services for vision 3) enhanced services for hearing 4) services for those who are incarcerated It was suggested that work groups would come together to focus on a specific subject, document a need/gap that the enhancement would address; make a case for the health benefit to the clients, cost effectiveness, etc. The program then can consider recommendations. The break out groups first meeting to be schedule in the month of May (tbd) and likely on a Wednesday afternoon (1-2 hrs).These meetings will be subject specific, relatively short and the goal is to make a case for consideration by the program of a future implementation. There is no timeline yet for any of these possible enhancements and they may not occur for some time. A – If CM’s know of individuals who have previously applied and were denied because of income; it was suggested that they reapply with CA in October. A – CAREAssist will meet internally to prioritize initiatives and determine timelines. An email will be sent to the CA Advisory Group asking about their interest in participating in work groups. CA Advisory Vic/ Jonathan Adjourn – 12:00 NEXT MEETING: June 17, 2015