Preventing Type 2 Diabetes

New grant focuses on providing assistance to at risk populations in 9 rural Missouri counties

i Mar 11th No Comments by

Missouri CLAIM will provide a one-stop shop to provide screening and application help for multiple assistance programs

Jefferson City, Mo– The Missouri Department of Insurance announced a new grant from the National Council on Aging’s Center for Benefits Access (NCOA). The Benefit Enrollment Center (BEC) Grant provides funding for a twenty month period (January 2019 – September 2020) to the Department to implement a Benefit Enrollment Center in 9 rural Missouri counties.

Benefit Enrollment Centers (BEC) use person-centered strategies in a coordinated, community-wide approach to find and enroll Medicare beneficiaries—both seniors aged 65+ years and adults living with disabilities — who have limited income and resources to access available benefits, with the primary focus being on the following five core benefit programs:

  • Medicare Part D Extra Help (or Low-Income Subsidy, LIS)
  • Medicare Savings Programs (MSP)
  • Medicaid
  • Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps)
  • Low-Income Home Energy Assistance Program (LIHEAP)

A “person-centered” approach is one in which someone is screened for and assisted with applying for multiple benefits at one time, based on that individual’s needs. Currently the department’s CLAIM program assists Missourians with the first three of these core services through the State Health Insurance Program (SHIP) and the Medicare Improvements for Patients and Providers Act (MIPPA) funding. This additional grant will allow CLAIM to assist 1,000 individuals to apply for and receive much needed assistance for which they may qualify.

The BEC grant focuses on 9 rural counties, and senior and disabled individuals in those counties who are most in need of the services. The target area includes these central Missouri counties: Callaway, Camden, Cole, Laclede, Miller, Morgan, Moniteau, Osage and Pulaski. 

The total population in these targeted counties is 328,992, of which:

  • 15.77% are age 65 and older
  • 16.42% have a disability (higher than MO at 14.44% and the US at 12.52%)
  • 15.54% live at or below FPL. Per capita income is $23,004, below the MO average of $27,044;
  • Over 17.25% of the population receives Medicaid
  • 14.44% of the adult population, age 18-64, lacks health insurance

Current Medicare program data indicate there are 12,973 disabled individuals residing in this defined area, 15,881 are low-income, and 13,802 are estimated to need and be eligible for MSP.

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department’s seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

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MINIEA IS NEW PRIMARIS FOUNDATION EXECUTIVE DIRECTOR

i Feb 14th No Comments by

February 14, 2019

By Jodie Jackson

COLUMBIA, MO. – Scott Miniea is the new executive director of the Primaris Foundation, taking the reins from Carol Beahan, who retired Jan. 30 after a 30-year career with Primaris.

Primaris CEO Richard A. Royer made the announcement of Miniea’s new post on Feb. 8. Primaris is a healthcare consulting and services firm; the Primaris Foundation is a non-profit organization that helps individuals and communities live healthier lives. The Foundation operates two primary programs: CLAIM, the Missouri State Health Insurance Assistance Program, and Insurance Counseling Services, or ICS.

“He brings a record of achievement here and a strong experience base elsewhere,” Royer said, noting that Miniea will work with “remarkably talented” staff. “With this team, the Foundation is in good hands,” Royer said.

Miniea said Beahan is “a living legend … who built the program into what it is” as executive director of the not-for-profit Foundation that was created in 2005. Miniea said he will be in regular contact with Beahan “as her mentorship and experience are invaluable to the program.”

(For more about Beahan’s retirement and tenure with the Primaris Foundation, listen toEpisode 59 of the Quality Talk podcast.)

Miniea will also make it a priority to continue nurturing the Foundation’s relationship with community partners that are vital in helping both CLAIM and ICS “educate and empower individuals and communities to make informed decisions in a complex healthcare environment.”

“As a CLAIM volunteer myself and an ACA insurance counselor and community health worker, I know how challenging the work we all do can be – and how important,” Miniea said. He served as the ICS director for the past 18 months and will remain focused on “ensuring as many Missourians as possible have health insurance coverage” as well as access to health care to improve their own lives and the health of their communities.

Carol Beahan: Thirty Years Have Gone By Very Quickly

i Jan 30th No Comments by
Carol Beahan, executive director of the Primaris Foundation and CLAIM program director, retires to cap off her 30-year career on Jan. 30, 2019, the 30th anniversary of the day she started working for the CLAIM program.https://soundcloud.com/primaris_health/ep-59-primaris-foundation-executive-director-carol-beahan

“I thought that would be a really good date to end on,” she says. “Thirty years have gone by very quickly.”

Quality Talk host Jodie Jackson Jr. explains that as one of the more popular Quality Talk guests, “and one of my all-time favorite people,” it was only fitting that Carol introduce Episode 59 of Quality Talk. This is Carol’s fifth episode, three of which were “Coffee With CLAIM” roundtable discussions with Carol and the CLAIM staff and regional liaisons.

Previous episodes featuring Carol Beahan and her team

Episode 4, Medicare Open Enrollment

Episode 6, Medicare Panel Discussion

Episode 27, Medicare Roundtable, “Coffee With CLAIM”

Episode 51, CLAIM Roundtable

Episode 59. 

3:07 – “It takes a while to make that decision about retiring.”

10:10 – Carol recalls the advent of Medicare Part D and other innovations. More than that, she has good memories of helping both policy-makers and beneficiaries understand Medicare. “We like to tell the stories behind those numbers.”

carol 3

14:59 – Baby Boomers aging into Medicare. “That’s been a new challenge for us. How to reach them and to serve them.” The Quality Talk podcast is one response. “We’re trying to improve our technology.” Also, she’s had to adjust to leadership changes in many agencies and organizations that CLAIM and the Foundation comes into contact with. “You’re always having to educate the community and the healthcare providers.”

19:35 – “It’s the people I work with right now that have really impressed me.”…“And I hope I encourage other people … to learn something new.”

Hail to the chief.

25:11 – Carol once rubbed shoulders with a president. “Up close and personal” with President George W. Bush at a Medicare Part D event.

28:22 – “My team is the most awesome team in the world.” She recognizes CLAIM Lead Trainer Tracey Wetzel, “My goodness, if I could just download her brain and put it into mine. She knows how to find answers.” Carol and Tracey worked together for 15 years.

32:04 – Carol’s professional life before Primaris: started working in Kansas for the state as an income maintenance workers (processing applications for assistance, including food stamps and Medicaid eligibility), then worked for home health agency and coordinated home delivered meal program in Des Moines, Iowa.
“That’s where I really think I developed my interest in working with older adults.” Also coordinated Head Start health and nutrition program in Missouri and was then a nutrition administrator for an Area Agency on Aging in Cole County.

‘That legacy will carry on.’

What’s the next step of your journey? “I think for the first 30 days, I’m not going to read one email. I’m going to take an email diet … Then I will probably find just the right place to be.” Volunteering somewhere, traveling, enjoying her five grandchildren. “I know I will be involved with the community. I’m a people person. I won’t be sitting at home all day.”

38:17 – In this age of technology and digital community, real connections “has to be a priority.”

“I always says that good manners go a long way. ‘Please’ and ‘thank you,’ being courteous and being able to listen to people is important … I hope we never lose that.”

“I know whoever has the fortunate opportunity to step into these shoes will do a great job. They get a great team, which is the No. 1 piece that makes you good. I work with awesome people. They do a lot. They expect a lot. They’re willing to go the extra mile.”

42:05 – “I am honored … I am in awe sometimes that I’ve had the opportunities that I’ve had. I’ve got to work with some people who have really made a difference. I think the work we do here at Primaris – it affects people. It affects healthcare providers. It affects the community … We just have an opportunity to make a difference. I know that legacy will carry on.”

Be sure to stay connected with us on Twitter – our handle is @Quality_Talk – and by emailing the host at jjackson@primaris.org. You can stream Quality Talk on SoundCloud or listen on iTunes.


More about CLAIM.

CLAIM stands for “Community Leaders Assisting the Insured of Missouri.” We have been the official State Health Insurance Assistance Program (SHIP) for Missouri since 1993.

We are a nonprofit organization and all of our services are free, unbiased and confidential. We are not an insurance agency. We do not sell anything and our counselors do not ask for money.

CLAIM has more than 300 volunteer counselors throughout Missouri providing local Medicare counseling in their communities. Volunteers receive extensive training to become a certified Medicare counselor, and continue to receive updates and trainings on a regular basis.

Primaris Foundation provides the services for the CLAIM program through a contract with the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP). Funding is provided by the Administration for Community Living with oversight by DIFP.

Topics: Quality Talk podcast

COFFEE WITH CLAIM: STEP-BY-STEP TIPS FOR MEDICARE OPEN ENROLLMENT

i Nov 29th No Comments by

Written by Jodie Jackson

Spoiler alert: You’re about to get a lively, fun, crash course on Medicare.

“Coffee With CLAIM” is Quality Talk’s fifth Medicare-related episode, highlighting the work CLAIM does as Missouri’s State Health Insurance Assistance Program (SHIP). Though CLAIM works in Missouri, the information presented in this episode applies to all SHIP programs and Medicare beneficiaries across the country.

Put simply, “We help people navigate Medicare,” says Carol Beahan, CLAIM executive director.

18-196-CL 25 years banner-01

CLAIM staff featured in this conversation with Quality Talk host Jodie Jackson Jr. and Beahan also includes Tracey Wetzel, lead trainer; Xavier Vaughn, Outreach/MIPPA project coordinator; Cindy Carr, Region 1 liaison (central Missouri); Julia Allen, Region 2 liaison (eastern Missouri, St. Louis area); Stacey Childs, Region 5 liaison (southwest Missouri); CLAIM newcomer Kori Ross, Region 6 liaison (Kansas City metro area and northwest Missouri); and Elizabeth Swanson, Region 7 liaison (northeast Missouri) and AmeriCorps project manager.

The conversation focuses on the annual enrollment period, Oct. 15-Dec. 7, with discussion also touching on the new Medicare cards that beneficiaries have already received or will receive – depending on the area of the coutry.

Previous episodes of Quality Talk that discussed Medicare topics and questions included Episode 27, “Coffee With CLAIM: Aging Into Medicare,” Episode 10, “New Medicare Cards Are Coming,” and Episode 6, “Medicare Panel Discussion.”Episode 4 featured vital information and tips for the 2017 fall Medicare open enrollment period.

Topics: Medicare enrollment

The Shoebox Project: Managing the Paperwork of Everyday Living

i Mar 26th No Comments by

CLAIM’s community partner, Shepherd’s Center Central was highlighted on National Council on Aging (NCOA) webinar in February and highlighted on their website. Read the article below.

Established in 1972, Shepherd’s Center Central in Kansas City, MO, offers a variety of programs for seniors that are primarily volunteer driven at three sites throughout the metropolitan area. The Medicare Assistance Program (MAP) is available at two locations staffed by two part-time persons and 12 certified CLAIM (Missouri State Health Insurance Assistance Program) volunteer counselors. MAP is a multi-faceted program providing Medicare/Medicaid education and individual counseling for beneficiaries and caregivers, and includes the SHOEBOX Project, which began in 2015 with a MIPPA special projects grant from CLAIM and continues today.

The idea for the SHOEBOX Project originated with the Apple Project at Southeast Missouri State University in Cape Girardeau, MO, which has been doing similar work since 1993. The name alludes to the variety of containers in which people who come in keep personal paperwork, such as a grocery bag, big purse, backpack, or a box that originally held a pair of shoes. It also attempts to generally describe the services offered:

  • Simple applications, LIS/MSP, legal forms (POAs), rent rebate claims
  • Health insurance forms, notary services
  • Organization of personal paperwork
  • Education about Medicare, Medicaid benefits
  • Budget and financial guidance and referrals
  • One-on-one confidential assistance to assure the person that we care
  • Xtra help to sort what to keep and what to throw away

Services are provided in Shepherd Center offices, or in senior centers and apartment complexes, and are always free of charge.

Who is the target audience?

The target audience of the SHOEBOX Project is primarily, though not limited to, low-income seniors and disabled persons who may have limited education or cognitive issues, vision impairment, or those for whom English is a second language who need assistance in reading and understanding various forms and letters sent to them. The goal is to be in a position to screen and enroll this population in the various benefit programs for which they may qualify.

What do they do?

Man with shoebox of papersThe project is advertised to Shepherd’s Center’s large constituency on several social media outlets, and email blasts to various partners and agencies providing services to the aging community, including social workers, coordinators in senior apartment complexes, hospital case managers, etc.  A “counter card-style” publicity flyer with a distinctive logo was developed and widely distributed.

A cloth-like document bag, imprinted with the project’s contact information, is given to each client who comes for paperwork sorting, along with a set of neatly labeled folders in which to file important documents. The goal is to assist persons with organization, form completion, and education about what is junk mail and what is important to keep, thus reducing stress levels in their lives.

In 2016, a new feature was added to make the program more accessible, which is to provide a “Walk-in Center” at one site where people can come in without an appointment to be seen by a staff member or volunteer counselor. This service has attracted many who are new to Medicare, want to compare Part D plans, or seek other types of counseling, but who are not necessarily low income.  This prompted us the addition of a monthly “lunch and learn” class called Medicare 101.  This class is purposely kept small so that the dozen or so attendees can ask questions that are related to their individual situations.

What are the results thus far?

Response to the program seems to increase each year.  In 2015, the Shepherd’s Center set a goal of reaching 50 clients; 61 people were served.

In 2016, 87 people sought the services of the SHOEBOX Project, and in 2017, 156 were seen by a counselor and provided the various services. Walk-in Center hours have been increased from three hours on two days per week, to five days per week, 9:00 am to 3:00 pm.

For more information

Joyce White
816-753-7039

February 2018 Fraud Fact by Missouri SMP

i Feb 1st No Comments by

It’s tax time, which of course brings out the scam artists. That means it’s time for a little primer from the Missouri SMP (Senior Medicare Patrol) to keep you from being a victim. Thousands of people have lost millions of dollars and personal information to scammers. First of all, if you are going to file a tax return, do so as soon as possible to keep an impostor from doing it using your information.Fraudsters use the telephone, email and snail mail to scam individuals.You need to remember that the IRS will not initiate contact with you by phone, email, text messages, Facebook or Twitter to request personal or financial information.

But, scammers claim to be IRS employees using fake names and badge ID numbers. They may change their caller ID’s so that it looks like the IRS is calling. These guys may know a lot about you. They probably found the information by Googling you. They tell you that you owe money that needs to be paid either by a gift card or wire transfer. DO NOT do it. They may threaten to have you arrested. They may tell you they are going to suspend your driver’s license. They can be hostile and insulting.
They may tell you that you have a refund coming, but ONLY if you provide your banking information for a direct transfer. They often tell you the matter is urgent. Some have even gone after deaf or hard of hearing people through video relay services.

DO NOT fall for it. The IRS does NOT demand immediate payment using a prepaid debit card, gift card or wire transfer. If you were to owe taxes, you would receive a bill in the mail.
The IRS will NOT threaten to have the police or sheriff’s office arrest you for nonpayment. The IRS will NOT demand payment without giving you a chance to question or appeal. And, they won’t ask for credit, debit or Social Security numbers over the phone. If you feel like you are a victim of a scam, report it to your police department.
As always, report suspected Medicare fraud to the Missouri (SMP) Senior Medicare Patrol at (888) 515-6565. SMPs are funded through the U.S. Department of Health and Human Services, Administration for Community Living, Administration on Aging.

*This project was supported, in part by grant number 90MP0204, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201.

Missouri Rx Changes Effective July 1, 2017

i Jun 20th No Comments by

Missouri Rx – Missouri’s State Pharmaceutical Assistance Program has been reauthorized by the state legislature for another 5 years until August, 28, 2022.  Missouri Rx works with a person’s stand alone Part D plan or Medicare Advantage plan to pay 50% of a person’s costs at the pharmacy.  Eligibility benefits for MO Rx benefit has been reduced to only those Medicare beneficiaries that are also enrolled into Medicaid. This change affects 64,000 enrollees. Our certified counselors can help you determine your options if you have lost this benefit. You have not lost your Medicare drug coverage.

Missouri Rx coverage will no longer pay 50% of the cost of Part D prescriptions for people enrolled in Medicare whose

  • Income $21,660 for a single person or $29,140 for a couple or
  • Enrolled into Extra Help from SSA sometimes called Low-Income Subsidy (LIS).

CLAIM Counselors can provide the following.

  • If you are affected by this change you have a Special Enrollment Period for two months to change your Part D plan. Counselors can assist with the comparison and enrollment into a another plan if this is your choice.
  • Counselors can screen and provide application assistance for Low-Income Subsidy through Social Security or Medicare Savings Program.
  • Check eligibility for Patient Assistance Programs to help cover some of your higher cost medications

www.rxassist.org – provides info and application links to assistance programs

www.needymeds.org – provides info and application links to assistance programs

www.rxoutreach.org  – discount purchasing program website

  • Other options may include talking with your doctor or going to a public health center that provides a sliding fee scale for prescriptions.

 

We encourage you to call or contact us to understand any options available to you.

March is National Kidney Month

i Mar 9th No Comments by

1 in 3 American adults is at risk for kidney disease. Medicare Part B covers preventive screening tests that help detect diabetes and high blood pressure – 2 conditions that may lead to kidney damage. Visit Medicare.gov/coverage/preventive-and-screening-services.html for more information.

Medicare Part B also covers up to 6 sessions of kidney disease education services if a person has Stage IV chronic kidney disease that will usually require dialysis or a kidney transplant. For more information, visit Medicare.gov/coverage/kidney-disease-edu.html.

Joplin TV news station shines a spotlight on CLAIM’s efforts

i Feb 10th No Comments by

Joplin TV news station shines a spotlight on CLAIM’s efforts

JOPLIN, Mo. – Now until December seventh is annual open enrollment. If you’re enrolled in Part D, Medicare’s drug coverage, you have the chance to either switch or stick with that insurance.

Karen Wells and her husband visited Mercy Hospital Joplin Friday to speak with CLAIM, the Missouri State Health Insurance Assistance Program about being enrolled in Part D, Medicare’s drug coverage.

“Confused, cause there’s so many plans and I work in the health care field, but still it’s all like Greek to me. So she helped to dispel a little bit of that and told me how they’ll use a computer and input a lot of our data and tell us which plans will probably be best for us,” Wells says.

Experts say from year to year, coverage changes, which means providers may not carry the same prescription drugs or the cost of coverage may increase. And it can get very confusing for the average person.

“We can’t imagine someone that doesn’t deal with this all the time to even understand it and the problem being if they don’t understand it and they don’t make necessary changes now, they’re in it for a year, so they can be out a lot of money simply from one little mistake,” Stacy Childs, Claim Missouri Regional Liaison Trainer for the Southwest District of Missouri.

To read the full story, click here.

Social Security and Veterans Affairs Partnership Means Faster Disability Decisions for Veterans

i Nov 22nd No Comments by

Today, the Social Security Administration announces the launch of a new Health IT initiative with the Department of Veterans Affairs (VA) that enables all Social Security disability case processing sites to receive medical records electronically from all VA facilities. Veterans will receive a faster decision on their Social Security disability claim, speeding them and their dependents through this new process. Both agencies will save time and money with an automatic request through the eHealth Exchange.

“President Obama has said, ‘we must maintain the sacred covenant we share with our veterans by ensuring they have the care and benefits they deserve,’ and I could not agree more,” said Carolyn W. Colvin, Acting Commissioner of Social Security. “We are committed to providing our veterans with the world class service they so richly deserve and improving the speed and efficiency of our disability program.”

The new Health IT program was tested successfully at Social Security locations around the country. On Veteran’s Day, November 11, the eHealth Exchange will go live, nationally, to all Social Security disability case processing sites.

Social Security requests nearly 15 million medical records annually from healthcare providers and organizations to make medical decisions on about three million disability claims. Medical documentation is essential to make a disability determination. Historically, the agency obtained medical records through a manual process (mail, fax, secure mail). This new national initiative puts in place an automated process to obtain medical records electronically without human intervention.

“VA is currently improving quality of life by enabling Veterans to share their health information with federal partners and integrating their data into a safe and secure health-related consumer application,” said Dr. David Shulkin, Under Secretary for Health of the Department of Veterans Affairs. “Currently, when eligible Veterans apply for Social Security Disability Insurance benefits the average wait time for Social Security to receive paper records from VA can take months; this partnership allows Social Security and VA to share the Veteran’s health information electronically in minutes. The Social Security and VA partnership allows VA to continue to be a leader in interoperability efforts among federal partners while improving overall quality of life for our Veteran patients.”

This partnership adds the VA to Social Security’s more than 50 other Health IT partners, including the Department of Defense, in approximately 7,000 facilities across the United States providing electronic health records. Social Security’s goal is to continue expanding the number of healthcare organizations and federal agencies providing electronic health records within a safe and secure environment.

To learn more about Health IT, please visit www.socialsecurity.gov/disabilityssi/hit.

Social Security offers two other programs to expedite disability claims filed by veterans. Wounded Warriors and veterans with a VA disability compensation rating of 100% Permanent & Total have their Social Security disability claims treated as high priority and receive expedited decisions. For more information about these programs, please visit www.socialsecurity.gov/people/veterans.

To get more Social Security news, follow the Press Office on Twitter @SSAPress.