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Healthy Communities Outreach & Case Management System

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About this HelpHome

This help documentation contains four major sections:

1. Policies

The Healthy Communities program is based on a set of policies that contractors are committed to comply with. These policies are described in this section.

2. Procedures

For each of these of policies; a set of procedures needs to be followed to comply with it. This section includes these. You'll notice how each policy links to its corresponding procedures and each procedure links back to its corresponding policy as well.

3. System Documentation

This section contains all the instructions on how to use the system.

4. Answers

This section is a dynamic Q&A forum for those questions that are not covered in the 3 previous sections. with this tool you'll be able to ask your question and see if there's already other users who have had the same question answered. This way you get a response much faster. If there hasn't been any answer to the specific question you have you'll be able to post it to the community of Healthy Communities Users throughout the state and get an answer shortly.

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PoliciesHome

Case Management and Program Policy ›

Case Management and Program PolicyClient Outreach and Program Education PolicyCommunity and Program Education PolicyPrivacy and Confidentiality PolicyProvider Outreach and Program Education Policy


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ProceduresHome

Assist Clients with Scheduling orAppointments and Transportation Needs ›

Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regardingtheir Enrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Liketo Become MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities


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Procedures

Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



System DocumentationHome

Overview ›

OverviewTechnology Configuration RequirementsAbout the TechnologyGetting StartedThe BasicsBuilding Blocks: Individuals, Households and OrganizationsInteractionsReferralsEnrollmentsHow to transfer an individual to another countyManaging DuplicatesOutreach EventsReportsTeam CollaborationNotes and AttachmentsFor Administrators


MENUAbout this Help

Policies

Procedures

System Documentation

OverviewTechnology Configuration RequirementsAbout the TechnologyGetting StartedThe BasicsBuilding Blocks: Individuals, Households and OrganizationsInteractionsReferralsEnrollmentsHow to transfer an individual to another countyManaging DuplicatesOutreach EventsReports

Team CollaborationNotes and AttachmentsFor Administrators

Answers


About this HelpThis help documentation contains four major sections:

1. Policies

The Healthy Communities program is based on a set of policies that contractors are committed to comply with. Thesepolicies are described in this section.

2. Procedures

For each of these of policies; a set of procedures needs to be followed to comply with it. This section includes these.You'll notice how each policy links to its corresponding procedures and each procedure links back to itscorresponding policy as well.

3. System Documentation

This section contains all the instructions on how to use the system.

4. Answers

This section is a dynamic Q&A forum for those questions that are not covered in the 3 previous sections. with thistool you'll be able to ask your question and see if there's already other users who have had the same questionanswered. This way you get a response much faster. If there hasn't been any answer to the specific question you haveyou'll be able to post it to the community of Healthy Communities Users throughout the state and get an answershortly.

Case Management and Program PolicyHome » Policies

DEFINITIONSFamily Health Coordinators shall assist clients with the overall program navigation of the Medicaid and CHP+ medical assistance programs on a day to day basis including but not limited to:

Contacting and assisting all clients through face to face, written, oral, and other methods of communication;

Assist clients with the application process which can include assisting the client face to face with a paper orPEAK application; Providing PE determinations on site to those that may qualify, and/or an appropriatereferral to another application assistance site such as local department of social/human services, PEAK,CAAS, other PE, or MA Site to facilitate the client’s enrollment into Medicaid and CHP+;

Provide follow up to pregnant women and children, families, and EBNE’s on the status of their application asrequested and/or assist the client in resolving any issues or concerns regarding their enrollment into amedical assistance program and/or eligibility issues;

Assist clients with the reporting of newborns; includes processing Add-A-Baby request for cases that areemergent or if services need to be expedited;

Provide clients with a list and referral to an appropriate Medicaid or CHP+ provider;

Assist clients with scheduling of appointments and transportation needs through the MedicaidTransportation Broker or appropriate local department of social/human services;

Provide follow up and assistance to clients who have not received services within six months of initialeligibility and annually thereafter for services defined in the Colorado Periodicity Schedule; and,

Assist clients with billing issues or other questions and issues regarding program benefits or navigation.

PURPOSE AND SCOPEThe purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to case management activities

All staff of the program shall perform these functions as defined in each of the contractors Statement ofWork

All services described shall be performed in accordance with all applicable state and federal regulations andpolicies

RATIONALEAll Family Health Coordinators shall provide comprehensive outreach and case management services to allpregnant women, and children and youth aged 20 and under who are EPSDT (Medicaid) eligible, CHP+ eligible,and those that are Eligible But Not Enrolled (EBNE) populations.

‹ Policies up Client Outreach and Program Education Policy›

GENERAL PRINCIPLESFamily Health Coordinators shall provide all outlined services in accordance with state and federalregulations and policies.

Family Health Coordinators shall perform these activities to ensure providers and all other interested partiesare informed about the services provided by Healthy Communities.

Family Health Coordinators shall perform these activities to ensure all appropriate resources and referralsand provided to the populations served.

POLICY STATEMENTFamily Health Coordinators shall provide case management to all eligible pregnant women, and children, youthaged 20 and under.

IMPLEMENTATION PROCEDURES1. Assist clients with the overall program navigation of the Medicaid and CHP+ medical assistance programs

on a day to day basis;

2. Contact and assist all clients through face to face, written, oral, and other methods of communicationincluding the use of social media. Initial contact shall be within 60 days of eligibility determination.

3. Assist clients with the application process; includes assisting the client face to face with a paper or PEAKapplication; Providing PE determinations on site to those that may qualify, and/or an appropriate referral toanother application assistance site such as the local department of social/human services, PEAK, CAAS,other PE, or MA Site to facilitate the client’s enrollment into Medicaid and CHP+.

4. Provide follow up to pregnant women and children, families, and EBNE’s on the status of their applicationas requested and/or assist the client in resolving any issues or concerns regarding their enrollment into amedical assistance program and/or eligibility issues.

5. Assist clients with the reporting of newborns which can include processing Add-A-Baby request for casesthat are emergent or if services need to be expedited.

6. Provide clients with a list and referral to an appropriate Medicaid or CHP+ provider;

7. Assist clients with scheduling of appointments and transportation needs through the MedicaidTransportation Broker or appropriate local department of social/human services.

8. Provide follow up and assistance to clients who have not received services within six months from initialeligibility and annually thereafter for services defined in the Colorado Periodicity Schedule.

9. Assist clients with billing issues or other questions and issues regarding program benefits or navigation.

10. Assist other family members in the home with referrals to low cost or free medical or non-medical serviceswithin their community as needed.


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Client Outreach and Program Education PolicyHome » Policies

DEFINITIONSFamily Health Coordinators shall perform “Client Outreach and Program Education” services by actively generating awareness and provide education to all pregnant women, and children, youth aged 20 and under, as well as the EBNE populations on the availability of medical assistance program through face to face, written, oral and other methods of communication.

Family Health Coordinators shall educate the outlined populations on the Medicaid and CHP+ program benefits including public health, mental health, education programs, and related programs such as Health Care Program for Children with Special Health Care Needs (HCP), Head Start, Title IXX social services programs, supplemental food programs for women, infants, and children (WIC) to ensure the effectiveness of child health programs.

Family Health Coordinators shall assist clients in finding or accessing appropriate medical and non medical community resources and ensure families have access to these programs.

Family Health Coordinators shall educate clients on the availability of Family Health Coordinators as a resource to all outlined populations, community partners, providers, and all other interested parties.

PURPOSE AND SCOPEThe purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Client Outreach Activities



RATIONALEClients eligible to receive services of this program shall be provided all appropriate resources that will assist inthe clients ability to be educated about their program benefits and other community resources to ensurepositive outcomes for program members.


Perform Program client outreach and program education services on a daily basis to best meet the needs ofthe clients served.

PROVIDE CLIENT OUTREACH AND PROGRAM EDUCATION SERVICES TO ALLELIGIBLE CLIENT OF THE HEALTHY COMMUNITIES PROGRAM AND IN A TIMELYMANNER POLICY STATEMENT

‹ Case Management and Program Policy up Community and Program Education Policy ›

Family Health Coordinators shall provide “Client Outreach and Program Education” services to all eligible clientsof the Healthy Communities Outreach and Case Management Program.

IMPLEMENTATION PROCEDURES1. Provide client outreach and program education services through face to face, written, oral or other methods

of communication.


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Community and Program Education PolicyHome » Policies

DEFINITIONSFamily Health Coordinators shall provide “Community Outreach and Program Education” services by providing training and education on the availability of services offered by the Healthy Communities Program to community organizations and other program related partners.Family Health Coordinators shall assist community partners in understanding the Medicaid and CHP+ medical assistance programs, program benefits, and general program administration principles.Family Health Coordinators shall plan, manage, and coordinate collaborative efforts or activities with other community organizations and partners to ensure better service delivery and education to the populations served. Family Health Coordinators shall attend meetings, conferences, and other channels of collaboration in conjunction with community organizations and community partners and actively represent the program at those meetings.

PURPOSE AND SCOPEThe purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Community Outreach activities



RATIONALEClients eligible to receive services of this program shall be provided all appropriate resources that will assist inthe clients ability to be educated about their program benefits and other community resources to ensurepositive outcomes for program members.


Family Health Coordinators shall perform these activities to ensure community partners, providers, and allother interested parties are informed about the services provided by Healthy Communities.


POLICY STATEMENTFamily Health Coordinators shall provide “Community Outreach and Program Education” services to communitypartners, providers, and all other interested parties on the services provided by the Healthy CommunitiesOutreach and Case Management Program.

‹ Client Outreach and Program EducationPolicy

up Privacy and Confidentiality Policy ›

IMPLEMENTATION PROCEDURES1. Train and educate community organizations and partners on the availability of services provided by Healthy

Communities.

2. Assist community partners in understanding the Medicaid and CHP+ Medical Assistance programs,program benefits, and general program administration guidelines.

3. Plan, manage, and coordinate collaborative efforts or activities with other community partners to ensurebetter service delivery and education to the populations served and assure services are duplicated betweenpartners.

4. Attend meetings, conferences, and other channels of collaboration in conjunction with communityorganizations and community partners and actively represent the program.


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Privacy and Confidentiality PolicyHome » Policies

DEFINITIONSPrivacy protects beneficiaries from unfair or unauthorized use of personal or sensitive information. Personal information is any information that can lead to an individual being identified or reasonably ascertained. Healthy Communities is obliged to meet the standards required in The Health Insurance Portability and Accountability Act of 1996 (HIPAA).Confidentiality relates to how information that has been disclosed in the course of a professional relationship is treated. The Healthy Communities staff have an obligation to take all reasonable measures to ensure all information disclosed in confidence, is not disclosed without beneficiary consent or otherwise unfairly or inappropriately.

PURPOSE AND SCOPEThe purpose of this policy is to establish standards of privacy and confidentiality for all aspects of theprogram’s dealings with all beneficiaries (including family members) of the service;

The Privacy and Confidentiality Policy applies to all beneficiaries. The offices where service is provided andany online presence of the program display brochures and/or pamphlets in an appropriate range oflanguages and formats about beneficiaries rights to privacy and confidentiality. The Privacy andConfidentiality Policy is to be provided to beneficiaries on request;

All staff of the program will be made aware of the Privacy and Confidentiality Policy, and contribute to anyreview of the policy based on its applicability to practice.

RATIONALEHealthy Communities is obliged to meet the standards required in the The Health Insurance Portability andAccountability Act of 1996 (HIPAA).

GENERAL PRINCIPLESBeneficiaries are to be informed of the purpose for collecting any information;

Information will be collected in a non-intrusive, non-coerced manner following the expressed or impliedconsent, as appropriate;

The only information about a beneficiary held by the service will be information necessary to provide theservice;

Information about beneficiaries will be held securely;

Details about beneficiaries are kept confidential, and only disclosed with the beneficiary’s consent for thepurpose of ensuring that beneficiaries receive the service they need;

The beneficiary will be made aware of, and be required to consent to, any exchange of information about thebeneficiary made with another person, including family/ significant others, and with another service.

‹ Community and Program Education Policy up Provider Outreach and Program EducationPolicy ›

POLICY STATEMENTThe Healthy Communities Program has a responsibility to respect its beneficiary’s right for privacy andconfidentiality by protecting them from unfair or unauthorised use of personal/sensitive information andapplying standards on how information is collected, used, secured and disclosed.

IMPLEMENTATION PROCEDURES1. Create New and Edit Beneficiary Records

2. Manage Enrollments

3. Log Interactions

4. Internal Communications

5. Reporting

6. System Security

7. Complaints of Privacy Breaches


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Provider Outreach and Program Education PolicyHome » Policies

DEFINITIONSFamily Health Coordinators shall provide education to providers on the services provided by or available through Healthy Communities including but not limited to: Assisting with missed appointment follow up; Provider office visits; Resolving or clarifying the client’s program eligibility: Reporting of the clients newborn; Scheduling or contacting the client for follow up services or other visits; and other services needed by the client.Family Health Coordinators shall educate and assist providers with services covered by the Medicaid and CHP+ medical assistance programs.Family Health Coordinators shall refer provider to the appropriate Department or other community resources including those that would like to become Medicaid or CHP+ providers.

PURPOSE AND SCOPEThe purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Provider Outreach activities



RATIONALEFamily Health Coordinators shall ensure good relationships with external partners to ensure all appropriateservices can be offered to the populations served.


Family Health Coordinators shall perform these activities to ensure providers and all other interested partiesare informed about the services provided by Healthy Communities.


POLICY STATEMENTFamily Health Coordinators shall provide “Provider Outreach and Program Education” services to providers andall other interested parties on the services provided by the Healthy Communities Outreach and CaseManagement Program.

IMPLEMENTATION PROCEDURES

‹ Privacy and Confidentiality Policy up

1. Educate providers on the services provided by or available through Healthy Communities including but notlimited to: Assisting with missed appointment follow up; Provider office visits; Resolving or clarifying theclients program eligibility; Reporting of clients newborn; Scheduling or contacting the client for follow upservices or other visits; and other services needed by the client.

2. Educate and assist providers with services covered by the Medicaid and CHP+ medical assistance programs.

3. Refer providers to appropriate Department or community resources including those that would like tobecome Medicaid or CHP+ providers.


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Policies

Case Management and Program Policy

DEFINITIONS

Family Health Coordinators shall assist clients with the overall program navigation of the Medicaid and CHP+medical assistance programs on a day to day basis including but not limited to:

Contacting and assisting all clients through face to face, written, oral, and other methods of communication;

Assist clients with the application process which can include assisting the client face to face with a paper orPEAK application; Providing PE determinations on site to those that may qualify, and/or an appropriate referralto another application assistance site such as local department of social/human services, PEAK, CAAS, otherPE, or MA Site to facilitate the client’s enrollment into Medicaid and CHP+;

Provide follow up to pregnant women and children, families, and EBNE’s on the status of their application asrequested and/or assist the client in resolving any issues or concerns regarding their enrollment into a medicalassistance program and/or eligibility issues;

Assist clients with the reporting of newborns; includes processing Add-A-Baby request for cases that areemergent or if services need to be expedited;

Provide clients with a list and referral to an appropriate Medicaid or CHP+ provider;

Assist clients with scheduling of appointments and transportation needs through the Medicaid TransportationBroker or appropriate local department of social/human services;

Provide follow up and assistance to clients who have not received services within six months of initialeligibility and annually thereafter for services defined in the Colorado Periodicity Schedule; and,

Assist clients with billing issues or other questions and issues regarding program benefits or navigation.

PURPOSE AND SCOPE

The purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to case management activities

All staff of the program shall perform these functions as defined in each of the contractors Statement of Work


RATIONALE

All Family Health Coordinators shall provide comprehensive outreach and case management services to all pregnantwomen, and children and youth aged 20 and under who are EPSDT (Medicaid) eligible, CHP+ eligible, and thosethat are Eligible But Not Enrolled (EBNE) populations.

GENERAL PRINCIPLES

Family Health Coordinators shall provide all outlined services in accordance with state and federal regulationsand policies.

Family Health Coordinators shall perform these activities to ensure providers and all other interested parties areinformed about the services provided by Healthy Communities.

Family Health Coordinators shall perform these activities to ensure all appropriate resources and referrals andprovided to the populations served.

POLICY STATEMENT

Family Health Coordinators shall provide case management to all eligible pregnant women, and children, youth aged20 and under.


1. Assist clients with the overall program navigation of the Medicaid and CHP+ medical assistance programs on aday to day basis;

2. Contact and assist all clients through face to face, written, oral, and other methods of communication includingthe use of social media. Initial contact shall be within 60 days of eligibility determination.

3. Assist clients with the application process; includes assisting the client face to face with a paper or PEAKapplication; Providing PE determinations on site to those that may qualify, and/or an appropriate referral toanother application assistance site such as the local department of social/human services, PEAK, CAAS, otherPE, or MA Site to facilitate the client’s enrollment into Medicaid and CHP+.

4. Provide follow up to pregnant women and children, families, and EBNE’s on the status of their application asrequested and/or assist the client in resolving any issues or concerns regarding their enrollment into a medicalassistance program and/or eligibility issues.

5. Assist clients with the reporting of newborns which can include processing Add-A-Baby request for cases thatare emergent or if services need to be expedited.

6. Provide clients with a list and referral to an appropriate Medicaid or CHP+ provider;

7. Assist clients with scheduling of appointments and transportation needs through the Medicaid TransportationBroker or appropriate local department of social/human services.

8. Provide follow up and assistance to clients who have not received services within six months from initialeligibility and annually thereafter for services defined in the Colorado Periodicity Schedule.

9. Assist clients with billing issues or other questions and issues regarding program benefits or navigation.














10. Assist other family members in the home with referrals to low cost or free medical or non-medical serviceswithin their community as needed.

Client Outreach and Program Education Policy

DEFINITIONS

Family Health Coordinators shall perform “Client Outreach and Program Education” services by actively generatingawareness and provide education to all pregnant women, and children, youth aged 20 and under, as well as the EBNEpopulations on the availability of medical assistance program through face to face, written, oral and other methods ofcommunication.

Family Health Coordinators shall educate the outlined populations on the Medicaid and CHP+ program benefitsincluding public health, mental health, education programs, and related programs such as Health Care Program forChildren with Special Health Care Needs (HCP), Head Start, Title IXX social services programs, supplemental foodprograms for women, infants, and children (WIC) to ensure the effectiveness of child health programs.

Family Health Coordinators shall assist clients in finding or accessing appropriate medical and non medicalcommunity resources and ensure families have access to these programs.

Family Health Coordinators shall educate clients on the availability of Family Health Coordinators as a resource to alloutlined populations, community partners, providers, and all other interested parties.

PURPOSE AND SCOPE

The purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Client Outreach Activities



RATIONALE

Clients eligible to receive services of this program shall be provided all appropriate resources that will assist in theclients ability to be educated about their program benefits and other community resources to ensure positive outcomesfor program members.

GENERAL PRINCIPLES


Perform Program client outreach and program education services on a daily basis to best meet the needs of theclients served.


PROVIDE CLIENT OUTREACH AND PROGRAM EDUCATIONSERVICES TO ALL ELIGIBLE CLIENT OF THE HEALTHYCOMMUNITIES PROGRAM AND IN A TIMELY MANNER POLICYSTATEMENT

Family Health Coordinators shall provide “Client Outreach and Program Education” services to all eligible clients ofthe Healthy Communities Outreach and Case Management Program.


1. Provide client outreach and program education services through face to face, written, oral or other methods ofcommunication.

Community and Program Education Policy

DEFINITIONS

Family Health Coordinators shall provide “Community Outreach and Program Education” services by providingtraining and education on the availability of services offered by the Healthy Communities Program to communityorganizations and other program related partners.Family Health Coordinators shall assist community partners in understanding the Medicaid and CHP+ medicalassistance programs, program benefits, and general program administration principles.Family Health Coordinators shall plan, manage, and coordinate collaborative efforts or activities with othercommunity organizations and partners to ensure better service delivery and education to the populations served. Family Health Coordinators shall attend meetings, conferences, and other channels of collaboration in conjunctionwith community organizations and community partners and actively represent the program at those meetings.

PURPOSE AND SCOPE

The purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Community Outreach activities



RATIONALE

Clients eligible to receive services of this program shall be provided all appropriate resources that will assist in theclients ability to be educated about their program benefits and other community resources to ensure positive outcomesfor program members.

GENERAL PRINCIPLES




Family Health Coordinators shall perform these activities to ensure community partners, providers, and allother interested parties are informed about the services provided by Healthy Communities.


POLICY STATEMENT

Family Health Coordinators shall provide “Community Outreach and Program Education” services to communitypartners, providers, and all other interested parties on the services provided by the Healthy Communities Outreachand Case Management Program.


1. Train and educate community organizations and partners on the availability of services provided by HealthyCommunities.

2. Assist community partners in understanding the Medicaid and CHP+ Medical Assistance programs, programbenefits, and general program administration guidelines.

3. Plan, manage, and coordinate collaborative efforts or activities with other community partners to ensure betterservice delivery and education to the populations served and assure services are duplicated between partners.

4. Attend meetings, conferences, and other channels of collaboration in conjunction with communityorganizations and community partners and actively represent the program.

Privacy and Confidentiality Policy

DEFINITIONS

Privacy protects beneficiaries from unfair or unauthorized use of personal or sensitive information. Personalinformation is any information that can lead to an individual being identified or reasonably ascertained. HealthyCommunities is obliged to meet the standards required in The Health Insurance Portability and Accountability Act of1996 (HIPAA).Confidentiality relates to how information that has been disclosed in the course of a professional relationship istreated. The Healthy Communities staff have an obligation to take all reasonable measures to ensure all informationdisclosed in confidence, is not disclosed without beneficiary consent or otherwise unfairly or inappropriately.

PURPOSE AND SCOPE

The purpose of this policy is to establish standards of privacy and confidentiality for all aspects of theprogram’s dealings with all beneficiaries (including family members) of the service;

The Privacy and Confidentiality Policy applies to all beneficiaries. The offices where service is provided andany online presence of the program display brochures and/or pamphlets in an appropriate range of languages









and formats about beneficiaries rights to privacy and confidentiality. The Privacy and Confidentiality Policy isto be provided to beneficiaries on request;

All staff of the program will be made aware of the Privacy and Confidentiality Policy, and contribute to anyreview of the policy based on its applicability to practice.

RATIONALE

Healthy Communities is obliged to meet the standards required in the The Health Insurance Portability andAccountability Act of 1996 (HIPAA).

GENERAL PRINCIPLES

Beneficiaries are to be informed of the purpose for collecting any information;

Information will be collected in a non-intrusive, non-coerced manner following the expressed or impliedconsent, as appropriate;

The only information about a beneficiary held by the service will be information necessary to provide theservice;

Information about beneficiaries will be held securely;

Details about beneficiaries are kept confidential, and only disclosed with the beneficiary’s consent for thepurpose of ensuring that beneficiaries receive the service they need;

The beneficiary will be made aware of, and be required to consent to, any exchange of information about thebeneficiary made with another person, including family/ significant others, and with another service.

POLICY STATEMENT

The Healthy Communities Program has a responsibility to respect its beneficiary’s right for privacy andconfidentiality by protecting them from unfair or unauthorised use of personal/sensitive information and applyingstandards on how information is collected, used, secured and disclosed.


1. Create New and Edit Beneficiary Records

2. Manage Enrollments

3. Log Interactions

4. Internal Communications

5. Reporting

6. System Security

7. Complaints of Privacy Breaches

Provider Outreach and Program Education Policy

DEFINITIONS

Family Health Coordinators shall provide education to providers on the services provided by or available throughHealthy Communities including but not limited to: Assisting with missed appointment follow up; Provider officevisits; Resolving or clarifying the client’s program eligibility: Reporting of the clients newborn; Scheduling orcontacting the client for follow up services or other visits; and other services needed by the client.Family Health Coordinators shall educate and assist providers with services covered by the Medicaid and CHP+medical assistance programs.Family Health Coordinators shall refer provider to the appropriate Department or other community resourcesincluding those that would like to become Medicaid or CHP+ providers.

PURPOSE AND SCOPE

The purpose of this policy is to establish and define the responsibilities of the Family Health Coordinators asthey related to Provider Outreach activities



RATIONALE

Family Health Coordinators shall ensure good relationships with external partners to ensure all appropriate servicescan be offered to the populations served.

GENERAL PRINCIPLES


Family Health Coordinators shall perform these activities to ensure providers and all other interested parties areinformed about the services provided by Healthy Communities.


POLICY STATEMENT

Family Health Coordinators shall provide “Provider Outreach and Program Education” services to providers and allother interested parties on the services provided by the Healthy Communities Outreach and Case ManagementProgram.


1. Educate providers on the services provided by or available through Healthy Communities including but notlimited to: Assisting with missed appointment follow up; Provider office visits; Resolving or clarifying theclients program eligibility; Reporting of clients newborn; Scheduling or contacting the client for follow upservices or other visits; and other services needed by the client.

2. Educate and assist providers with services covered by the Medicaid and CHP+ medical assistance programs.

3. Refer providers to appropriate Department or community resources including those that would like to becomeMedicaid or CHP+ providers.





Assist Clients with Scheduling or Appointments and Transportation NeedsHome » Procedures

‹ Procedures up Assist Clients with the Application Process ›

OVERVIEWSome clients are more likely to receive health care, in a timely manner, if an appointment is made for him/her, so by assisting in scheduling an appointment, you are assured that the client has been scheduled to be seen by the provider of their choice. Clients state a barrier to receiving health care is the inability to get to the provider. By assisting clients with transportation issues, the client will receive the health care needed.Assist clients with scheduling of appointments and transportation needs through the Medicaid Transportation Broker or appropriate local department of social/human services

POLICIES APPLICABLECase Management and Program Policy

PROCEDURE DETAILS1. You will offer assistance in scheduling of appointments to both pregnant women and children with their

selected providers, unless the client prefers to schedule their own appointment(s).

2. If client prefers to utilize a provider list without assistance, follow up will be required with the family toensure a provider was selected and an appointment was scheduled. You will inform the family at time ofvisit that you will follow up within 2weeks.You must create a task to flag yourself in the data system forfollow up within 2 week time period.

3. Have working knowledge of your Transportation broker or DHS contact person in your area, so that areferral can be given to a client needing transportation for Medical appointments.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization Clinics



Contact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Assist Clients with the Application ProcessHome » Procedures

OVERVIEWApplying for Medicaid/CHP+ can be a very confusing, time consuming, and very frustrating process for many families, to the point where some would rather do without. The responsibility of HC is to remove these barriers, provide a more friendly experience, and assure families apply and receive the medical services they need and deserve. Assisting clients with the application process includes assisting the client face to face with a paper or PEAK application, providing PE determinations on site to those that may qualify, and/or an appropriate referral to another application assistance site; local department of social/human services, PEAK, CAAS, other PE, or MA Site to facilitate the client’s enrollment into Medicaid and CHP+


PROCEDURE DETAILS1. Complete a financial screen by phone to see if client could be eligible for Medicaid and/or CHP+. This

avoids having a client come in if they will not be eligible for either program and then referrals can be madeto other programs for assistance.

2. If a PE Site, meet with the client as soon as they are able, so client is readily served. If not a PE site, referto appropriate location to apply (ie: PE Site, MA Site, DSS, or PEAK)

3. Follow up with client or site to assure client applied.

4. If a PE Site, inform client of the documents required to complete an application. Although not a requirementfor PE, it can make the processing of the application more expedient.

5. If a pregnant client, inform client proof of pregnancy is required. This must be signed by a clinic, physicianor nurse.

6. Meet with the client face to face.

7. Assist client with completing application, by answering questions and confirming all sections that apply tothe client have been completed.

8. Make sure application has been signed and dated.

a. Date stamp on application, date on affidavit (bottom of each child’s page), and the signature date mustall be the same.

9. Enter data in CBMS and run PE, print PE Cards.

10. Explain the PE Card and all services provided under the PE Card

11. Assure that each applicant has a PCP/Pediatrician, dental, vision provider. If pregnant, assure the client hasan OB Provider.


‹ Assist Clients with Scheduling orAppointments and Transportation Needs

up Assist Clients with the Overall ProgramNavigation of the MEDICAID and CHP+

Medical Assistance Programs on a Day to DayBasis ›

12. If a PE Site, follow up with your DSS or MA Site for status on application.

13. Assist clients to collect and submit necessary documents (income verification, birth certificate, photo ID orother acceptable documents) if not provided at time of application.

14. All contact and client interaction must be entered into HC data base.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like to


Become MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Assist Clients with the Overall Program Navigation of the MEDICAID and CHP+Medical Assistance Programs on a Day to Day Basis

Home » Procedures

OVERVIEWEducating, advocating, and continual follow up on the Medicaid/CHP+ Medical assistance programs will empower your clients and encourage self-sufficiency. Clients can accept the responsibility of their family’s health care more readily with your enduring assistance and support.


PROCEDURE DETAILS1. Make sure families know: those under 21 years of age should have an EPSDT complete physical yearly, (or

more frequent for those under age 2), developmental and autism screenings, dental checkups are every 6months beginning at age 1, lead testing is required at 12 and 24 months or between 36 and 73 months ifnot previously tested, vision screenings and glasses are covered as needed and not limited to 1 pair/yr,hearing screenings, and mental health screenings, depression screenings (including for teens) per theColorado Periodicity Schedule. Ask families if their children are current on their Immunizations, and providean immunization schedule. Provide information on Family Planning.

2. Educate on the dangers of second-hand smoke and provide information on the Quit Line for those clientswanting to quit smoking.

3. Provide information on the Nurse Support Line by explaining what it is, and giving the State Flyer. Provideinformation and flyer for the pregnant women interested in Text4baby.

4. You will offer assistance in scheduling of appointments to both pregnant women and children with theirselected providers, unless the client prefers to schedule their own appointment(s).

5. If client prefers to utilize a provider list without assistance, follow up will be required with the family toensure a provider was selected and an appointment was scheduled. You will inform the family at time ofvisit that you will follow up within 2weeks.You must create a task to flag yourself in the data system forfollow up within 2 week time period .

6. Screening protocols should be followed to allow the HC staff to make necessary and appropriate referrals toCommunity Programs and Organizations.

7. Assist family with the Medicaid/CHP+ application and process PE.

a. If not a PE Site, then refer family to the PE Site in your county. It is strongly recommended you call thePE site and schedule an appointment for your family so they know the time, date, and location where theyneed to apply.b. You will create a task to follow up after scheduled PE appt. to check PE status in CBMS. The follow uptask ensures that the family applied and received a PE .c. If not in CBMS showing active PE, then a follow up contact is required to assist families in accessing


‹ Assist Clients with the Application Process up Assist Clients with the Reporting of Newborns›

services needed.

8. All contacts, referrals and follow up will be entered in the HC Data system.

9. Provide the contact information for Health Colorado and explain why a client or family will need to contactthem, including upcoming letters for passive enrollment into managed care or accountable careorganizations

10. Provide the contact for the Ombudsman for Medicaid Managed Care and explain when they can assist aclient with specific issues or concerns.

11. Provide education and assistance in using Colorado PEAK

12. Give all contact information for their local HC Office



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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education Services


Provide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Assist Clients with the Reporting of NewbornsHome » Procedures

‹ Assist Clients with the Overall Program up Assist Community Partners in Understanding

OVERVIEWWhen Add-a-babies are completed immediately after birth and processed by the client’s County DHS or MA Site, new babies born to Medicaid/CHP+ mothers can access health care from their provider(s) from time of birth and through the baby’s first year.Assisting clients with the reporting of newborns includes processing Add-A-Baby request for cases that are emergent or if services need to be expedited.


PROCEDURE DETAILS1. All Healthy Communities will complete an Add-a-baby form for babies born to Medicaid or CHP+ mothers.

a. Make sure spelling is correct and verify date of birth and gender.

2. Encourage mom to select a provider for her newborn baby, if she does not have one already selected.

a. Provide appropriate provider list and offer assistance to schedule an appointment.

3. Inform mom that her newborn should be seen by baby’s provider according to the Colorado PeriodicitySchedule.

4. Inform mom of the process and give an approximate time when she may receive a Medicaid Card.

5. Inform mom of the benefits her newborn is eligible for under Medicaid or CHP+.

6. Give mom your contact information so that she can contact your for a vision provider list at 6 months, anda dental provider list before 1yr.

7. Inform mom of the periodicity schedule for well child visits.

8. Provide an immunization schedule.

9. Give other educational materials.

10. Send Add-a-baby form to be processed by MA Site or DHS.

11. Follow up with Site to see when baby is added and contact mom to give her State ID and ensure she is ableto access services.

12. If it has been more than 2 weeks and baby has not been added, it is the responsibility of the FHC to followup with the necessary agencies so that baby is added. Some providers may not be willing to provideservices until baby has a State ID.


Navigation of the MEDICAID and CHP+Medical Assistance Programs on a Day to DayBasis

the Medicaid and CHP+ Medical AssistanceProgram, Program Benefits, and General

Program Administration Guidelines ›


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Assist Community Partners in Understanding the Medicaid and CHP+ MedicalAssistance Program, Program Benefits, and General Program AdministrationGuidelines

Home » Procedures

‹ Assist Clients with the Reporting ofNewborns

up Attend Meetings, Conferences, and otherChannels of Collaboration in Conjunction with

Community Organizations and CommunityPartners ›

OVERVIEWEducating your community partners/organizations on the Medicaid/CHP+ benefits will allow theagency/organization to better serve their families when they present to them having medical/health problems or concerns. The organization/agency will know the best assistance they can offer their family would be to refer them to HC for services and follow-up.

POLICIES APPLICABLECommunity and Program education policy

PROCEDURE DETAILS1. Educate the community partner/organizations on the benefits provided to Medicaid and CHP+ Eligible

children and pregnant women.

2. Educate community partners that we refer to PCMP/Pediatricians, OB/Gyn, Dental, Vision, Mental Health,and Specialty providers that are taking new and existing Medicaid and CHP+ families and individuals.

3. Inform community partners and/or organizations that HC is a State and Federally funded program and mustprovide neutral navigation to services, and assistance is provided to all Families, no matter their choice ofprovider or hospital.

4. Inform community partners and/or organizations that assists all Medicaid/CHP+ Providers no matter theiraffiliation.

5. Inform community partners and/or organizations that follow-up services are provided to families andreferrals made to community organizations for other assistance as needed or requested.

6. Educate our community partners and/or organizations concerning Medicaid and CHP+ medical assistanceprograms, by introducing and informing about Presumptive Eligibility, PEAK, MA sites, DHS and otheravenues clients may access other Medical assistance programs.



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Attend Meetings, Conferences, and other Channels of Collaboration in Conjunctionwith Community Organizations and Community Partners

Home » Procedures

‹ Assist Community Partners in Understandingthe Medicaid and CHP+ Medical AssistanceProgram, Program Benefits, and GeneralProgram Administration Guidelines

up Contact Clients Attending InmunizationClinics ›

OVERVIEWBecoming involved in your community is an essential piece of the HC Program. These are excellent opportunities for community outreach, building working relationships, decision making in programs that that are utilized by HC Families, and educating the public on the services provided by HC to families and providers.


PROCEDURE DETAILS1. Participate as a member of Advisory Boards, representing HC, not a Department or Unit

2. Participate as a member of coalitions

3. Participate in early childhood councils

4. Participate in child welfare activities and meetings

5. Attend local city or county government meetings

6. Participate in your local school boards or PTA meetings

7. Participate in Health Fairs or other fairs in your community or surrounding communities

8. Network with other vendors at fairs; possibly set a time for an in-service

9. Network at local or state conferences

10. All contacts and follow up will be entered in the HC Data system.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical Assistance



Programs on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Contact Clients Attending Inmunization ClinicsHome » Procedures

‹ Attend Meetings, Conferences, and otherChannels of Collaboration in Conjunction withCommunity Organizations and CommunityPartners

up Contact and Assist all Clients Referred to theHealthy Communities Program Through Faceto Face, Written, Oral, and Other Methods of

Communication Including the Use of SocialMedia ›

OVERVIEWContacting clients while attending Immunization clinics, assures clients are current with their immunizations. You can assist clients find a provider for other preventive health care benefits, and to receive medical attention when ill. This also offers an opportunity to provide education on other health issues and refer to other community services.

POLICIES APPLICABLEPrivacy policy related to immunization clinics and appropriate outreach to clients

PROCEDURE DETAILS1. Contact local Health Department to participate in immunization clinics

a. Bring provider lists and applications to assist those clients without a medical home or those that areuninsured EBNE’s to apply for Medicaid or CHP+.

2. If applicable and necessary, contact your Immunization Coalition for local opportunities and to provideinformation on your availability and services to the shared clients in the area


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,


Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Contact and Assist all Clients Referred to the Healthy Communities Program ThroughFace to Face, Written, Oral, and Other Methods of Communication Including the Useof Social Media

Home » Procedures

‹ Contact Clients Attending InmunizationClinics

up Educate Providers on the Services Provided byor Available Through Healthy Communities ›

OVERVIEWMaking a contact is not what is relevant, but the manner in which the contact is made is of most importance. It allows you to build the relationships with your clients, which is crucial to the success of the program. Whether a face to face, phone call, letter, text or email, if a client is shown compassion, treated with respect, and knows that their FHC has done ALL that is possible to assist him/her, clients will bond with their FHC and reach out to them for future assistance.


PROCEDURE DETAILS1. Face to Face could be scheduled or walk-in either at the clients home, a community location or at the HC

office.

a. Face to Face contacts are encouraged to create a relationship between Family Health Coordinators andfamilies.

2. Hospital visits/ER visits

3. Letter

a. State authorized correspondence only.

4. Email

a. Warning: must be encrypted for HIPPA if contains Personal Health Information

5. Telephone contacts

6. FAX

7. Text messages from HC date system


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Educate Providers on the Services Provided by or Available Through HealthyCommunities

Home » Procedures

OVERVIEWThe assistance HC offers to Providers can be a deciding factor as to whether that provider may choose to accept new Medicaid/CHP+ patients, which is imperative with the shortage of providers in many areas. Providers appreciate having a ‘local’ office to contact when having issues/questions regarding patients and/or Medicaid/CHP+ benefits or billing. Advocating for providers is mandated for HC FHCs.

POLICIES APPLICABLEProvider Outreach and Program Education Policy

PROCEDURE DETAILS1. Explain to Providers how you can assist to find ‘real’ time eligibility on patients by using CBMS.

2. Train providers how to read the eligibility documentation from CMRS or another eligibility system, includingmanaged care and RCCO assignments as well as BHO assignments and what those may mean to a practice.

3. If you are a presumptive eligibility site, explain what presumptive eligibility is, the importance, and howProviders can use PE.

A. Provide samples of PE Cards to the providers so their office knows what to expect when a patientpresents coverage under PE.

4. Explain to the Provider the benefits that are covered under PE.

A. Make it clear in-patient is covered for children, while it is not for pregnant women.B. Dental is not covered under CHP+ until the client has received their Delta Dental CardC. PARs must be completed under PE as they would be required under Medicaid Guidelines.

5. Offer assistance with problems that may arise from accepting a PE Card and billing being rejected by State.The Family Health Coordinator will contact the state for any denials for services provided underPresumptive Eligibility if a service was a benefit of Medicaid/CHP+ and did not require a PAR.

6. Assist Providers with clients that have excessive missed appointments.

A. Contact the family to see what barriers may be preventing them from attending their appointment.B. Inform Providers that it will be stressed to families that a provider may chose to not continue servingthe patient for excessive missed appointments.

7. Inform providers that accept new Medicaid and or CHP+ patients that they will be on a list given to clientswho are looking for a provider. HC staff must work with the current provider recruitment and retentionstaff as to best explain their options related to accepting new or existing clients.

8. Inform Providers that if transportation is a barrier for their patients keeping their appointments, providersshould refer to Healthy Communities so we may make the necessary referrals for the clients to receive


‹ Contact and Assist all Clients Referred to theHealthy Communities Program Through Faceto Face, Written, Oral, and Other Methods ofCommunication Including the Use of SocialMedia

up Educate and Assist Providers with ServicesCovered by the Medicaid and CHP+ Medical

Assistance Programs ›

transportation assistance.

9. Inform providers that Healthy Communities offices will coordinate with other Healthy Communities teamsto assist their patients that live in other counties.

10. Give providers contact information to their local Healthy Communities office.



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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding their


Enrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Educate and Assist Providers with Services Covered by the Medicaid and CHP+Medical Assistance Programs

Home » Procedures

‹ Educate Providers on the Services Providedby or Available Through Healthy Communities

up Manage Complaints of Privacy Breaches ›

OVERVIEWKnowledge of Medicaid/CHP+ benefits and understanding treatment options will allow providers to build relations with their patients and provide complete health care services. Providers can also offer better health services to their patients by knowing about Presumptive Eligibility (EBNE) and the referral process to HC


PROCEDURE DETAILS1. Provide the ACS Automated Voice Response System (AVRS) (1-800-237-0757 or 1-800-237-0044)

regarding questions on Client Eligibility Verification, Claims Submission, Claims Status, Claims Inquiry, andProvider Warrants Verification. Inform Providers that there is no longer a limit of inquiries.

2. Provide information for the Provider services available in the HCPF website, including providers interested inbecoming a Colorado Medicaid Provider

3. Inform Providers they can visit the Benefits Collaborative section of the HCPF website for ensuring thatbenefit coverage decisions are based on the best available clinical evidence and that all benefit coveragepolicies promote the improved health and functioning of Medicaid clients.

4. Refer Providers to the Provider tab in the HCPF for information regarding provider services: Billing Manuals,Provider Bulletins, Colorado PAR Program, forms, frequently asked questions, comprehending thereimbursement and supplemental payments.

5. Refer Providers to the Colorado Medical Assistance Program Web Portal. The user guides and EDI Supportfor enrollment purposes is available also on the HCPF website.


7. Referral process to other providers including the use of the Early Intervention Colorado and BehavioralHealth referral forms. Providers shall also be trained to understand the different needs for managed careand accountable care related to referrals.


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Manage Complaints of Privacy BreachesHome » Procedures

‹ Educate and Assist Providers with ServicesCovered by the Medicaid and CHP+ MedicalAssistance Programs

up Outreach to Child Care Centers/ Homes ›

OVERVIEWKeeping protected health information safe is of primary concern. FHC staff will share only the minimal information that is needed to assure services or benefits are accessed. Information will not be shared with other programs or units within FHC offices unless approved by the State. Data sharing for data sake is not allowed. Data requests can be made directly with the Department for other programs or units needed information related to Medicaid clients.

POLICIES APPLICABLEPrivacy and Confidentiality Policy

PROCEDURE DETAILS1. All FHC staff need to assure data is kept in a manner that meets federal privacy standards.

2. ALL FHC staff need to meet their own employers policies related to HIPAA.

3. All FHC staff must only share minimal information with others that is needed to assure the service orbenefit can be accessed.

4. All FHC staff will understand a business associate of the program and share information accordingly.

5. All staff have the ability to access data from their local WIC programs and should assure this option isexercised when tracking clients.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community Partners



Contact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Outreach to Child Care Centers/ HomesHome » Procedures

‹ Manage Complaints of Privacy Breaches up Outreach to Community ›

OVERVIEWFamilies with very young children (birth to pre-school ages) can be informed of the services provided by HC.

POLICIES APPLICABLEOutreach to early care and education providers (day care) as well as regular meetings with Head Start, Early HeadStart and other early care and education programs in your service areas.

PROCEDURE DETAILS1. Network with school districts for Colorado Preschool Program enrollments

2. Work with your local Early Childhood Council

3. Call local daycare and childcare facilities to schedule an in-service

4. Meet with local HeadStart and Early HeadStart offices at least twice a year.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ Homes


Outreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Outreach to CommunityHome » Procedures

‹ Outreach to Child Care Centers/ Homes up Outreach to EPSDT Clients at Events ›

OVERVIEWMore families can be informed about HC services through several avenues, one being collaborative efforts with other county HCs. Current or potential clients can be contacted at regional events, fairs, and festivities. Community outreach does not mean providers only, but can also include any location or event wherecurrent/potential clients can be found, information about HC can be provided, and therefore your yearly quota can be met.Establish a yearly quota that takes into account the size of the county.

POLICIES APPLICABLEEstablish quota for outreach in the community to a realistic number, but not one that is less than 2 contacts per month.Partner with other HC offices when your service areas overlap (ie RCCO or HCP regions)

PROCEDURE DETAILS1. Health Fair participation

2. In service to Providers

3. In service to community organizations and partners such as food banks or other non-profit organizationsin your service area.

4. Schools

a. School based clinicb. Child Findc. Enrollmentd. Back to school nightse. Open houses

5. Health Department

6. Fire stations

7. DHS

8. Police Departments

9. Community coalitions and advisory boards


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Outreach to EPSDT Clients at EventsHome » Procedures

‹ Outreach to Community up Plan, Manage, and Coordinate CollaborativeEfforts or Activities with Other Community

Partner to Ensure Better Service Delivery andEducation to the Populations Served ›

OVERVIEWOutreach to clients at events is an avenue FHCs can use to provide information about the services provided by HC. Information can be given to large number of current and/or potential clients (EBNE).Events include Healthy Children Clinic, HCP Ortho and Neuro Clinics, Child Find, Head Start registration, Boo at the Zoo in October for Lead Testing, WIC clinics, health fairs, school functions, or any other local event where there will be families and children.

APPLICABLENetwork with all programs that provide services to clients who are HC clients

PROCEDURE DETAILS1. Provide educational material, Healthy Community brochures

2. Provider lists

3. Community Resources

4. Applications

5. Answer questions and concerns concerning barriers or requests to receive services

6. Provide contact information

7. Enter Outreach / Event in HC data base


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,


Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Plan, Manage, and Coordinate Collaborative Efforts or Activities with OtherCommunity Partner to Ensure Better Service Delivery and Education to thePopulations Served

Home » Procedures

‹ Outreach to EPSDT Clients at Events up Provide Case Follow-Up ›

OVERVIEWCollaborating with community partners/organizations is an exceptional way to build strong working relationships with the partners and organizations in your community. This is imperative since many of these organizations/agencies work with the same families as Healthy Communities. This also allows you to become aware and knowledgeable of the resources in your community so that you can refer HC clients toagencies/programs and therefore provide complete services. Collaboration also allows programs not to duplicate services within the community or family structure.


PROCEDURE DETAILS1. Attend Health fairs put on by your community and partner in planning as appropriate.

2. Participate with schools to host a table to provide HC information to families at open houses,parent/teacher conferences, enrollment days

3. Contact any college/university in your area since some students may have children of their own and may beeligible for Family Medicaid, or may now qualify for Medicaid under the Adults without Dependent ChildrenProgram and are under the age of 21.

4. Coordinate with other HC Programs for annual festivities held in certain cities or towns.

5. Build strong working relationship with community partners.

a. Local library, schools (office staff, school counselor or nurse), fire departments, senior citizen groups(many grandparents raising grandchildren), father’s groups, pregnancy centers, homeless shelters, foodbanks, head start programs, early care and education providers, domestic violence shelters, to name afew. These locations should know who you are and how you can assist their clients through HC Services.

6. Actively participate with community partners in planning and attending events in your community.



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Provide Case Follow-UpHome » Procedures

‹ Plan, Manage, and Coordinate CollaborativeEfforts or Activities with Other CommunityPartner to Ensure Better Service Delivery andEducation to the Populations Served

up Provide Client Outreach and ProgramEducation Services ›

OVERVIEWA state requirement for all Healthy Communities is care coordination. That includes not only the initial contact you have with a client, but the continued assistance to the client. The follow-up will assure you your clients are receiving all medical services required to be healthy (physically and emotionally)and that your clients receive the care they need when they become ill.Prioritize dental and depression screening follow-up, come up with other priorities for follow-up

POLICIES APPLICABLEHC offices are required to assure that at least 80% of the children in their service areas are accessing well child visits one time per yearHC offices are required to assure at least 80% of their children in their service areas are accessing a oral health service one time per year. As of 2013, a 5% increase in required over 2010 EPSDT 416 rates.HC offices are required to assure that applicable lead testing is being completed in the community and to make provides aware this is required in Colorado.HC offices are required to assure that applicable and needed behavioral health assessments are being referred to local BHO providers to complete.

PROCEDURE DETAILS1. Assure that local goals and objectives include those for EPSDT2. Choose priority areas, but understand that all areas will need to be reached in order to meet state and

federal goals3. Priorities can include:

a. Children with special needsb. Children with severe medical conditionsc. Pregnant teensd. High risk pregnanciese. Dental screeningsf. Depression screenings for teensg. Immunizationsh. EPSDT well child visits---


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Provide Client Outreach and Program Education ServicesHome » Procedures

‹ Provide Case Follow-Up up Provide Clients with a List and Referral to anAppropriate Medicaid or CHP+ Provider ›

OVERVIEWBy reaching out to all current and potential clients and providing program education, clients can receive the optimal services from their Healthy Communities’ Coordinator and therefore best utilize the Medicaid/CHP+ Services and community services for the best health outcomes.Provide client outreach and program education services through face to face, written, oral or other methods of communication

POLICIES APPLICABLEClient Outreach and Program Education Policy

PROCEDURE DETAILS1. Check CBMS for Medicaid/CHP+ Status by checking Med Span for each family member that is an HC Client.

Do not assume that all members are active because you find one member active.

2. If active, then you will check to see if this client is in the HC Data Base. If not, a new household will need tobe entered. This includes all active Medicaid / CHP+ members.

3. A contact will be made to the family by face to face, phone, letter, email or text as appropriate. Warning: Allcommunications by email with client data must be encrypted.

4. Educate families on EPSDT benefits for Medicaid eligible families, including well child and oral health careas outlined by the Colorado Periodicity Schedule. Education shall include the need for lead testing at 12and 24 months as well as between 36 and 72 months if not previously tested.

5. Educate families on benefits available for CHP+ eligible families, including well child and oral health care.

6. Educate on dangers of second-hand smoke and provide information on the Quit Line for those clientswanting to quit smoking.


8. Assist families to find a provider for all Medicaid /CHP+ services by accessing the Provider list in the HCdata base.

9. Make necessary and appropriate referrals to Community Programs and Organizations.



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Provide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderHome » Procedures

‹ Provide Client Outreach and ProgramEducation Services

up Provide Follow Up to Pregnant Women andChildren, Families, and EBNE's on the Status

of their Application as Requested and/orAssist the Client in Resolving any Issues orConcerns Regarding their Enrollment into aMedical Assistance Program and/or Eligibi ›

OVERVIEWClients may have a Medicaid/CHP+ card, but may still not access health care for all benefits offered by their health plan if they do not have the appropriate providers. FHC’s will provide lists of the providers currently accepting new patients. Clients can overcome many of their barriers with the assistance of their FHC so they can receive the preventive health care services and receive health care when ill.


PROCEDURE DETAILS1. Compile and keep a list of all Providers that are taking new Medicaid and CHP+ families that is accessible to

clients and community agencies and providers.

a. Enter all providers into the HC data base, including hours, ages, working hours, affiliations, ADAaccessible, etc.

2. Notify the provider that you will be emailing them every 6 months to assure all of the information in thedata base is up to date.

3. Every 6 months send out an email compiled from the HC data base to update provider information.

4. Assure all clients have the appropriate providers, have scheduled the necessary appointments forpreventive health, and assist with barriers preventing them from receiving these services.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of Newborns



Assist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Provide Follow Up to Pregnant Women and Children, Families, and EBNE's on theStatus of their Application as Requested and/or Assist the Client in Resolving anyIssues or Concerns Regarding their Enrollment into a Medical Assistance Programand/or Eligibi

Home » Procedures

‹ Provide Clients with a List and Referral to anAppropriate Medicaid or CHP+ Provider

up Refer Providers to Appropiate Department orCommunity Resources Including those thatWould Like to Become MEDICAID or CHP+

Providers ›

OVERVIEWFamilies will receive the medical benefits they need and deserve because providers will not hesitate to serve them when the client’s application has been processed and has been approved.


PROCEDURE DETAILS1. Assist clients to collect and submit necessary documents (income verification, birth certificate, photo IdD if

not provided at time of application

2. The FHC will advocate for clients, when they have questions or concerns about eligibility and applicationstatus, by contacting the MA sites, County Department of Human Services, CBMS system, HCPF, MAXIMUS,and/or assist the client navigate PEAK.**

**Resolving the family’s issues is not just giving a phone number to the client so the client can call. Manyfamilies have already attempted these options, have gotten no response, and are now reaching out to their FHCfor further assistance. It is the responsibility of the FHC to acquire the information for the family by making allnecessary contacts.


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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration Guidelines



Attend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Refer Providers to Appropiate Department or Community Resources Including thosethat Would Like to Become MEDICAID or CHP+ Providers

Home » Procedures

OVERVIEWEducating Providers on the community resources will allow the provider to not only care for his/her patient’s medical/health needs but also provide assistance to their patients with other needs (social and/or or mental) which can attribute to better health outcomes.


PROCEDURE DETAILS1. Refer Provider to HCPF Website, Provider tab to include the Provider Services page for the Colorado Medical

Assistance Program.

2. Site includes the Medicaid Fee Schedule information

3. Provider then will go to enrollment tab which will provide FAQs, link for Provider not yet enrolled, and linkfor providers already enrolled.

4. Information for the Provider Enrollment Application Workshop that providers are strongly encouraged toattend.

5. Standard Billing enrollment documents are also provided in this web site.

6. The Department's fiscal agentoffers technical assistance to providers who electronically submit ColoradoMedical Assistance Program claims. This assistance includes:

7. Enrolling providers in Electronic Claims Submission and Report Retrieval

8. Identifying and troubleshooting technical problems

9. Providing assistance with Submitter testing

10. Providing technical assistance to Billing Agents, Clearinghouses, and Software

11. Vendors

12. Verifying claim receipt

13. The Support Unit can provide practices with detailed information that will make a transition to an electronicenvironment an easy one. Support is available Monday through Friday, 8:00 AM to 5:00 PM at 1-800-237-0757 or 1-800-237-0044, toll free.

14. Contact State Recruiter and/or give contact information

15. Refer to the provider to the accountable care section of the HCPF website, including but not limited to theirlocal agency and/or ACC recruitment staff


‹ Provide Follow Up to Pregnant Women andChildren, Families, and EBNE's on the Statusof their Application as Requested and/orAssist the Client in Resolving any Issues orConcerns Regarding their Enrollment into aMedical Assistance Program and/or Eligibi

up Train and Educate Community Organizationsand Partners on the Availability of Services

Provided by Healthy Communities ›

16. Refer the provider to the managed care section of the website for information related to referrals and plans

17. Refer the provider to the behavioral section of the website for information related to plans, coverage andreferrals including the Department referral form



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Assist Clients with Scheduling or Appointments and Transportation NeedsAssist Clients with the Application ProcessAssist Clients with the Overall Program Navigation of the MEDICAID and CHP+ Medical AssistancePrograms on a Day to Day BasisAssist Clients with the Reporting of NewbornsAssist Community Partners in Understanding the Medicaid and CHP+ Medical Assistance Program,Program Benefits, and General Program Administration GuidelinesAttend Meetings, Conferences, and other Channels of Collaboration in Conjunction with CommunityOrganizations and Community PartnersContact Clients Attending Inmunization ClinicsContact and Assist all Clients Referred to the Healthy Communities Program Through Face to Face,Written, Oral, and Other Methods of Communication Including the Use of Social MediaEducate Providers on the Services Provided by or Available Through Healthy CommunitiesEducate and Assist Providers with Services Covered by the Medicaid and CHP+ Medical AssistanceProgramsManage Complaints of Privacy BreachesOutreach to Child Care Centers/ HomesOutreach to CommunityOutreach to EPSDT Clients at EventsPlan, Manage, and Coordinate Collaborative Efforts or Activities with Other Community Partner toEnsure Better Service Delivery and Education to the Populations ServedProvide Case Follow-UpProvide Client Outreach and Program Education ServicesProvide Clients with a List and Referral to an Appropriate Medicaid or CHP+ ProviderProvide Follow Up to Pregnant Women and Children, Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client in Resolving any Issues or Concerns Regarding their


Enrollment into a Medical Assistance Program and/or EligibiRefer Providers to Appropiate Department or Community Resources Including those that Would Like toBecome MEDICAID or CHP+ ProvidersTrain and Educate Community Organizations and Partners on the Availability of Services Provided byHealthy Communities



Train and Educate Community Organizations and Partners on the Availability ofServices Provided by Healthy Communities

Home » Procedures

‹ Refer Providers to Appropiate Department orCommunity Resources Including those thatWould Like to Become MEDICAID or CHP+Providers

up

OVERVIEWUtilizing community organizations and partners is one of the best ways to reach out to many families that could utilize HC Services. Community outreach must be done so that organizations have a clear comprehension on the services provided by HC, understand the value of the program, and therefore eager to refer their clients to HC. Community Outreach must also be done to assure services are not duplicated within the programs used by a family or pregnant woman.


PROCEDURE DETAILS1. Contact community partner or organization to schedule a time to meet.

2. Meetings can be scheduled during monthly or quarterly team meetings to attempt to meet with all staff.Sometimes early morning or lunch times are better times to try to meet with many organizations/partners

3. Educate their teams about Healthy Communities, explaining the services you provide to clients (ieeducating families on their benefits, assisting families finding providers, referring to appropriate resources)and the continued follow up.

4. Explain to the organization how you assist the Eligible But Not Enrolled. If you are a PE Site, explain thebenefits of receiving a PE and your role in the PE Process. If not a PE Site, explain how you refer to theappropriate site to apply and how you follow-up with the families to assure they have applied.

5. Stress the important role that the community partner or organization plays in referring clients to you. Evenif the partner is not sure it is an appropriate referral, they should refer anyway and your office can eitherprocess PE or refer to appropriate site to apply.

6. Inform community partners and organizations that Healthy Communities is a neutral program, and we donot favor any provider. HC offers the client options and allows the client to make their own decision whenselecting any provider.



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Procedures

Assist Clients with Scheduling or Appointments andTransportation Needs

OVERVIEW

Some clients are more likely to receive health care, in a timely manner, if an appointment is made for him/her, so byassisting in scheduling an appointment, you are assured that the client has been scheduled to be seen by the providerof their choice. Clients state a barrier to receiving health care is the inability to get to the provider. By assistingclients with transportation issues, the client will receive the health care needed.Assist clients with scheduling of appointments and transportation needs through the Medicaid Transportation Brokeror appropriate local department of social/human services

POLICIES APPLICABLE


PROCEDURE DETAILS


2. If client prefers to utilize a provider list without assistance, follow up will be required with the family to ensurea provider was selected and an appointment was scheduled. You will inform the family at time of visit that youwill follow up within 2weeks.You must create a task to flag yourself in the data system for follow up within 2week time period.

3. Have working knowledge of your Transportation broker or DHS contact person in your area, so that a referralcan be given to a client needing transportation for Medical appointments.

Assist Clients with the Application Process

OVERVIEW

Applying for Medicaid/CHP+ can be a very confusing, time consuming, and very frustrating process for manyfamilies, to the point where some would rather do without. The responsibility of HC is to remove these barriers,provide a more friendly experience, and assure families apply and receive the medical services they need anddeserve.


Assisting clients with the application process includes assisting the client face to face with a paper or PEAKapplication, providing PE determinations on site to those that may qualify, and/or an appropriate referral to anotherapplication assistance site; local department of social/human services, PEAK, CAAS, other PE, or MA Site tofacilitate the client’s enrollment into Medicaid and CHP+

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Complete a financial screen by phone to see if client could be eligible for Medicaid and/or CHP+. This avoidshaving a client come in if they will not be eligible for either program and then referrals can be made to otherprograms for assistance.

2. If a PE Site, meet with the client as soon as they are able, so client is readily served. If not a PE site, refer toappropriate location to apply (ie: PE Site, MA Site, DSS, or PEAK)

3. Follow up with client or site to assure client applied.

4. If a PE Site, inform client of the documents required to complete an application. Although not a requirementfor PE, it can make the processing of the application more expedient.

5. If a pregnant client, inform client proof of pregnancy is required. This must be signed by a clinic, physician ornurse.

6. Meet with the client face to face.

7. Assist client with completing application, by answering questions and confirming all sections that apply to theclient have been completed.

8. Make sure application has been signed and dated.

a. Date stamp on application, date on affidavit (bottom of each child’s page), and the signature date must all bethe same.

9. Enter data in CBMS and run PE, print PE Cards.

10. Explain the PE Card and all services provided under the PE Card

11. Assure that each applicant has a PCP/Pediatrician, dental, vision provider. If pregnant, assure the client has anOB Provider.

12. If a PE Site, follow up with your DSS or MA Site for status on application.

13. Assist clients to collect and submit necessary documents (income verification, birth certificate, photo ID orother acceptable documents) if not provided at time of application.

14. All contact and client interaction must be entered into HC data base.

Assist Clients with the Overall Program Navigation ofthe MEDICAID and CHP+ Medical Assistance


Programs on a Day to Day Basis

OVERVIEW

Educating, advocating, and continual follow up on the Medicaid/CHP+ Medical assistance programs will empoweryour clients and encourage self-sufficiency. Clients can accept the responsibility of their family’s health care morereadily with your enduring assistance and support.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Make sure families know: those under 21 years of age should have an EPSDT complete physical yearly, (ormore frequent for those under age 2), developmental and autism screenings, dental checkups are every 6months beginning at age 1, lead testing is required at 12 and 24 months or between 36 and 73 months if notpreviously tested, vision screenings and glasses are covered as needed and not limited to 1 pair/yr, hearingscreenings, and mental health screenings, depression screenings (including for teens) per the ColoradoPeriodicity Schedule. Ask families if their children are current on their Immunizations, and provide animmunization schedule. Provide information on Family Planning.

2. Educate on the dangers of second-hand smoke and provide information on the Quit Line for those clientswanting to quit smoking.



5. If client prefers to utilize a provider list without assistance, follow up will be required with the family to ensurea provider was selected and an appointment was scheduled. You will inform the family at time of visit that youwill follow up within 2weeks.You must create a task to flag yourself in the data system for follow up within 2week time period .

6. Screening protocols should be followed to allow the HC staff to make necessary and appropriate referrals toCommunity Programs and Organizations.

7. Assist family with the Medicaid/CHP+ application and process PE.

a. If not a PE Site, then refer family to the PE Site in your county. It is strongly recommended you call the PEsite and schedule an appointment for your family so they know the time, date, and location where they need toapply.b. You will create a task to follow up after scheduled PE appt. to check PE status in CBMS. The follow uptask ensures that the family applied and received a PE .c. If not in CBMS showing active PE, then a follow up contact is required to assist families in accessingservices needed.



9. Provide the contact information for Health Colorado and explain why a client or family will need to contactthem, including upcoming letters for passive enrollment into managed care or accountable care organizations

10. Provide the contact for the Ombudsman for Medicaid Managed Care and explain when they can assist a clientwith specific issues or concerns.

11. Provide education and assistance in using Colorado PEAK

12. Give all contact information for their local HC Office


Assist Clients with the Reporting of Newborns

OVERVIEW

When Add-a-babies are completed immediately after birth and processed by the client’s County DHS or MA Site,new babies born to Medicaid/CHP+ mothers can access health care from their provider(s) from time of birth andthrough the baby’s first year.Assisting clients with the reporting of newborns includes processing Add-A-Baby request for cases that are emergentor if services need to be expedited.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. All Healthy Communities will complete an Add-a-baby form for babies born to Medicaid or CHP+ mothers.

a. Make sure spelling is correct and verify date of birth and gender.

2. Encourage mom to select a provider for her newborn baby, if she does not have one already selected.

a. Provide appropriate provider list and offer assistance to schedule an appointment.

3. Inform mom that her newborn should be seen by baby’s provider according to the Colorado PeriodicitySchedule.

4. Inform mom of the process and give an approximate time when she may receive a Medicaid Card.

5. Inform mom of the benefits her newborn is eligible for under Medicaid or CHP+.

6. Give mom your contact information so that she can contact your for a vision provider list at 6 months, and adental provider list before 1yr.

7. Inform mom of the periodicity schedule for well child visits.


8. Provide an immunization schedule.

9. Give other educational materials.

10. Send Add-a-baby form to be processed by MA Site or DHS.

11. Follow up with Site to see when baby is added and contact mom to give her State ID and ensure she is able toaccess services.

12. If it has been more than 2 weeks and baby has not been added, it is the responsibility of the FHC to follow upwith the necessary agencies so that baby is added. Some providers may not be willing to provide services untilbaby has a State ID.

Assist Community Partners in Understanding theMedicaid and CHP+ Medical Assistance Program,Program Benefits, and General ProgramAdministration Guidelines

OVERVIEW

Educating your community partners/organizations on the Medicaid/CHP+ benefits will allow the agency/organizationto better serve their families when they present to them having medical/health problems or concerns. Theorganization/agency will know the best assistance they can offer their family would be to refer them to HC forservices and follow-up.

POLICIES APPLICABLE

Community and Program education policy

PROCEDURE DETAILS

1. Educate the community partner/organizations on the benefits provided to Medicaid and CHP+ Eligible childrenand pregnant women.

2. Educate community partners that we refer to PCMP/Pediatricians, OB/Gyn, Dental, Vision, Mental Health, andSpecialty providers that are taking new and existing Medicaid and CHP+ families and individuals.

3. Inform community partners and/or organizations that HC is a State and Federally funded program and mustprovide neutral navigation to services, and assistance is provided to all Families, no matter their choice ofprovider or hospital.

4. Inform community partners and/or organizations that assists all Medicaid/CHP+ Providers no matter theiraffiliation.

5. Inform community partners and/or organizations that follow-up services are provided to families and referralsmade to community organizations for other assistance as needed or requested.


6. Educate our community partners and/or organizations concerning Medicaid and CHP+ medical assistanceprograms, by introducing and informing about Presumptive Eligibility, PEAK, MA sites, DHS and otheravenues clients may access other Medical assistance programs.


Attend Meetings, Conferences, and other Channels ofCollaboration in Conjunction with CommunityOrganizations and Community Partners

OVERVIEW

Becoming involved in your community is an essential piece of the HC Program. These are excellent opportunities forcommunity outreach, building working relationships, decision making in programs that that are utilized by HCFamilies, and educating the public on the services provided by HC to families and providers.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Participate as a member of Advisory Boards, representing HC, not a Department or Unit

2. Participate as a member of coalitions

3. Participate in early childhood councils

4. Participate in child welfare activities and meetings

5. Attend local city or county government meetings

6. Participate in your local school boards or PTA meetings

7. Participate in Health Fairs or other fairs in your community or surrounding communities

8. Network with other vendors at fairs; possibly set a time for an in-service

9. Network at local or state conferences


Contact Clients Attending Inmunization Clinics


OVERVIEW

Contacting clients while attending Immunization clinics, assures clients are current with their immunizations. Youcan assist clients find a provider for other preventive health care benefits, and to receive medical attention when ill. This also offers an opportunity to provide education on other health issues and refer to other community services.

POLICIES APPLICABLE

Privacy policy related to immunization clinics and appropriate outreach to clients

PROCEDURE DETAILS

1. Contact local Health Department to participate in immunization clinics

a. Bring provider lists and applications to assist those clients without a medical home or those that areuninsured EBNE’s to apply for Medicaid or CHP+.

2. If applicable and necessary, contact your Immunization Coalition for local opportunities and to provideinformation on your availability and services to the shared clients in the area

Contact and Assist all Clients Referred to the HealthyCommunities Program Through Face to Face, Written,Oral, and Other Methods of Communication Includingthe Use of Social Media

OVERVIEW

Making a contact is not what is relevant, but the manner in which the contact is made is of most importance. It allowsyou to build the relationships with your clients, which is crucial to the success of the program. Whether a face toface, phone call, letter, text or email, if a client is shown compassion, treated with respect, and knows that their FHChas done ALL that is possible to assist him/her, clients will bond with their FHC and reach out to them for futureassistance.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Face to Face could be scheduled or walk-in either at the clients home, a community location or at the HCoffice.

a. Face to Face contacts are encouraged to create a relationship between Family Health Coordinators and


families.

2. Hospital visits/ER visits

3. Letter

a. State authorized correspondence only.

4. Email

a. Warning: must be encrypted for HIPPA if contains Personal Health Information

5. Telephone contacts

6. FAX

7. Text messages from HC date system

Educate Providers on the Services Provided by orAvailable Through Healthy Communities

OVERVIEW

The assistance HC offers to Providers can be a deciding factor as to whether that provider may choose to accept newMedicaid/CHP+ patients, which is imperative with the shortage of providers in many areas. Providers appreciatehaving a ‘local’ office to contact when having issues/questions regarding patients and/or Medicaid/CHP+ benefits orbilling. Advocating for providers is mandated for HC FHCs.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Explain to Providers how you can assist to find ‘real’ time eligibility on patients by using CBMS.

2. Train providers how to read the eligibility documentation from CMRS or another eligibility system, includingmanaged care and RCCO assignments as well as BHO assignments and what those may mean to a practice.

3. If you are a presumptive eligibility site, explain what presumptive eligibility is, the importance, and howProviders can use PE.

A. Provide samples of PE Cards to the providers so their office knows what to expect when a patient presentscoverage under PE.

4. Explain to the Provider the benefits that are covered under PE.

A. Make it clear in-patient is covered for children, while it is not for pregnant women.


B. Dental is not covered under CHP+ until the client has received their Delta Dental CardC. PARs must be completed under PE as they would be required under Medicaid Guidelines.

5. Offer assistance with problems that may arise from accepting a PE Card and billing being rejected by State.The Family Health Coordinator will contact the state for any denials for services provided under PresumptiveEligibility if a service was a benefit of Medicaid/CHP+ and did not require a PAR.

6. Assist Providers with clients that have excessive missed appointments.

A. Contact the family to see what barriers may be preventing them from attending their appointment.B. Inform Providers that it will be stressed to families that a provider may chose to not continue serving thepatient for excessive missed appointments.

7. Inform providers that accept new Medicaid and or CHP+ patients that they will be on a list given to clients whoare looking for a provider. HC staff must work with the current provider recruitment and retention staff as tobest explain their options related to accepting new or existing clients.

8. Inform Providers that if transportation is a barrier for their patients keeping their appointments, providersshould refer to Healthy Communities so we may make the necessary referrals for the clients to receivetransportation assistance.

9. Inform providers that Healthy Communities offices will coordinate with other Healthy Communities teams toassist their patients that live in other counties.

10. Give providers contact information to their local Healthy Communities office.


Educate and Assist Providers with Services Covered bythe Medicaid and CHP+ Medical Assistance Programs

OVERVIEW

Knowledge of Medicaid/CHP+ benefits and understanding treatment options will allow providers to build relationswith their patients and provide complete health care services. Providers can also offer better health services to theirpatients by knowing about Presumptive Eligibility (EBNE) and the referral process to HC

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Provide the ACS Automated Voice Response System (AVRS) (1-800-237-0757 or 1-800-237-0044) regardingquestions on Client Eligibility Verification, Claims Submission, Claims Status, Claims Inquiry, and ProviderWarrants Verification. Inform Providers that there is no longer a limit of inquiries.

2. Provide information for the Provider services available in the HCPF website, including providers interested in


becoming a Colorado Medicaid Provider

3. Inform Providers they can visit the Benefits Collaborative section of the HCPF website for ensuring that benefitcoverage decisions are based on the best available clinical evidence and that all benefit coverage policiespromote the improved health and functioning of Medicaid clients.

4. Refer Providers to the Provider tab in the HCPF for information regarding provider services: Billing Manuals,Provider Bulletins, Colorado PAR Program, forms, frequently asked questions, comprehending thereimbursement and supplemental payments.

5. Refer Providers to the Colorado Medical Assistance Program Web Portal. The user guides and EDI Supportfor enrollment purposes is available also on the HCPF website.


7. Referral process to other providers including the use of the Early Intervention Colorado and Behavioral Healthreferral forms. Providers shall also be trained to understand the different needs for managed care andaccountable care related to referrals.

Manage Complaints of Privacy Breaches

OVERVIEW

Keeping protected health information safe is of primary concern. FHC staff will share only the minimal informationthat is needed to assure services or benefits are accessed. Information will not be shared with other programs or unitswithin FHC offices unless approved by the State. Data sharing for data sake is not allowed. Data requests can bemade directly with the Department for other programs or units needed information related to Medicaid clients.

POLICIES APPLICABLE

Privacy and Confidentiality Policy

PROCEDURE DETAILS

1. All FHC staff need to assure data is kept in a manner that meets federal privacy standards.

2. ALL FHC staff need to meet their own employers policies related to HIPAA.

3. All FHC staff must only share minimal information with others that is needed to assure the service or benefitcan be accessed.

4. All FHC staff will understand a business associate of the program and share information accordingly.

5. All staff have the ability to access data from their local WIC programs and should assure this option isexercised when tracking clients.

Outreach to Child Care Centers/ Homes


OVERVIEW

Families with very young children (birth to pre-school ages) can be informed of the services provided by HC.

POLICIES APPLICABLE

Outreach to early care and education providers (day care) as well as regular meetings with Head Start, EarlyHeadStart and other early care and education programs in your service areas.

PROCEDURE DETAILS

1. Network with school districts for Colorado Preschool Program enrollments

2. Work with your local Early Childhood Council

3. Call local daycare and childcare facilities to schedule an in-service

4. Meet with local HeadStart and Early HeadStart offices at least twice a year.

Outreach to Community

OVERVIEW

More families can be informed about HC services through several avenues, one being collaborative efforts with othercounty HCs. Current or potential clients can be contacted at regional events, fairs, and festivities. Communityoutreach does not mean providers only, but can also include any location or event where current/potential clients canbe found, information about HC can be provided, and therefore your yearly quota can be met.Establish a yearly quota that takes into account the size of the county.

POLICIES APPLICABLE

Establish quota for outreach in the community to a realistic number, but not one that is less than 2 contacts per month.Partner with other HC offices when your service areas overlap (ie RCCO or HCP regions)

PROCEDURE DETAILS

1. Health Fair participation

2. In service to Providers

3. In service to community organizations and partners such as food banks or other non-profit organizations inyour service area.

4. Schools

a. School based clinicb. Child Findc. Enrollmentd. Back to school nightse. Open houses

5. Health Department

6. Fire stations

7. DHS

8. Police Departments

9. Community coalitions and advisory boards

Outreach to EPSDT Clients at Events

OVERVIEW

Outreach to clients at events is an avenue FHCs can use to provide information about the services provided by HC. Information can be given to large number of current and/or potential clients (EBNE).Events include Healthy Children Clinic, HCP Ortho and Neuro Clinics, Child Find, Head Start registration, Boo at theZoo in October for Lead Testing, WIC clinics, health fairs, school functions, or any other local event where there willbe families and children.

APPLICABLE

Network with all programs that provide services to clients who are HC clients

PROCEDURE DETAILS

1. Provide educational material, Healthy Community brochures

2. Provider lists

3. Community Resources

4. Applications

5. Answer questions and concerns concerning barriers or requests to receive services

6. Provide contact information

7. Enter Outreach / Event in HC data base

Plan, Manage, and Coordinate Collaborative Efforts or

Activities with Other Community Partner to EnsureBetter Service Delivery and Education to thePopulations Served

OVERVIEW

Collaborating with community partners/organizations is an exceptional way to build strong working relationshipswith the partners and organizations in your community. This is imperative since many of theseorganizations/agencies work with the same families as Healthy Communities. This also allows you to become awareand knowledgeable of the resources in your community so that you can refer HC clients to agencies/programs andtherefore provide complete services. Collaboration also allows programs not to duplicate services within thecommunity or family structure.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Attend Health fairs put on by your community and partner in planning as appropriate.

2. Participate with schools to host a table to provide HC information to families at open houses, parent/teacherconferences, enrollment days

3. Contact any college/university in your area since some students may have children of their own and may beeligible for Family Medicaid, or may now qualify for Medicaid under the Adults without Dependent ChildrenProgram and are under the age of 21.

4. Coordinate with other HC Programs for annual festivities held in certain cities or towns.

5. Build strong working relationship with community partners.

a. Local library, schools (office staff, school counselor or nurse), fire departments, senior citizen groups (manygrandparents raising grandchildren), father’s groups, pregnancy centers, homeless shelters, food banks, headstart programs, early care and education providers, domestic violence shelters, to name a few. These locationsshould know who you are and how you can assist their clients through HC Services.

6. Actively participate with community partners in planning and attending events in your community.


Provide Case Follow-Up


OVERVIEW

A state requirement for all Healthy Communities is care coordination. That includes not only the initial contact youhave with a client, but the continued assistance to the client. The follow-up will assure you your clients are receivingall medical services required to be healthy (physically and emotionally)and that your clients receive the care theyneed when they become ill.Prioritize dental and depression screening follow-up, come up with other priorities for follow-up

POLICIES APPLICABLE

HC offices are required to assure that at least 80% of the children in their service areas are accessing well child visitsone time per yearHC offices are required to assure at least 80% of their children in their service areas are accessing a oral healthservice one time per year. As of 2013, a 5% increase in required over 2010 EPSDT 416 rates.HC offices are required to assure that applicable lead testing is being completed in the community and to makeprovides aware this is required in Colorado.HC offices are required to assure that applicable and needed behavioral health assessments are being referred to localBHO providers to complete.

PROCEDURE DETAILS

1. Assure that local goals and objectives include those for EPSDT2. Choose priority areas, but understand that all areas will need to be reached in order to meet state and federal

goals3. Priorities can include:

a. Children with special needsb. Children with severe medical conditionsc. Pregnant teensd. High risk pregnanciese. Dental screeningsf. Depression screenings for teensg. Immunizationsh. EPSDT well child visits---

Provide Client Outreach and Program EducationServices

OVERVIEW

By reaching out to all current and potential clients and providing program education, clients can receive the optimalservices from their Healthy Communities’ Coordinator and therefore best utilize the Medicaid/CHP+ Services andcommunity services for the best health outcomes.Provide client outreach and program education services through face to face, written, oral or other methods ofcommunication

POLICIES APPLICABLE

Client Outreach and Program Education Policy

PROCEDURE DETAILS

1. Check CBMS for Medicaid/CHP+ Status by checking Med Span for each family member that is an HC Client.Do not assume that all members are active because you find one member active.

2. If active, then you will check to see if this client is in the HC Data Base. If not, a new household will need tobe entered. This includes all active Medicaid / CHP+ members.

3. A contact will be made to the family by face to face, phone, letter, email or text as appropriate. Warning: Allcommunications by email with client data must be encrypted.

4. Educate families on EPSDT benefits for Medicaid eligible families, including well child and oral health care asoutlined by the Colorado Periodicity Schedule. Education shall include the need for lead testing at 12 and 24months as well as between 36 and 72 months if not previously tested.

5. Educate families on benefits available for CHP+ eligible families, including well child and oral health care.

6. Educate on dangers of second-hand smoke and provide information on the Quit Line for those clients wantingto quit smoking.


8. Assist families to find a provider for all Medicaid /CHP+ services by accessing the Provider list in the HC database.

9. Make necessary and appropriate referrals to Community Programs and Organizations.


Provide Clients with a List and Referral to anAppropriate Medicaid or CHP+ Provider

OVERVIEW

Clients may have a Medicaid/CHP+ card, but may still not access health care for all benefits offered by their healthplan if they do not have the appropriate providers. FHC’s will provide lists of the providers currently accepting newpatients. Clients can overcome many of their barriers with the assistance of their FHC so they can receive thepreventive health care services and receive health care when ill.

POLICIES APPLICABLE




PROCEDURE DETAILS

1. Compile and keep a list of all Providers that are taking new Medicaid and CHP+ families that is accessible toclients and community agencies and providers.

a. Enter all providers into the HC data base, including hours, ages, working hours, affiliations, ADA accessible,etc.

2. Notify the provider that you will be emailing them every 6 months to assure all of the information in the database is up to date.

3. Every 6 months send out an email compiled from the HC data base to update provider information.

4. Assure all clients have the appropriate providers, have scheduled the necessary appointments for preventivehealth, and assist with barriers preventing them from receiving these services.

Provide Follow Up to Pregnant Women and Children,Families, and EBNE's on the Status of theirApplication as Requested and/or Assist the Client inResolving any Issues or Concerns Regarding theirEnrollment into a Medical Assistance Program and/orEligibi

OVERVIEW

Families will receive the medical benefits they need and deserve because providers will not hesitate to serve themwhen the client’s application has been processed and has been approved.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Assist clients to collect and submit necessary documents (income verification, birth certificate, photo IdD if notprovided at time of application

2. The FHC will advocate for clients, when they have questions or concerns about eligibility and applicationstatus, by contacting the MA sites, County Department of Human Services, CBMS system, HCPF, MAXIMUS,and/or assist the client navigate PEAK.**

**Resolving the family’s issues is not just giving a phone number to the client so the client can call. Many families


have already attempted these options, have gotten no response, and are now reaching out to their FHC for furtherassistance. It is the responsibility of the FHC to acquire the information for the family by making all necessarycontacts.

Refer Providers to Appropiate Department orCommunity Resources Including those that WouldLike to Become MEDICAID or CHP+ Providers

OVERVIEW

Educating Providers on the community resources will allow the provider to not only care for his/her patient’smedical/health needs but also provide assistance to their patients with other needs (social and/or or mental) which canattribute to better health outcomes.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Refer Provider to HCPF Website, Provider tab to include the Provider Services page for the Colorado MedicalAssistance Program.

2. Site includes the Medicaid Fee Schedule information

3. Provider then will go to enrollment tab which will provide FAQs, link for Provider not yet enrolled, and linkfor providers already enrolled.

4. Information for the Provider Enrollment Application Workshop that providers are strongly encouraged toattend.

5. Standard Billing enrollment documents are also provided in this web site.

6. The Department's fiscal agentoffers technical assistance to providers who electronically submit ColoradoMedical Assistance Program claims. This assistance includes:

7. Enrolling providers in Electronic Claims Submission and Report Retrieval

8. Identifying and troubleshooting technical problems

9. Providing assistance with Submitter testing

10. Providing technical assistance to Billing Agents, Clearinghouses, and Software

11. Vendors

12. Verifying claim receipt


13. The Support Unit can provide practices with detailed information that will make a transition to an electronicenvironment an easy one. Support is available Monday through Friday, 8:00 AM to 5:00 PM at 1-800-237-0757 or 1-800-237-0044, toll free.

14. Contact State Recruiter and/or give contact information

15. Refer to the provider to the accountable care section of the HCPF website, including but not limited to theirlocal agency and/or ACC recruitment staff

16. Refer the provider to the managed care section of the website for information related to referrals and plans

17. Refer the provider to the behavioral section of the website for information related to plans, coverage andreferrals including the Department referral form


Train and Educate Community Organizations andPartners on the Availability of Services Provided byHealthy Communities

OVERVIEW

Utilizing community organizations and partners is one of the best ways to reach out to many families that couldutilize HC Services. Community outreach must be done so that organizations have a clear comprehension on theservices provided by HC, understand the value of the program, and therefore eager to refer their clients to HC. Community Outreach must also be done to assure services are not duplicated within the programs used by a family orpregnant woman.

POLICIES APPLICABLE


PROCEDURE DETAILS

1. Contact community partner or organization to schedule a time to meet.

2. Meetings can be scheduled during monthly or quarterly team meetings to attempt to meet with all staff.Sometimes early morning or lunch times are better times to try to meet with many organizations/partners

3. Educate their teams about Healthy Communities, explaining the services you provide to clients (ie educatingfamilies on their benefits, assisting families finding providers, referring to appropriate resources) and thecontinued follow up.

4. Explain to the organization how you assist the Eligible But Not Enrolled. If you are a PE Site, explain thebenefits of receiving a PE and your role in the PE Process. If not a PE Site, explain how you refer to theappropriate site to apply and how you follow-up with the families to assure they have applied.


5. Stress the important role that the community partner or organization plays in referring clients to you. Even ifthe partner is not sure it is an appropriate referral, they should refer anyway and your office can either processPE or refer to appropriate site to apply.

6. Inform community partners and organizations that Healthy Communities is a neutral program, and we do notfavor any provider. HC offers the client options and allows the client to make their own decision whenselecting any provider.


OverviewHome » System Documentation

This documentation is related to the Outreach & Case Management System used by the Healthy Communities programs across the state of Colorado and is managed by the Department of Health Care Policy and Financing of the State of Colorado.

Basic ConceptsIndividuals

Each of your clients or potential clients will have a single Individual record in the system. All information about this person will be available to you, including name, address, phone, etc. and you can make needed edits from within that Individual record. Individuals are typically connected to Accounts.

Accounts

Each individual will be associated with an Account. Accounts can be households or organizations such as hospitals or service providers. Some examples of how you can connect Accounts and Individuals are:

You can associate a mother (Individual record) with her three children to the same household (Account record) . This will allow youto see all the information in one place and let you provide services to the whole family through this system. You can associate a mother (Individual record) who has given birth at a hospital (Account record). This will allow you to see all theinformation in one place and let you determine services based on current information.

Interactions

Each Interaction is a summary log of a communication with an Individual or Account via mail, phone, email, etc. Interactions are savedwithin the system and provide a historical view of all relevant communications. Interactions are typically referred to as contacts and canalso be used as task reminders. When you enter an Interaction with a due date in the future, it serves as a task list for the user withinthat Individual or Account and will appear as an Open Interaction in the system. Some examples of how you can log Interactions are:

You can log an interaction with an Individual when you have a CHP+ 1st contact.You can log an interaction with an organization when you make a provider contact. You can log an interaction to remind you to call a client in two weeks.

Referrals

There are two types of referrals, 'Outbound' (when you interact with a client and refer them to a service provider and 'Inbound' when you receive a new client that was referred to you from another agency, for example.

Enrollments

For those individuals that are already enrolled in Medicaid you'll have their individual record associated with an 'Enrollment' which will contain the information relevant to that enrollment, like checkups.

Outreach Events

Community and partner outreach events you attend and/or organize will be logged in the system.

What does it do?This system was built to meet ten main needs:

1. Automated, Integrated Reporting

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2. Improve client retention

3. Speed up data entry

4. Improve information discovery

5. Make complying with HIPAA easier

Reports are now automated and state staff can now access each county's reports directly so there's no need to store reports in excel files on your computer and there's no need to build, encrypt and send those reports every month. By eliminating this process the system avoids having to export personal health information into local PCs and send that information over the internet; which are the two biggest risks HIPAA intends to prevent.

6. Improve data quality

7. Measure program performance and impact

This system allows each team member, from the state level staff to the program supervisors to the coordinators to see real-time graphs and reports of key performance indicators and other relevant information customized to their role and level of access.

8. Enable state-wide self-service provider directory

Coming Soon!

9. Enable program scalability

As teams grow and change, new users can be added on the go and existing users can be disabled as needed.

10. Improve team collaboration

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Training and System Documentation

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Technology Configuration RequirementsHome » System Documentation

‹ Overview up About the Technology ›

The following requirements are needed to ensure that your team has the necessary tools to use the system without encountering any issues.

1. Upgrade the default web-browser to its latest version. All major web-browsers are supported as long asthey're on their latest version. 1. Use this configuration for Internet Explorer and this one for Firefox.2. Internet Explorer 6,7, 8 and 9 are no longer supported. Upgrade IE 11. Check your current version.

2. For all browsers, you must enable JavaScript, cookies, and SSL 3.0.3. Use monitors with a screen resolution of 1024 x 768 or higher for the best possible user experience.4. Deploy email filtering technology (Anti-spam filters) and make sure all users can receive Emails from every

Salesforce IP address, the following 52 IP Addresses must be whitelisted by the email filtering system:96.43.144.64 to 96.43.144.6596.43.148.64 to 96.43.148.65182.50.78.64 to 182.50.78.79204.14.232.64 to 204.14.232.79204.14.234.64 to 204.14.234.79

5. Install and maintain desktop protection software (Anti-virus) on all user machines in the network and keepall applications and definitions up to date.

6. If there is domain whitelisting security in place, add these to the list of allowed domains:.staticforce.com.content.force.com.force.com.salesforce.comhcpf.upleaf.comvimeo.com

7. Provide a minimum internet download speed of 10 mbps per user. Note that your contracted speed mayneed to be divided by the number of concurrent users. It's important to really see what speed each user canreach on a normal day of work where all users are heavily using the web to access this system at the sametime. Use Speedtest.net to test your current speed.

8. Most of the tech support provided to users of this system is done via GoToMeeting and Join.me so ensuringthat this tool works seamlessly is critical.

9. Make sure each machine meets these minimum requirements for optimum performance (Alternatively youcan use machines running on Google Chrome OS):

Processor speed: 1 GHzRAM: 1 GB (32-bit) or 2 GB (64-bit)Hard drive space: 16 GB (32-bit) or 20 GB (64-bit)Operating System: Windows 7 or higher, Mac OS 10.4 or higher

http://help.salesforce.com/apex/HTViewHelpDoc?id=getstart_browser_ie.htm&language=en_US#getstart_browser_ie

http://help.salesforce.com/apex/HTViewHelpDoc?id=getstart_browser_firefox.htm&language=en_US#getstart_browser_firefox

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http://www.speedtest.net/

http://www.gotomeeting.com/online/meeting/online-meeting-support

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About the TechnologyHome » System Documentation

‹ Technology Configuration Requirements up Getting Started ›

This system is built of top of the Force.com platform. A web-based constituent relationships management system (CRM). We're using this technology because it offers four main attributes that are essential to the needs of the Healthy Communities program:

1. Cloud-based Infrastructure

Because the system is web-based it can be accessed from anywhere, from any device. This allows us to offer one integrated system for all counties across the state at a much lower cost. It also allows for the visualization of real-time data at the state level without the need for the counties to be preparing reports all the time.

2. Reliability

Force.com has a proven 99.9+ percent uptime record for years. To ensure maximum uptime and continuous availability, Force.com provides redundant data protection and the most advanced facilities protection available, along with a complete data recovery plan. More Info.

3. Security

This system has been configured to protect personal health information and to meet the security requirements of the state of Colorado. It includes these security measures:

1. Data Sharing: All data is isolated by contractor so your information is not available to other counties unlessyou choose to share it.

2. Password Policies: Strict password rules are in place to prevent unauthorized access to the system.3. Session Limits: Login sessions are locked to the IP address from which they originated, require secure

connections (HTTPS) and allow for SMS-based identity confirmation.

In addition to these configuration settings, the Salesforce Platform already includes robust security features bydefault. See more details.

4. Always up-to-date software

This system is upgraded every quarter making sure the infrastructure is always working at optimum levels, it'salways compatible with the latest browser versions and new features are added seamlessly.


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Getting StartedHome » System Documentation

How to Login1. Go to https://hcpf.my.salesforce.com, input your username (your email) and password and hit enter or click the'Login to Salesforce' button.

Note: You may want to save this web address to your favorites or bookmarks so that you can easily get back to it with one click.

2. This is your Homepage:

https://hcpf.my.salesforce.com/

Edit your Profile1. Click on your name (top right hand corner of your screen) and then on 'My Profile

2. Add your photo

3. Crop the photo if needed

4. Edit your profile information by clicking on the pencil icon next to the 'Contact' or 'About Me' sections beneath thephoto. (notice that there are two tabs inside the 'edit profile' window: contact and about).

5. You are done!

‹ About the Technology up The Basics ›


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The BasicsHome » System Documentation

‹ Getting Started up Search for Anything ›

Search for AnythingHow to create a new recordHow to edit an existing recordThe SidebarEdit My Settings


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Building Blocks: Individuals, Households and OrganizationsHome » System Documentation

‹ Edit My Settings up About Individuals ›

About IndividualsAbout HouseholdsAbout Organizations


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InteractionsHome » System Documentation

How to log an interaction

Completed offline Interactions:

Go to the related individual or organization record and click on the 'Log an Interaction' button under the 'InteractionsHistory' related list. Select the interaction record type and proceed to fill out the form.

There are 4 interaction record type you can manage:

1. CHP Interactions: Interactions with those individuals that are eligible for CHP+ benefits2. EBNE Interactions: Interactions with those individuals that qualify as Eligible but not Enrolled3. Medicaid Interactions: Interactions with those individuals that are enrolled in the Medicaid program4. Tasks: All other interactions, To Dos or delegated assignments handled through the system

For each record type the page will include a custom set of fields that are relevant to that particular category ofinteraction. For example for Medicaid Interactions we include the 'Referred From' and 'Who initiated' fields that are notincluded for CHP Interactions.

Note: All interactions logged from the 'Log an Interaction' button are automatically marked as completed.

Follow Up tasks

From within the interaction form, you'll be able to create an open follow up task, including who to assign the Task to,whether to notify the assignee by email and when to trigger a reminder for it.

Send an Email

You can send a personalized email directly from within the system, while automatically logging an interaction of type'email' all in one step.

How to Send an Email

1. Click on the 'Send an Email' button inside the 'Interactions History' related list.2. Select a template. See how to create email templates3. Add attachments by clicking on the 'Attach File' button4. Just like a regular email, you can select who to CC and BCC.5. Edit the Subject and body of the email6. Check Spelling7. Send8. You'll be returned to the related record and then you can edit the newly created interaction to change its record

type or any other field.


Mail Merge

You can generate a Microsoft Word document that includes data from the record selected while also logging aninteraction. This is very useful for routine notifications or reminders.

How to send a mail merge

1. Click on the 'Mail Merge' button inside the 'Interactions History' related list2. Select a template. See how to create mail merge templates3. Click on the 'Generate' button4. A Word file will download onto your computer. You can then proceed to print this document and mail it.5. When done you'll be returned to the related record and then you can edit the newly created interaction to change its

record type or any other field.


How to create an open interaction

Open interactions are a great way to delegate tasks within a team, organize your day or week and make sure follow upshappen by creating dynamic, easy to use To Dos

You can create an open interaction by:

1. clicking on the 'new task' button inside the 'open interactions' related list2. Select the interaction record type and proceed to the form3. In this form you'll be able to fill out all corresponding fields, decide who to assign the Task to, when to remind

them automatically and whether to create a recurring series of tasks.

4. When saving you can choose to also create a new task with one click.

‹ About Organizations up How to create email templates ›

How to create email templatesHow to create mail merge templatesMy List of TasksCollaborating around a assigned to you


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ReferralsHome » System Documentation

‹ Collaborating around a assigned to you up Enrollments ›

How to log outbound referrals1. From within the individual record, click on the 'new referral' button inside the 'referrals' related list

2. Once on the form, you'll be able to easily select the provider, category, type, date and comments of the referral; aswell as create multiple referrals from the same form.

3. Use the 'Remove Row' option to make sure you don't have empty rows before hitting 'save'.


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EnrollmentsHome » System Documentation

What is an enrollmentAn Enrollment in the system is the equivalent of a real life program enrollment, either of Medicaid or CHP+ for one individual.

One individual can have more than one enrollment as in real life an individual can be eligible and enroll at one time in her life then drop out and later on become eligible and enroll again. The goal is to reflect this reality by allowing you to create and close enrollments as needed for each individual.

How to create a new enrollmentWhen you assign the record type 'client' to an individual you'll have a new related list available called Enrollment.

1. Click on the 'New Enrollment' button inside the 'Enrollments' related list of the individual record.

2. Fill out the corresponding fields. Provider information, like primary care physician will be available as a 'ServiceProvider' related list once you save the form.

3. To add providers, click on the 'New Service Provider' button inside the 'Service Provider' related list.

Ending an EnrollmentEnrollments in the system should very closely resemble enrollments in CBMS. So if someone is no longer receivingbenefits you need to edit their enrollment record and edit the end date field.

‹ Referrals up How to transfer an individual to another county ›


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How to transfer an individual to another countyHome » System Documentation

‹ Enrollments up Managing Duplicates ›

Important: Once you've transferred a record, you won't be able to see it anymore. You will however be able to use Chatter to coordinate with the recipient of your transfer to make sure they followed up on it.

1. Go to the individual record and scroll down to 'system information'2. If hidden, click on the 'System Information' arrow to expand the fields inside.3. Click on the 'change' link next to the 'Individual Owner' field

4. Search for the user you want to transfer the record by clicking on the magnifying glass icon next to the 'owner' field

5. Check the 'send notification email' checkbox to notify the new owner that you've transfered a record to them6. Save changes7. Once you've transferred an individual, assuming you're transferring all family members, follow the same steps

above to transfer each individual in the household. Then follow these steps to transfer the household too.


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Managing DuplicatesHome » System Documentation

Important Note: To merge record you need to first 'own' them. During the steps described below, the first step is to always check who owns both records and change the record owner to you. Here's how to change record owners.

There are two ways you can detect and merge duplicates: by automated detection and by manual search.

Automated DetectionThe system implements automated duplicate matching rules for individuals and organizations:

1. State ID and Social Security Numbers: the value of these fields has to be unique for each record. If there is anotherrecord with the same value you'll get an error message when you try to save your changes letting you know and you canthen use the search box to find the existing record. Ideally these cases will be in the minority because you'll always firstsearch for existing records before attempting to create a new one.

2. Individual Full Name and Organization Name: If you create a new record or edit a record and when you save it; itmatches the exact name of another existing record you'll receive a 'potential duplicate' task assignment and bothrecords will log that into the 'potential duplicates' related list. You'll be able to merge duplicate records or simply ignorethe potential duplicates flag if that's what's needed. See below how to merge records.

How to merge duplicate records flagged automatically

1. Click on the duplicate alert link to view it (see column 'Duplicate Alert')

2. Verify that both contacts are owned by you (see top of this page)3. Click on the 'Merge or Convert Duplicates' button

4. Follow the instructions on the merge screen. The surviving record is the one for which you check the 'merge to'checkbox. You can then pick and choose the field values you want to keep so for example you can keep IndividualA, but with the State ID of Individual B.

If you have three records available to merge, you can always uncheck the 'contact select' checkbox to not mergethe third one if that's what you need.

Note that when merging you keep the field values you select in this screen but you also keep the aggregate of allthe related lists of the duplicate records. For example if you select to keep the SSN of Individual A, the value ofthat field in Individual B will be deleted, but if you have 1 interaction in Individual A and one in Individual B, you'llkeep both interactions in the resulting merged record.

5. When ready, click on the 'Merge' button at the bottom of the screen. You'll be redirected to the surviving record foryour review. The merge process is 'destructive' so make sure you have kept the field values yo want before clickingmerge. (There's no 'UNDO' for this one!).

Manual SearchYou can manually search for duplicates and merge them as needed. You can merge both individuals and organizations.

Search for and Merge Individual duplicates

1. Go to the '+' tab

2. Click on the 'Contact Merge' link

3. Type the name of the contacts you want to merge and click search

4. Verify that both contacts are owned by you (see top of this page)

5. Check the boxes for the two individuals you want to merge and click the 'Next' button

6. Select which individual should survive the merge and then select the fields you want to keep from each one, thenwhen ready, click on the 'Merge' button

‹ How to transfer an individual to another county up Merge Duplicate Service Providers ›

Search for and merge organization duplicates1. Go to the ‘Organizations’ tab and click on the ‘merge organizations’ link at the bottom of the page.2. Follow the same steps described above for individuals

Merge Duplicate Service Providers


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Outreach EventsHome » System Documentation

How to Create an Outreach Event1. Like all other records in the system you can always use the 'Create New' dropdown on the left sidebar or go to the

'Outreach Events' tab and click on the 'new' button.

2. Fill out the form with the corresponding information and click save.

Notes:

For the Community Contact field; you'll need to select the organization with which you are collaborarting for thisevent. For the Contact Person field; you'll need to select the individual that is your point person for this event.

‹ Merge Duplicate Service Providers up Reports ›

For the HC Initials field; the system won't autmatically fill this out, you need to just type in the initials of thecoordinator involved in the event; this is setup in this way assuming that the person creating the event in the systemis not necessarily the same person who attended or coordinated the event.


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ReportsHome » System Documentation

How to view reports1. Go to the 'reports' tab2. Select the folder where your report is on the left sidebar and click on the report from the right hand panel.3. Reports are always up to date so what you see is the latest information based on the filters and date ranges

specified in the report.

How to create reports1. Go to the 'reports' tab

2. Click on the 'new report' button

3. Select a report type and click the 'create' button

4. You'll land on the report builder. This builder interface will display a sample of your data so you can build yourreport by easily drag and dropping columns, filters and groupings. The first step is to select the report format

5. Drag and drop the fields that you want to see

6. Add any filters and date ranges needed (relative date ranges like 'last month' are great for reports you needregularly)

7. Add a graph (you need to have selected the 'sumary' format and have a grouping field to build graphs)

8. Click the 'Run report' button

9. You can always make changes by clicking on the 'customize' button and after you've made your changes on the 'runreport' button again.

10. Once you're happy with the report save it.

11. Once you've saved a report once, you can always come back to it and see the most up-to-date information.

‹ Outreach Events up Team Collaboration ›

How to export reportsView the report and click on the 'printable view' or 'export details' buttons. Printable View gives you a formatted versionof the report while Export Details gives you the raw data. To grab the graphs simply right click on them and save themas a picture to your hard drive.


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Team CollaborationHome » System Documentation

This system includes a fully featured collaboration tool that will help you get more done by making much easier and faster to collaborate with your team. This tool is called 'Chatter' and works like an internal, secure social network.

Who and what to 'Follow'

You choose who's activity to follow, for example, a supervisor may want to follow a new staff member during hertraining period to help her along the way. You can also follow records, for example, the new baby that you just enrolledlast week, to make sure you're in the loop with any interactions any other team members log that are related to hercase. When you follow a user or a record, you will get updates related to these into your 'chatter feed'.

Chatter FeedThe feed is a reverse chronological list of updates from those users or records that you've chosen to follow.

You can always 'hide' the feed from a page if it takes up too much space at the top. Just click on the 'hide feed' button.To expand the feed again, just click on 'show feed'.

The chatter feed is available in several places:

Your Home page

When you first sign in to the system every morning you'll have a feed of the most recent activity.

The Chatter tab This tab is very similar to your homepage but has a custom left hand sidebar that allows you to better filter your feed.

‹ Reports up Notes and Attachments ›

The record pagesWhen you visit an individual or organization record detail page, you'll be able to view the most recent chatter activityrelated to that particular record, right inside the page.


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Notes and AttachmentsHome » System Documentation

You can attach files—such as Microsoft® Office documents, Adobe® PDFs, and images and videos—to individual and organization records. You can also add notes that help you and your team stay on the same page.

Add an attachment1. Go to the record you want to add an attachment to2. Click Attach File in the 'Notes and Attachments related list of the record

3. Click Browse and find the file you want to attach (only files in your computer's hard-drive are available in this step)

4. Click Attach File to upload the file

5. Click Done when the upload is finished

Notes:

The size limit for an attached file is 5 MB when attached directly to the related list. The size limit for all files attachedto an email is 10 MB.When a file is attached to a record’s Chatter feed it’s added to the Notes and Attachments related list as a feedattachment. The file size limit for Chatter feed attachments is 2 GB.To email an attachment you need to download it to your computer and then attach it from there. (sounds archaic soas soon as the system supports it, we'll make this process easier!)

Add a note1. Go to the record you want to add a note to2. Click New Note in the Notes and Attachments related list

3. Enter a title and body text

‹ Team Collaboration up For Administrators ›

4. Click Save

Important: Notes and Attachments won't automatically log a new interaction.


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‹ Notes and Attachments up How to transfer ownership of inactive usersusing the dataloader.io app ›

How to transfer ownership of inactive users using the dataloader.io app


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OverviewThis documentation is related to the Outreach & Case Management System used by the Healthy Communities programs across the stateof Colorado and is managed by the Department of Health Care Policy and Financing of the State of Colorado.

Basic Concepts

Individuals

Each of your clients or potential clients will have a single Individual record in the system. All information about this person will beavailable to you, including name, address, phone, etc. and you can make needed edits from within that Individual record. Individuals aretypically connected to Accounts.

Accounts

Each individual will be associated with an Account. Accounts can be households or organizations such as hospitals or service providers.Some examples of how you can connect Accounts and Individuals are:

You can associate a mother (Individual record) with her three children to the same household (Account record) . This will allowyou to see all the information in one place and let you provide services to the whole family through this system. You can associate a mother (Individual record) who has given birth at a hospital (Account record). This will allow you to see allthe information in one place and let you determine services based on current information.

Interactions

Each Interaction is a summary log of a communication with an Individual or Account via mail, phone, email, etc. Interactions are savedwithin the system and provide a historical view of all relevant communications. Interactions are typically referred to as contacts and canalso be used as task reminders. When you enter an Interaction with a due date in the future, it serves as a task list for the user within thatIndividual or Account and will appear as an Open Interaction in the system. Some examples of how you can log Interactions are:

You can log an interaction with an Individual when you have a CHP+ 1st contact.You can log an interaction with an organization when you make a provider contact. You can log an interaction to remind you to call a client in two weeks.

Referrals

There are two types of referrals, 'Outbound' (when you interact with a client and refer them to a service provider and 'Inbound' when youreceive a new client that was referred to you from another agency, for example.

Enrollments

For those individuals that are already enrolled in Medicaid you'll have their individual record associated with an 'Enrollment' which willcontain the information relevant to that enrollment, like checkups.

Outreach Events

Community and partner outreach events you attend and/or organize will be logged in the system.

What does it do?

This system was built to meet ten main needs:

1. Automated, Integrated Reporting

2. Improve client retention

3. Speed up data entry

4. Improve information discovery

5. Make complying with HIPAA easier

Reports are now automated and state staff can now access each county's reports directly so there's no need to store reports in excel fileson your computer and there's no need to build, encrypt and send those reports every month. By eliminating this process the system avoidshaving to export personal health information into local PCs and send that information over the internet; which are the two biggest risks

HIPAA intends to prevent.

6. Improve data quality

7. Measure program performance and impact

This system allows each team member, from the state level staff to the program supervisors to the coordinators to see real-time graphsand reports of key performance indicators and other relevant information customized to their role and level of access.

8. Enable state-wide self-service provider directory

Coming Soon!

9. Enable program scalability

As teams grow and change, new users can be added on the go and existing users can be disabled as needed.

10. Improve team collaboration

Training and System Documentation

Technology Configuration RequirementsThe following requirements are needed to ensure that your team has the necessary tools to use the system without encountering anyissues.

1. Upgrade the default web-browser to its latest version. All major web-browsers are supported as long as they're on their latestversion.

1. Use this configuration for Internet Explorer and this one for Firefox.2. Internet Explorer 6,7, 8 and 9 are no longer supported. Upgrade IE 11. Check your current version.

2. For all browsers, you must enable JavaScript, cookies, and SSL 3.0.3. Use monitors with a screen resolution of 1024 x 768 or higher for the best possible user experience.4. Deploy email filtering technology (Anti-spam filters) and make sure all users can receive Emails from every Salesforce IP address,

the following 52 IP Addresses must be whitelisted by the email filtering system:96.43.144.64 to 96.43.144.6596.43.148.64 to 96.43.148.65182.50.78.64 to 182.50.78.79204.14.232.64 to 204.14.232.79204.14.234.64 to 204.14.234.79

5. Install and maintain desktop protection software (Anti-virus) on all user machines in the network and keep all applications anddefinitions up to date.


http://help.salesforce.com/apex/HTViewHelpDoc?id=getstart_browser_ie.htm&language=en_US#getstart_browser_ie

http://help.salesforce.com/apex/HTViewHelpDoc?id=getstart_browser_firefox.htm&language=en_US#getstart_browser_firefox

http://windows.microsoft.com/en-us/internet-explorer/which-version-am-i-using


6. If there is domain whitelisting security in place, add these to the list of allowed domains:.staticforce.com.content.force.com.force.com.salesforce.comhcpf.upleaf.comvimeo.com

7. Provide a minimum internet download speed of 10 mbps per user. Note that your contracted speed may need to be divided by thenumber of concurrent users. It's important to really see what speed each user can reach on a normal day of work where all users areheavily using the web to access this system at the same time. Use Speedtest.net to test your current speed.

8. Most of the tech support provided to users of this system is done via GoToMeeting and Join.me so ensuring that this tool worksseamlessly is critical.

9. Make sure each machine meets these minimum requirements for optimum performance (Alternatively you can use machinesrunning on Google Chrome OS):

Processor speed: 1 GHzRAM: 1 GB (32-bit) or 2 GB (64-bit)Hard drive space: 16 GB (32-bit) or 20 GB (64-bit)Operating System: Windows 7 or higher, Mac OS 10.4 or higher

About the TechnologyThis system is built of top of the Force.com platform. A web-based constituent relationships management system (CRM). We're usingthis technology because it offers four main attributes that are essential to the needs of the Healthy Communities program:

1. Cloud-based Infrastructure

Because the system is web-based it can be accessed from anywhere, from any device. This allows us to offer one integrated system for allcounties across the state at a much lower cost. It also allows for the visualization of real-time data at the state level without the need forthe counties to be preparing reports all the time.

2. Reliability

Force.com has a proven 99.9+ percent uptime record for years. To ensure maximum uptime and continuous availability, Force.comprovides redundant data protection and the most advanced facilities protection available, along with a complete data recovery plan. MoreInfo.

3. Security

This system has been configured to protect personal health information and to meet the security requirements of the state of Colorado. Itincludes these security measures:

1. Data Sharing: All data is isolated by contractor so your information is not available to other counties unless you choose to share it.2. Password Policies: Strict password rules are in place to prevent unauthorized access to the system.3. Session Limits: Login sessions are locked to the IP address from which they originated, require secure connections (HTTPS) and

allow for SMS-based identity confirmation.

In addition to these configuration settings, the Salesforce Platform already includes robust security features by default. See more details.

4. Always up-to-date software

This system is upgraded every quarter making sure the infrastructure is always working at optimum levels, it's always compatible withthe latest browser versions and new features are added seamlessly.

Getting StartedHow to Login

http://www.speedtest.net/

http://www.gotomeeting.com/online/meeting/online-meeting-support

https://join.me/

http://www.salesforce.com/force/features/



https://trust.salesforce.com/trust/security/

1. Go to https://hcpf.my.salesforce.com, input your username (your email) and password and hit enter or click the 'Login to Salesforce'button.

Note: You may want to save this web address to your favorites or bookmarks so that you can easily get back to it with one click.

2. This is your Homepage:

https://hcpf.my.salesforce.com/

Edit your Profile

1. Click on your name (top right hand corner of your screen) and then on 'My Profile

2. Add your photo

3. Crop the photo if needed

4. Edit your profile information by clicking on the pencil icon next to the 'Contact' or 'About Me' sections beneath the photo. (notice thatthere are two tabs inside the 'edit profile' window: contact and about).

5. You are done!

The Basics

Search for AnythingThe first step whenever you need to work with an individual or organization is to first search for them in the system. The goal is to avoidduplicates and to make it easier for you to just edit an existing record instead of creating a new one from scratch.

The system offers several ways for you to find the record you need:

1. The search box

This is a universal search box. Much like Google; it allows you to search for almost anything that has been recorded in the system. Forexample:

Social Security Numbers

State IDsPhone numbersEmailsNamesIDs

2. Recent Items

A list of the most recent items you have worked with is always one click away on the left hand sidebar and inside each of the tabs(individuals, organizations, etc...) so that you can easily get back to a case you were working on.

3. Suggested records

When editing a record, some fields are used to associate that record with other records and for those cases, the system will suggest themost recent records you've worked on so that you can quickly select the one you want without having to search for it.

For example when editing an individual you can start typing in the household she belongs to and the system will suggest the matchinghousehold from those households you've recently worked with.

4. Find Who Owns a Record My Team Doesn't Have Access To

https://14-lvl3-pdl.vimeocdn.com/01/4555/2/72778205/184608048.mp4?expires=1497899585&token=0ac43e0ab1d37eb611bfd

https://14-lvl3-pdl.vimeocdn.com/01/4555/2/72778205/184608048.mp4?expires=1497899585&token=0ac43e0ab1d37eb611bfd

Or download the video >

How to create a new record

If you have already searched for an record and it doesn't exist yet in the system you can easily create it by following one of these alternatemethods (depending on which one is more convenient for you at the moment):

The Create New...' sidebar dropdown:

Go to the left sidebar and select the type of record you want to create from the 'Create New' dropdown that's the first option at the top ofthe sidebar.

The 'New' button inside each tab

Go to the corresponding tab and then click on the 'New' button available right at the beginning of the page.

https://hcpf.upleaf.com/sites/default/files/New%20Owner%20Search.mp4

From within the related record

You can easily create a new record from inside a related record. For example you can create a new referral to an individual from withinthe individual record. Just go to the 'referrals' related list inside the individual record and click on the 'new referral' button.

Related lists are always listed as links right below the name of the record and in an expanded view at the bottom of the page.

At the top of the page:

And at the bottom of the page:

The 'Save and New' button

Whenever you are saving a record you will have the choice to either click on the 'save' or the 'save and new' button. 'Save' will redirectyou to the record you just saved or to the record from where you started. 'Save and new' will save the record and automatically take to theform to create a new record of the same kind.

How to edit an existing recordSearch for the record following these instructions and once you've found it, you can edit it in a couple of different ways:

1. Edit particular fields by just double clicking on them

2. Edit the whole record by clicking on the 'edit' button

The SidebarHide/Show the left hand sidebar

The left hand sidebar is a useful tool but sometimes, especially if you have a smaller screen, it's convenient to just hide the sidebar tohave more room to work with. To toggle the sidebar simply click on the small arrow on the top right hand side of it.


Edit My Settings

1. Click on your name (top right hand corner of your screen) and then on 'My Settings'

2. Use the left sidebar on the resulting screen to find the setting you want to change.

Building Blocks: Individuals, Households and Organizations

About IndividualsIndividual Record Types

There are 6 types of individuals you can manage:

1. Clients: People with a Medicaid or CHP+ enrollment already.2. DSS/DHS Technician: employees at the DSS/DHS that you want to have available to associate with client enrollments3. Government Agency Contact: People within local or federal government with which you interact for outreach events or other

activities4. Services Provider Contact: Those people that work at a service provider with whom you need to interact with or want to have

available to provide as part of referrals.5. Non-client: people you need to keep track of as part of a case but that are not clients themselves. For example, the legal guardian

of a child.6. Potential Client: People you need to follow up with that may be elegible to be enrolled but are not enrolled yet.

For each record type the page will include a custom set of fields and related lists that are relevant to that particular type of individual. Forexample for non-clients, no enrollment information is needed, only for clients.

Note: You can always change the record type of an individual simply by editing the record type field. This is particularly useful whenyou need to upgrade a potential client to client.

Individual Related Lists

Below is a list of all available related lists. Not all of these are included for all types of individuals; only for those to which they arerelevant:

Interaction History

List of all interactions with an individual that have been logged in the system. See Interactions for more details

Open Interactions

List of interactions that are pending. These include scheduled follow ups. See Interactions for more details.

Enrollments

History of enrollments that the individual has had, including current ones. See Enrollments for more details.

Referrals

History of outbound referrals that have been provided to the individual. See Referrals for more details.

Notes and Attachments

List of internal notes and attached files related to the individual. This may be particularly useful to attach scanned application forms, sothat all information about a client is in one place and easy to retrieve.

Potential Duplicates

List of duplicate alerts where this individual has been found to match another individual's name. See Managing Duplicates for moredetails.

What if a client dies or asks not to be contacted anymore?

You can flag these individuals by editing the 'status' field.

How the Social Security Number Field WorksPlease play this video below to watch a brief tuturial on how the SSN field works. Click on the bottom right hand corner icon of the videoscreen to view it in full screen.

About Households

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Households are a great way of working with families. Each individual is associated with a household and you can always move them to anew household when needed.

The household is also where you can input contact information for the family, like phone numbers, addresses and email.

How to create a new household

You don't need to create households manually as there is one household for each individual already in the system. When you add multiplepeople to the same household the name of the house changes accordingly.

Manage household members

Add new members:

You can add always add new people to an existing household by selecting that household in the household field of the new client you'recreating.

Move People from one household to another:

Case 1: The individual belongs to a household; there are other people in that same household and the household you want to move themto already exists:

Simply edit the household field of the individual and search for and select the household you want to move them to.

Case 2: The individual belongs to a household but it's only that one individual in that household: Follow these instructions in the videoebelow:

About OrganizationsOrganization Record Types

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There are 5 types of individuals you can manage:

1. Community Agency: community-based organizations with which you interact for outreach events or other activities2. Government Agency: local or federal government agency with which you interact for outreach events or other activities3. Government Agency Contact: People within local or federal government with which you interact for outreach events or other

activities4. Services Provider: Entities with which you need to interact with or want to have available to provide as part of referrals5. Workplace: Any other entity that doesn't fit the four options above. Private businesses for example.

For each record type the page will include a custom set of fields and related lists that are relevant to that particular type of organization.For example for Service Provider, fields like services offered and programs accepted are included.

Organization Related Lists

Below is a list of all available related lists. Not all of these are included for all types of organizations; only for those to which they arerelevant:

Individuals

List of all individualas associated with this organization. For example the key contact at a government agency or the physician at adoctor's office.

Interaction History

List of all interactions with an individual that have been logged in the system. See Interactions for more details

Open Interactions

List of interactions that are pending. These include scheduled follow ups. See Interactions for more details.

Clients

List of enrollments for which this provider has been defined as a service provider. For example Primary Care Physician. See Enrollmentsfor more details.

Referrals

History of outbound referrals where this organization has been referred. See Referrals for more details.

Notes and Attachments

List of internal notes and attached files related to the organization.

Potential Duplicates

List of duplicate alerts where the organization has been found to match another. See Managing Duplicates for more details.

InteractionsHow to log an interaction

Completed offline Interactions:

Go to the related individual or organization record and click on the 'Log an Interaction' button under the 'Interactions History' related list.Select the interaction record type and proceed to fill out the form.

There are 4 interaction record type you can manage:

1. CHP Interactions: Interactions with those individuals that are eligible for CHP+ benefits2. EBNE Interactions: Interactions with those individuals that qualify as Eligible but not Enrolled3. Medicaid Interactions: Interactions with those individuals that are enrolled in the Medicaid program4. Tasks: All other interactions, To Dos or delegated assignments handled through the system

For each record type the page will include a custom set of fields that are relevant to that particular category of interaction. For examplefor Medicaid Interactions we include the 'Referred From' and 'Who initiated' fields that are not included for CHP Interactions.

Note: All interactions logged from the 'Log an Interaction' button are automatically marked as completed.

Follow Up tasks

From within the interaction form, you'll be able to create an open follow up task, including who to assign the Task to, whether to notifythe assignee by email and when to trigger a reminder for it.

Send an Email

You can send a personalized email directly from within the system, while automatically logging an interaction of type 'email' all in onestep.

How to Send an Email

1. Click on the 'Send an Email' button inside the 'Interactions History' related list.2. Select a template. See how to create email templates3. Add attachments by clicking on the 'Attach File' button4. Just like a regular email, you can select who to CC and BCC.5. Edit the Subject and body of the email6. Check Spelling7. Send8. You'll be returned to the related record and then you can edit the newly created interaction to change its record type or any other

field.


Mail Merge

You can generate a Microsoft Word document that includes data from the record selected while also logging an interaction. This is veryuseful for routine notifications or reminders.

How to send a mail merge

1. Click on the 'Mail Merge' button inside the 'Interactions History' related list2. Select a template. See how to create mail merge templates3. Click on the 'Generate' button4. A Word file will download onto your computer. You can then proceed to print this document and mail it.5. When done you'll be returned to the related record and then you can edit the newly created interaction to change its record type or

any other field.


How to create an open interaction

Open interactions are a great way to delegate tasks within a team, organize your day or week and make sure follow ups happen bycreating dynamic, easy to use To Dos

You can create an open interaction by:

1. clicking on the 'new task' button inside the 'open interactions' related list2. Select the interaction record type and proceed to the form3. In this form you'll be able to fill out all corresponding fields, decide who to assign the Task to, when to remind them automatically

and whether to create a recurring series of tasks.

4. When saving you can choose to also create a new task with one click.

How to create email templatesSend a draft of the templates you'd like to create to [email protected] and we'll create them for you.

How to create mail merge templatesThe state is exploring allowing all counties to send direct mail via a centralized state service. For now, please coordinate with the state tocreate your templates and how to send them.

My List of TasksThe 'Home' tab contains a section called 'My Tasks' where you'll find all open tasks and interactions assigned to you.

Use the right hand side dropdown to select the time frame that you want to see.

Collaborating around a assigned to youIf you receive a new task assignment and you want to ask a question to who assigned it to you, just go to the related record, for example,the individual referenced in the task and use Chatter.

ReferralsHow to log outbound referrals

1. From within the individual record, click on the 'new referral' button inside the 'referrals' related list

mailto:[email protected]

2. Once on the form, you'll be able to easily select the provider, category, type, date and comments of the referral; as well as createmultiple referrals from the same form.

3. Use the 'Remove Row' option to make sure you don't have empty rows before hitting 'save'.

EnrollmentsWhat is an enrollment

An Enrollment in the system is the equivalent of a real life program enrollment, either of Medicaid or CHP+ for one individual.

One individual can have more than one enrollment as in real life an individual can be eligible and enroll at one time in her life then dropout and later on become eligible and enroll again. The goal is to reflect this reality by allowing you to create and close enrollments asneeded for each individual.

How to create a new enrollment

When you assign the record type 'client' to an individual you'll have a new related list available called Enrollment.

1. Click on the 'New Enrollment' button inside the 'Enrollments' related list of the individual record.

2. Fill out the corresponding fields. Provider information, like primary care physician will be available as a 'Service Provider' related listonce you save the form.

3. To add providers, click on the 'New Service Provider' button inside the 'Service Provider' related list.

Ending an Enrollment

Enrollments in the system should very closely resemble enrollments in CBMS. So if someone is no longer receiving benefits you need toedit their enrollment record and edit the end date field.

How to transfer an individual to another countyImportant: Once you've transferred a record, you won't be able to see it anymore. You will however be able to use Chatter to coordinatewith the recipient of your transfer to make sure they followed up on it.

1. Go to the individual record and scroll down to 'system information'2. If hidden, click on the 'System Information' arrow to expand the fields inside.3. Click on the 'change' link next to the 'Individual Owner' field

4. Search for the user you want to transfer the record by clicking on the magnifying glass icon next to the 'owner' field

5. Check the 'send notification email' checkbox to notify the new owner that you've transfered a record to them6. Save changes7. Once you've transferred an individual, assuming you're transferring all family members, follow the same steps above to

transfer each individual in the household. Then follow these steps to transfer the household too.

Managing DuplicatesImportant Note: To merge record you need to first 'own' them. During the steps described below, the first step is to always check who

owns both records and change the record owner to you. Here's how to change record owners.

There are two ways you can detect and merge duplicates: by automated detection and by manual search.

Automated Detection

The system implements automated duplicate matching rules for individuals and organizations:

1. State ID and Social Security Numbers: the value of these fields has to be unique for each record. If there is another record with thesame value you'll get an error message when you try to save your changes letting you know and you can then use the search box to findthe existing record. Ideally these cases will be in the minority because you'll always first search for existing records before attempting tocreate a new one.

2. Individual Full Name and Organization Name: If you create a new record or edit a record and when you save it; it matches the exactname of another existing record you'll receive a 'potential duplicate' task assignment and both records will log that into the 'potentialduplicates' related list. You'll be able to merge duplicate records or simply ignore the potential duplicates flag if that's what's needed. Seebelow how to merge records.

How to merge duplicate records flagged automatically

1. Click on the duplicate alert link to view it (see column 'Duplicate Alert')

2. Verify that both contacts are owned by you (see top of this page)3. Click on the 'Merge or Convert Duplicates' button

4. Follow the instructions on the merge screen. The surviving record is the one for which you check the 'merge to' checkbox. You canthen pick and choose the field values you want to keep so for example you can keep Individual A, but with the State ID ofIndividual B.

If you have three records available to merge, you can always uncheck the 'contact select' checkbox to not merge the third one ifthat's what you need.

Note that when merging you keep the field values you select in this screen but you also keep the aggregate of all the related lists ofthe duplicate records. For example if you select to keep the SSN of Individual A, the value of that field in Individual B will bedeleted, but if you have 1 interaction in Individual A and one in Individual B, you'll keep both interactions in the resulting mergedrecord.

5. When ready, click on the 'Merge' button at the bottom of the screen. You'll be redirected to the surviving record for your review.The merge process is 'destructive' so make sure you have kept the field values yo want before clicking merge. (There's no 'UNDO'for this one!).

Manual Search

You can manually search for duplicates and merge them as needed. You can merge both individuals and organizations.

Search for and Merge Individual duplicates

1. Go to the '+' tab

2. Click on the 'Contact Merge' link

3. Type the name of the contacts you want to merge and click search

4. Verify that both contacts are owned by you (see top of this page)

5. Check the boxes for the two individuals you want to merge and click the 'Next' button

6. Select which individual should survive the merge and then select the fields you want to keep from each one, then when ready, click onthe 'Merge' button

Search for and merge organization duplicates

1. Go to the ‘Organizations’ tab and click on the ‘merge organizations’ link at the bottom of the page.2. Follow the same steps described above for individuals

Merge Duplicate Service Providers1. Go to the 'Organizations' tab2. Scroll to the bottom of the screen and click on the 'Merge Organizations' link3. Type a word or words that is/are common to both record's names. For example 'John Doe'. Use asterisks (*) before and after these

keywords to expand your search. Then click on the 'Find Organizations' button4. Check the checkbox for two of the duplicates to be merged and click on the 'Next' button on the bottom right hand corner.

Outreach Events

How to Create an Outreach Event

1. Like all other records in the system you can always use the 'Create New' dropdown on the left sidebar or go to the 'OutreachEvents' tab and click on the 'new' button.

2. Fill out the form with the corresponding information and click save.

Notes:

For the Community Contact field; you'll need to select the organization with which you are collaborarting for this event. For the Contact Person field; you'll need to select the individual that is your point person for this event. For the HC Initials field; the system won't autmatically fill this out, you need to just type in the initials of the coordinator involvedin the event; this is setup in this way assuming that the person creating the event in the system is not necessarily the same personwho attended or coordinated the event.

ReportsHow to view reports

1. Go to the 'reports' tab2. Select the folder where your report is on the left sidebar and click on the report from the right hand panel.

3. Reports are always up to date so what you see is the latest information based on the filters and date ranges specified in the report.

How to create reports

1. Go to the 'reports' tab

2. Click on the 'new report' button

3. Select a report type and click the 'create' button

4. You'll land on the report builder. This builder interface will display a sample of your data so you can build your report by easilydrag and dropping columns, filters and groupings. The first step is to select the report format

5. Drag and drop the fields that you want to see

6. Add any filters and date ranges needed (relative date ranges like 'last month' are great for reports you need regularly)

7. Add a graph (you need to have selected the 'sumary' format and have a grouping field to build graphs)

8. Click the 'Run report' button

9. You can always make changes by clicking on the 'customize' button and after you've made your changes on the 'run report' buttonagain.

10. Once you're happy with the report save it.

11. Once you've saved a report once, you can always come back to it and see the most up-to-date information.

How to export reports

View the report and click on the 'printable view' or 'export details' buttons. Printable View gives you a formatted version of the reportwhile Export Details gives you the raw data. To grab the graphs simply right click on them and save them as a picture to your hard drive.

Team CollaborationThis system includes a fully featured collaboration tool that will help you get more done by making much easier and faster to collaboratewith your team. This tool is called 'Chatter' and works like an internal, secure social network.

Who and what to 'Follow'

You choose who's activity to follow, for example, a supervisor may want to follow a new staff member during her training period to helpher along the way. You can also follow records, for example, the new baby that you just enrolled last week, to make sure you're in theloop with any interactions any other team members log that are related to her case. When you follow a user or a record, you will getupdates related to these into your 'chatter feed'.

Chatter Feed

The feed is a reverse chronological list of updates from those users or records that you've chosen to follow.

You can always 'hide' the feed from a page if it takes up too much space at the top. Just click on the 'hide feed' button. To expand the feedagain, just click on 'show feed'.

The chatter feed is available in several places:

Your Home page

When you first sign in to the system every morning you'll have a feed of the most recent activity.

The Chatter tab

This tab is very similar to your homepage but has a custom left hand sidebar that allows you to better filter your feed.

The record pages

When you visit an individual or organization record detail page, you'll be able to view the most recent chatter activity related to that

particular record, right inside the page.

Notes and AttachmentsYou can attach files—such as Microsoft® Office documents, Adobe® PDFs, and images and videos—to individual and organizationrecords. You can also add notes that help you and your team stay on the same page.

Add an attachment

1. Go to the record you want to add an attachment to2. Click Attach File in the 'Notes and Attachments related list of the record

3. Click Browse and find the file you want to attach (only files in your computer's hard-drive are available in this step)

4. Click Attach File to upload the file

5. Click Done when the upload is finished

Notes:

The size limit for an attached file is 5 MB when attached directly to the related list. The size limit for all files attached to an emailis 10 MB.When a file is attached to a record’s Chatter feed it’s added to the Notes and Attachments related list as a feed attachment. The filesize limit for Chatter feed attachments is 2 GB.To email an attachment you need to download it to your computer and then attach it from there. (sounds archaic so as soon as thesystem supports it, we'll make this process easier!)

Add a note

1. Go to the record you want to add a note to2. Click New Note in the Notes and Attachments related list

3. Enter a title and body text

4. Click Save

Important: Notes and Attachments won't automatically log a new interaction.

For Administrators

How to transfer ownership of inactive users using thedataloader.io app

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