On the first day of training for the workers who will help Arkansans navigate the effects of the 2010 federal health-care law, Julie Nelson told her students their task won’t always be easy.
“It’s going to be a difficult thing to see the kind of reaction you’re going to get,” Nelson said. “Some people are going to say, ‘Obamacare? Don’t even come in my door.’”
Nelson, an instructor at Pulaski Technical College who also works as a medical transcriptionist at a hospital, on Monday taught a class of13 people, including five in training to become outreach workers, at the college’s Business and Industry Center in Little Rock.
Similar classes were held at National Park Community College in Hot Springs, East Arkansas Community College in Forrest City, and Northwest Arkansas Community College in Bentonville.
Eventually, the training will spread to each of the state’s 22 two-year colleges, as well as to the University of Arkansas at Fort Smith, as more outreach workers are hired.
The effort, aimed at helping the state’s more than 500,000 uninsured sign up for subsidized coverage that will be available starting Oct. 1, is expected to involve 542 outreach workers employed by 26 nonprofits, businesses and government agencies under contracts with the Arkansas Insurance Department.
On Monday, the class at Pulaski Technical College included two workers and a supervisor from the Harmony Health Clinic in Little Rock and one supervisor each from the Mental Health Council of Arkansas and Arkansas Health Care Access Foundation, a Little Rock nonprofit that refers uninsured people to doctors who provide free care. Several workers from the Insurance Department’s consumer assistance division also attended.
Speaking to the students, Nelson and Sandra Cook, a community assistance specialist with the Insurance Department, emphasized the significance of the task.
“You are a part of history right now,” Cook told the students. “You are going to be very instrumental in changing people’s lives.”
That message resonated with Monesha Coffey, 19, who was hired as an outreach worker after completing an internship as a pharmacy technician at the Harmony Health Clinc.
“I feel like I’m a part of history,” she said. “I’m a part of a movement.”
She also admitted, “I’m anxious and nervous, but I think I’m going to do well.”
The first phase of training, held at the colleges, spans five days and covers topics such as the history of U.S. healthcare programs, understanding insurance terms, protectingconfidential information and interacting with people of other cultures.
The students will also complete 20 hours of online training, by the U.S. Department of Health and Human Services, on using a federal website on which applicants will be able to compare insurance plansthat will be offered through a federal exchange, or marketplace.
The third phase of training, held at the colleges, will cover Arkansas-specific topics, such as the expansion of Medicaid through subsidized private insurance plans that will also be offered on the exchange being developed by the federal government under a partnership with the state.
Even before their training is complete, the workers will be attending public events and disseminating information about the insurance options that will be available, Insurance Department spokesman Heather Haywood said.
Once the workers complete the training, they will be able to help people use the federal website to compare plans, although they will be barred from making an assertion about which plan is best for the applicant.
Cynthia Crone, a deputy director at the Insurance Department, said training will direct the workers to present information in a neutral way.
“Their role is not to convince anybody or convert them or do anything other than help them understand the requirements,” Crone said.
On Monday at Pulaski Tech, the first part of class focused on communication skills - including listening, understanding body language and providing “exceptional service.” The students completed a brief quiz before breaking for lunch.
Kim Fowler, of North Little Rock, the supervisor at the Arkansas Health Care Access Network, said the first day of class made her think about what she might encounter as she talks to people about the federal health-care law.
“I was thinking they’d be more open and welcoming,” Fowler said. “Now I’m starting to see it will be a challenge.”
Revisions to the curriculum, developed by the colleges and the Insurance Department, were still being finished as class started, with Michael Ekbladh, the college’s project coordinator, passing out sections for the students to add to their workbooks during the class.
The comprehensive test at the end of the first phase Friday will include a role-playing exercise, simulating an interaction with a prospective applicant for coverage, Ekbladh said.
Planned Parenthood has applied for funding to hire seven outreach workers under an Insurance Department contract, but that contract was delayed after some legislators objected. Insurance Commissioner Jay Bradford said last week that he plans to submit a proposed contract to the Legislature for approval after the group pledged that no money from the contract would support abortion-related activities.
The subsidies that will be available under the 2010 Patient Protection and Affordable Care Act include tax credits that will be available to those with incomes of up to 400 percent of the federal poverty level - $45,960 for an individual or $94,200 for a family of four.
Additionally, the Legislature this year extended eligibility for Medicaid to adults with incomes up to 138 percent of the poverty level -$15,860 for an individual or $32,500 for a family of four. Those newly eligible for Medicaid will be able to sign up for private plans on the exchange, and Medicaid will pay their premiums.
The Department of Human Services had planned to provide funding to hire 100 workers who would focus on those eligible for Medicaid, but the department scrapped the plans last week after some legislators objected to state money being used for the effort. The 542 workers being paid under contracts with the Insurance Department are being paid with $16 million in federal grant money.
The Insurance Department has been told that the grant-funded workers cannot target those eligible for Medicaid, but the department will coordinate its efforts with the Human Services Department to provide as much help as possible, Crone said.
State Rep. John Burris, R-Harrison said he hopes the federal Centers for Medicare and Medicaid Services will allow the grant-funded workers to help those eligible for Medicaid as well as for the tax credit subsidies.
At a hearing last month, he predicted that the outreach worker program would be “the part that goes the most terribly out of all of this,” in part because it will be difficult for even the workers to understand aspects of the health-care law.
On Monday, he said he remains skeptical, but added, “I hope the Insurance Department gives good training and makes it as impactful as possible.”
“I hope we at least get a little bang for the buck,” he said.
Northwest Arkansas, Pages 7 on 06/25/2013