Medicare Network
Special Conference Call
Should There Be an Association of Consumer Health Assistance Programs?
August 4, 2003

I. Introduction

At the Health Assistance Partnership conference in January 2003, the National Association of State Long Term Care Ombudsman Programs (NASOP) and the National Association of Local Long Term Care Ombudsmen (NALTCO) talked about the value of their associations.  Since then, the HAP private insurance network and the HAP Medicaid network have had follow-up discussions about whether consumer health assistance programs could benefit from an association. 

The purpose of this special Medicare Network conference call was to give SHIPs an opportunity to discuss the possible benefits of forming an association of consumer health assistance programs, to raise questions, and to express opinions about the possible value of an association of consumer health assistance programs.

II. The National Association of State Long Term Care Ombudsman Programs (NASOP), Carol Scott, President

Ms. Scott reiterated the substance of her presentation at HAP’s national conference in January 2003.  The long term care ombudsman programs have gained multiple benefits from their associations.  The benefits include:

• Meeting the mandate of looking at issues from a national perspective.  It is easy to become absorbed in the day-to-day work and not have the time to take a national view of emerging issues.  Association staff and volunteers can look at the issues from a broad perspective and share that perspective with the membership.
  
• Establish a national presence at meetings and liaison with related organizations.  While the Long Term Care Resource Center does a great job of putting together resources for ombudsman programs so that no program needs to “reinvent the wheel,” there is great value to direct representation from the ombudsman association at national forums.
  
• Systems advocacy and education.  There is a great need for Congress and the national advocacy organizations to better understand what the ombudsman programs do, and the association has made the education campaign easier.  An association staff person can bring questions from Congress or national organizations back to the ombudsman programs for direct responses.
  
• Model best practices and mentor new staff to improve ombudsman programs.  There is a growing recognition that being an ombudsman requires a skills set and standards of professional practice.  The association works on professional development.
  
• NALTCO has created a newsletter to share best practices and articulate local program needs. Unlike the state-level ombudsmen, who have regional and national meetings, local program staff have few means to communicate with each other. 

NASOP charges programs a $200 per year membership fee, and around 44 states have joined.  The remaining state programs cannot join, mostly due to state budgetary constraints; in those states, NASOP charges individual state program staff a $25 individual membership fee.  As a 501(c) (3) organization, NASOP can solicit grants and donations.  NASOP encourages members to donate honoraria to the organization. NASOP recently won its first grant and used it for a retreat to consider the future of the long term care ombudsman program.   The budget is used to hire two staff people (one very part-time) and to sponsor two national meetings for the membership. 

NASOP is very supportive of NALTCO, understanding the value of locals talking to each other. The two organizations are separate, in recognition that local programs need their own association, as they have their own interests and their unique needs, but the two organizations work very closely together.

III. HAP Memorandum to SHIPs on Associations, Cheryl Fish-Parcham

Ms Fish-Parcham, HAP Medicaid Coordinator, reviewed the memorandum she prepared describing similar associations. To view the memorandum, please click here. Ms. Fish-Parcham encouraged SHIPs to review the memorandum.

Ms. Fish-Parcham noted that similar associations engage in the following activities:

• Comment on policy,
• Advocate for funding,
• Create model state legislation,
• Send liaisons to other organizations and partner associations,
• Exchange information, 
• Plan conferences, and
• Advance professional development of members.

Associations are financed by a wide variety of mechanisms.  Generally, a membership fee is charged.  The fee varies and may be quite modest.  Fees paid by association members may be hefty if an association maintains data systems.

IV. How the Medicaid Network Views the Concept of an Association, Greg Knoll, Executive Director, Center for Consumer Education and Advocacy, Legal Aid Society, San Diego, California

Mr. Knoll is a member of HAP’s Advisory Board and participated in the conversations of the HAP Medicaid and the HAP private insurance networks about the possible value of an association.    Mr. Knoll observed that while the last thing busy advocates need is another meeting to attend, as an experienced consumer health advocate, he believes in the value of an association of consumer health assistance programs.  He observed that the work of such an association is limited only by the vision of its members.  As consumer health ombudsman programs go about their work, the possible benefits he sees include:

• Three networks of consumer health assistance staff who deal with a full spectrum of national consumer health policy speaking with one authoritative voice, representing large and diverse constituencies;
• Being able to put local matters into a national perspective; and
• Addressing sustainability issues, such as adequate funding, training, and resources.

Mr. Knoll observed that a state-wide association in California has been very helpful to the Medicaid advocacy programs in that state.  He further reported that the HAP Medicaid and HAP private insurance networks are interested in continuing to explore formation of an association.

V.  SHIP Discussion, Martha Taylor and Jay Dobbs

The following questions were considered:

• Would there be a value to the SHIPs of an association of consumer health assistance programs?
• What could such an association do?  Possible functions include:
  • Liaison with national organizations,
  • Take positions on federal issues,
  • Communicate with a larger body of consumer health assistance programs, and
  • Identify and disseminate best practices or professional standards.
• Could an association be helpful regarding state legislation or budget issues?
• What could be the relationship of an association of consumer health assistance programs to various resource centers?
• Could your program join such an association?  Could you join as an individual?
• How could an association of consumer health assistance programs balance the interests of diverse programs? 
  • Network representation?
  • Nonprofits versus government programs?
  • State-level versus local programs?
  • Managed care versus access-oriented programs?
  • Other?

The more than 20 SHIP participants in the call were generally in favor of further exploration of the idea of an association of consumer health assistance programs.  Participants noted the need for additional development of the goals and functions of an association of consumer health assistance programs. Concern was raised about how SHIP programs would be able to pay dues or even attend out-of-state meetings.

Mr. Knoll observed that by thinking strategically about how to form such an association, the SHIPs had moved the discussion forward and were “miles ahead” of the other two networks.

Ms. Taylor stated that since it appeared there was a consensus that there are many reasons to proceed, discussions and information-gathering about the idea of an association would continue.  Accordingly, the SHIP Steering Committee will discuss the idea of formation of an association of consumer health assistance programs at its September 2003 meeting in Memphis.  She urged SHIPs to consider the value of the strength in numbers that could be gained from formation of an association.

Ms. Fish-Parcham announced that HAP’s next step would be to call together a group of representatives of each of the three networks of consumer health assistance programs for a meeting in Washington, D.C.  That meeting will take place on September 17, 2003, in conjunction with a HAP Advisory Board meeting.

SHIPs are encouraged to share their further thoughts, opinions, and suggestions with Martha Taylor mtaylor@mail.de.state.az.us or Jay Dobbs jay@mymmap.org, on behalf of the SHIP Steering Committee or Hilary Dalin hdalin@healthassistancepartnership.org or Cheryl Fish-Parcham cparcham@healthassistancepartnership.org at the Health Assistance Partnership.

Many thanks to all who participated for their thoughtful contributions to this important conversation.