Medicaid Managed Care - U.S. Senate Special Committee on Aging

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to respond. Dois remailed the letters and provided additional time for
beneficiaries to respond. And it has only been recently-more than a year
after full implementation of the mandatory program in the first
county-that many of the enrollment materials have begun to be
translated into all of the state's "threshold' languages. ' Although DHS has
established a work group to address problems associated with the
enrollment packet, all planned changes are not expected unfil
November 1997, at which time many beneficiaries will have already been
enrolled. 17
Initially, there also were a number of problems with the toll-free call
center, which was set up to provide beneficiaries access to additional
information about how health plans operate and how to use them. The call
center, however, often was a source of frustration and confusion because
callers could not get through, messages went unanswered, voicemail
boxes were full, or counselors provided incorrect information. However, a
review of Hon'S recently instituted "problem tog' revealed that the
problems have largely disappeared under the current enrollment broker,
Maximus, which expanded the call-center operation
There also have been problems with the uico presentations. Through
county-by-county preimplementation reviews, HCFA often found that the
presentations were confusing, not conducted in the appropriate language,
not accurate or performed as scripted or scheduled, or not sufficiently
informative. In addition, beneficiary attendance has been low. State
officials recognize that the limited number of presentation sites may make
it difficult for beneficiaries to attend. For example, in June 1997, Los
Angeles County-which comprises 88 cities and 136 unincorporated areas
and covers over 4,000 square miles-had 35 presentation sites.
Officials from one managed care plan we contacted believed that poor
attendance at the ico presentations was due in part to Umitations in the
.state's outreach to beneficiaries. The officials believed that by working
closely with community-based organizations that beneficiaries know and
trust, such as churches and legal aid services, more beneficiaries could be
reached, in addition, these organizations could provide outreach services
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