Department of Health and Human Services
Administration on Aging

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Program Instructions

AOA-PI-98-06 September 30, 1998
- Grants to State Agencies on Aging for the Support of Information and Referral for Medicare Beneficiaries
Attachment: Part I. Background Information and Program Priority
See also: Part II. Guidelines for Preparing and Submitting the Application
The closing date for submission of applications has been extended to: November 9, 1998.

Administration on Aging (AoA)

Grants to State Agencies on Aging for the Support of Information and Referral for Medicare Beneficiaries

PROGRAM DESCRIPTION AND GUIDELINES FOR PREPARING AND SUBMITTING APPLICATIONS

SUMMARY: These Guidelines have two parts. Part I describes the program priority, Information and Referral for Medicare Beneficiaries Projects, under which the AoA is inviting State Agencies on Aging to submit grant award applications for funding. Part II describes procedures for preparing and submitting the application.

All of the forms (Standard Form 424), Assurances, and Certifications necessary to complete the application are included following Part III.

The deadline date for the submission of applications is October 30, 1998.

Application receipt point: U.S. Department of Health and Human Services, Administration on Aging, Office of Administration and Management, 330 Independence Avenue, S.W., Room 4643, Washington, DC 20201.

For further information contact, Department of Health and Human Services, Administration on Aging, Office of State and Community Programs, 330 Independence Avenue, S.W., Room 4747, Washington, DC 20201, telephone: (202) 619-0011.

Part I. Background Information and Program Priority
A. Statutory Authority

The statutory authority for awards made under this program priority is contained in the Older Americans Act, (42 U.S.C. 3001 et seq.), as amended by the Older Americans Act Amendments of 1992, Pub.L.102-375, September 30, 1992.

B. Eligible Applicants

Eligibility is limited to State Agencies on Aging.

C. Level of Funding

Part A

State Agencies on Aging, including the District of Columbia and Puerto Rico, submitting acceptable applications shall each receive base funding of $10,000. Additional variable funding has been allocated based on the number of Medicare beneficiaries (75% allocation) and the number of Medicare beneficiaries enrolled in managed care in the state (25% allocation). Funding allocation is as follows:

Source: Medicare Managed Care Contract Report dated June 1, 1998

D. Program Priority Description

The Information and Referral for Medicare Beneficiaries Projects

1) Background

The Balanced Budget Act of 1997 established a new Part C for Medicare: the Medicare+Choice (M+C) Program . The law authorizes the creation of new Medicare health plan options from which beneficiaries may choose.

Prior to the 1997 Balanced Budget Act, Medicare beneficiaries could choose to receive their care through "original," fee-for-service Medicare or through health maintenance organizations (HMOs) and similar organizations; i.e., competitive medical plans. M+C introduces new private health plan options, many of which are modeled after options available in the commercial market place. In addition to the original fee-for-service program and HMOs, the new authorized options include health maintenance organizations with a point of service option, preferred provider organizations, provider- sponsored organizations, private fee-for-service plans and medical savings accounts. The range of options available to beneficiaries in any particular geographic area will depend upon the type and number of health plans that choose to operate in the area.

The Health Care Financing Administration (HCFA) has embarked on a broad educational effort--The National Medicare Education Program (NMEP)-- designed to provide Medicare beneficiaries with accurate information about their benefits, rights and health plan options. Components of the NMEP include the development and dissemination of a variety of print materials, toll-free telephone services, Internet resources, a train-the-trainer program, a national publicity campaign, state and community-based publicity and outreach campaigns, enhanced beneficiary insurance counseling services and a beneficiary-based evaluation of the effectiveness of this year's outreach efforts in order to improve efforts in the years following. Most of these activities are being conducted nationwide and have engaged the aging network across the country.

A set of more intensive activities will be undertaken in five pilot states (Arizona, Florida, Ohio, Oregon and Washington) beginning this fall. In these states all beneficiaries will be mailed the Medicare & You handbook which will include comparative information on managed care plans that are available in their area. More intensive and varied forms of education will also be conducted in the five states. Medicare beneficiaries throughout the rest of the country will be mailed a Medicare & You bulletin that highlights information about Medicare program changes, including general information about the new health plan options authorized by Congress. As part of a continuous improvement strategy for the NMEP, all activities conducted this fall and next spring will be evaluated to determine their effectiveness.

In the fall of 1999, Medicare beneficiaries in all states will be sent the Medicare & You handbook with comparative information about specific plans in their area.

AoA is working in collaboration with HCFA on the NMEP. HCFA has provided AoA with funding which will enhance the capacity of the aging network's information and referral systems to provide accurate information and make appropriate referrals for M+C inquiries.

2) Project Objectives and Activities

The Information and Referral for Medicare Beneficiaries Projects are designed to strengthen the capability and capacity of the aging network's information and referral (I&R) providers at the State, Area Agency and local levels to respond to inquiries regarding M+C. Since I&R services are community- based and well-known to older persons, they are a natural source of information on M+C. As older people become aware of the new Medicare options, they are expected to contact a variety of sources, including the aging network programs with which they are familiar. The extent to which I&R programs will provide in-depth assistance in helping older people make decisions about their health plan options will vary. In most states, that role is likely to be performed by Health Insurance Counseling and Assistance Programs. However, I&R services will need to have a baseline understanding of the M+C program to effectively handle inquiries and refer beneficiaries to appropriate sources of information.

Applications are sought from SUAs to plan and carry out projects in support of M+C implementation. State Agencies on Aging may pursue various methods of establishing projects to advance this effort. However, in every case the SUA must propose activities that will train I&R staff at the State, Area Agency, and provider levels on M+C. States may consider additional activities that will enhance the network's capability to handle M+C inquires such as special outreach efforts. Each application must encompass the following components:

• facilitate training on M+C for I&R staff at the State, Area Agency and local levels in coordination with the state's area agencies on aging and health insurance counseling and assistance programs;

• track and report on the number of I&R services participating in M+C activity; the number of I&R staff trained about M+C, including the dates and locations of the training sessions; and

• plan(s) for measuring the degree to which project objectives have been accomplished.

HCFA has developed training materials and conducted train the trainer sessions on M+C. Many State and Area Agency staff have participated in those sessions. AoA is currently customizing the HCFA developed training materials to adapt them for an audience of I&R staff. These customized materials will be provided to State Agencies on Aging along with an I&R desk reference on M+C.

INQUIRIES: Inquiries should be addressed to Regional Administrators on Aging, HHS regional offices.

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