4-JM26-96 Quote for U3P posting.pdf

Attachment F

Take Care Utah Proposal:

The purpose of this amendment is to engage Utah Health Policy Project (UHPP) as community navigators to assist members with the impact of H.R. 1 Policy changes. UHPP will provide statewide hands-on assistance, community education, and technical training regarding the new 6-month renewal cycles, work requirement provisions, and updated qualified immigrant eligibility definitions. This partnership aims to maintain continuity of coverage for eligible members by providing direct support for complex eligibility redeterminations and administrative requirements.

1. General H.R. 1 Education & Capacity Building

Targeting: All populations impacted by H.R. 1 policy changes.

● Strategy 1.A: Extended Take Care Utah Office Hours o Description: Maintain Take Care Utah office hours from 8 AM to 8 PM Monday through Friday and 10 AM to 6 PM on Saturdays.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Provide enrollment services outside of standard DWS operating hours (5PM to 8PM Monday to Friday and 10AM to 6PM on Saturdays, except holidays) to at least 600 individuals.

o Cost: $200,000 o Key Performance Indicators (KPIs):

• Number of appointments made

• Number of people assisted

• Status of individuals at intake (Data will be derived in part from documented case history, when available, and self-reporting (e.g. lost coverage due to work requirements or need to do a review)

• Number of individuals applied and application status (submitted, approved, declined)

• Reason for denial and percentage of individuals declined for procedural, not ineligibility, reasons

• Number of individuals enrolled by Medicaid program

• Number of 6-month renewals completed (without a break in coverage vs. with a break in coverage)

● Strategy 1.B: Responding to Community Needs One-on-One o Description: Building Take Care Utah internal capacity to address additional incoming referrals from DHHS, the Utah Department of Workforce Services (DWS), accountable care organizations (ACOs), health systems, providers and other community partners to address work and community engagement compliance one-on-one with clients.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Provide one-on-one counseling, eligibility screening or enrollment support for up to 30,000 individuals. Document application assistance, eligibility determinations and/or referrals to state or other agencies.

o Cost: $450,000 o KPIs:

• Number of appointments made

• Number of people assisted

• Status of individuals at intake (Data will be derived in part from documented case history, when available, and self-reporting; e.g. lost coverage due to work requirement, need to do a review)

• Number of individuals applied and application status (submitted, approved, declined)

• Reason for denial and percentage of individuals declined for procedural, not ineligibility, reasons

• Number of individuals enrolled by Medicaid program

• Number of 6-month renewals completed (without a break in coverage vs. with a break in coverage)

• Number of one-on-one inquiries handled through counseling, eligibility screening or referred to other agencies

• Number of individuals educated and who can confirm they understand the

80-hour rule

• Number of partner agencies educated on new eligibility requirements

2. Safety Net Transition for Non-Citizens

Targeting: The Elimination of Federal Funding for Lawfully Residing Non-Citizens.

● Strategy 2.A: Federally Qualified Health Centers (FQHCs), Direct Primary Care, and Charity Care Bridge Program o Description: A dedicated initiative to seamlessly transition individuals losing Medicaid/CHIP onto sliding-fee scales at FQHCs and local charity clinics. Includes a public education campaign to combat decreased participation in public benefit programs in mixed-status families.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Create and disseminate educational resources through partner organizations, events, meetings and online.

o Cost: $30,000 o KPIs:

• Number of resources distributed, number of referrals made to FQHC, Direct

Care or Charity Care

• Number of educational events held to address transitioning individuals no longer eligible for Medicaid

• Number of one-on-one inquiries referred to other agencies

3. Feedback Loop & Continuous Improvement

Targeting: Emerging roadblocks, systems challenges, and operational agility.

● Strategy 3.A: Bureaucratic/Systems Monitoring o Description: As the boots on the ground, Take Care Utah staff are in the best position to collect real-time data and patient stories. This involves actively documenting exactly how work requirements and 6-month churn are impacting families and system capacity.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Informed strategy discussions with state partners.

o Cost: $50,000 o KPIs:

• Number of feedback items transmitted to DHHS/DWS

• Summary of outcomes of feedback items

● Strategy 3.B: Continuous Improvement o Description: Establishing a formalized, bi-weekly "Rapid Cycle Review" committee between Take Care Utah leadership and DHHS operational staff. This ensures that the qualitative and quantitative data gathered by Take Care Utah staff is immediately utilized to update outreach scripts, fix state portal bugs, and pivot resources to the interventions showing the highest success rates.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Resolved issues affecting segments of beneficiaries.

o Cost: $25,000 o KPIs:

• Number of calls held

• How many feedback items transmitted to DHHS/DWS

• Summary of outcomes of feedback items

● Strategy 3.C: Quarterly Impact Audits o Description: Conducting 90-day reviews of all implemented strategies to monitor progress, identify barriers, and measure key performance indicators (KPIs) such as successful redetermination rates and exemption approvals, ensuring interventions remain effective as the policy landscape matures. Additional KPIs may be added based on mutual written agreement between DHHS and UHPP which may be provided by email.

o Timeline: July 15, 2026 through July 14, 2027. Work may continue beyond July 14, 2027 at the written request and approval of DHHS.

o Expected Outcomes: Provide progress, barrier, and KPI reports to DHHS to allow for adjustments to strategies and tactics.

o Cost: $15,000 o KPIs:

• Quarterly produced report that combines all project KPIs with written analysis of accomplishments, challenges and suggested modifications to project work.

4. Project Outcomes

1. Expected Outcomes: UHPP shall:

● maintain continuity of coverage by preventing procedural disenrollment related to the 6-month renewal cycles and Community Engagement (CE)/Work requirement reporting;

● increase literacy regarding 80-hour monthly work requirements; and

● build a self-sustaining community support network.

2. Outcome Measures include: UHPP shall measure:

● the percentage rate of members who lose coverage due to “paperwork reasons” rather than actual ineligibility;

● the number of members educated who can confirm they understand the

80 – hour rule of their specific eligibility group; and

● the number of community partners trained.

3. Outcome Reporting: UHPP shall submit a report on the outcomes listed above to

DHHS.

5. Miscellaneous

1. Modifications to activities and funding: Dollars may be shifted between activities, and activities may be revised or added within the original budget of this proposal, with written permission from DHHS.