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In this one-day interactive session, grantee and contractor staff
will be trained to:
 Meet the payer of last
resort requirements of the CARE Act;
Adopt effective fiscal, scheduling,
referral, and other strategies to promote financial solvency;
Estimate cost of your services to assist in
negotiating contracts with CARE Act grantees and managed care plans;
Identify commercial insurers and
managed care organizations to expand TPR billing;
Implement effective eligibility determination
processes to ensure clients enroll in health insurance, income assistance,
housing, and other programs that best meet their needs;
Participate as providers in the new
Florida Medicaid managed care initiative and ensure your clients enroll in a
managed care plan that best meets their needs; and
Train others in your organizations
about these topics.
Target Audience: CARE Act funded program board
members, executive directors, chief financial officers, program directors, case
management supervisors, case managers, and client advocates. For Broward and
Duval Counties, we will explore topics related to the upcoming Florida Medicaid
HIV managed care initiative.
Training Dates: Broward County (for grantees and
contractors in Broward County only, June 7th), Duval County (for grantees and
contractors in Duval County only, June 26th), Miami/Dade County (June 29th),
Orlando (June 12th), Palm Beach County (June 5th), St. Petersburg (May 23rd)
Intensive Third Party Reimbursement (TPR)
Workshop
In this three-hour interactive workshop, grantee and contractor
staff will be trained on:
HAB’s payer
of last resort policies related to TPR;
Effectively
applying strategies billing and collection processes;
Establishing
health records and applying codes that adhere to federal and professional
standards;
Methods for
organizing a billing unit;
Using TPR
data for financial forecasting, performance measurement, and treatment and
utilization patterns among your clients; and
How to train
others in your organizations about these topics.
Target Audience: This is an introductory session
for CARE Act funded program chief financial officers and scheduling, billing,
and coding staff.
Training Dates: Ft. Lauderdale (for Broward and
Palm Beach County attendees, June 20th), Miami/Dade County (for other South
Florida attendees, June 30th), Orlando (June 14th), St. Petersburg, May 24th
Your Trainer
Julia Hidalgo, ScD, MSW, MPH serves as Chief
Executive Officer of Positive Outcomes, Inc. and Research Professor in Health
Policy at the George Washington University. She has worked for two decades in
HIV service planning, financing, research, and program evaluation at the local,
State, and national levels.
For ten years beginning in the mid-1980s, she was Chief of the
Maryland Center for AIDS Services, Planning, and Development where she
organized and sought funds for a statewide network of HIV care. Prior to
authorization of the CARE Act, she authored several successful demonstration
applications to HRSA to initiate funding of HIV care. She managed complex
statewide Titles II and IV, CDC, and HOPWA programs. During her tenure, she
worked with HIV clinicians, government officials, and persons with HIV, to plan
and finance the HIV care infrastructure. Those grants laid the foundation for
the HIV care system that exists now in Maryland. She served five-year and
six-year terms on the Baltimore and Washington, DC, Title I Planning Councils,
respectively. She also served on numerous consortia and HIV care planning
bodies and committees.
While working for the State of Maryland, Dr. Hidalgo also served
for over a decade as the lead HIV consultant to the Maryland Medical Assistance
Program. She advised Medicaid staff on numerous policy matters. She designed
the first statewide Medicaid AIDS capitated managed care program in the US. She
monitoring Medicaid payments related to AIDS and other HIV-related conditions.
She also advised Medicaid regarding the cost-benefit and likely fiscal impact
of various HIV drug and laboratory cost containment methods. A multi-year grant
from HCFA (now CMS) supported these activities.
Since 1997, Dr. Hidalgo has worked extensively as a consultant
and grantee for HAB and other funders on HIV financing projects. Dr. Hidalgo is
a nationally recognized expert in HIV services financing. In this role, she
advised the Florida Agency for Health Care Administration in setting HIV/AIDS
capitation rates for the new Florida Medicaid managed care initiative. She
served as a consultant for five years to the New York Medicaid Program and AIDS
Institute in developing the request for proposal, network design, quality
standards, evaluation plan, and capitation rate setting for New York State
Medicaid Special Needs Plans, managed care plans for HIV+ Medicaid
beneficiaries. She consulted with State Medicaid programs in California, DC,
Maryland, New York, North Carolina, and Maine in implementing managed care and
waiver demonstration programs. She has provided TA and assessments to over 40
HIV clinics and other programs to identify alternative approaches to ensure
solvency and maximize third party reimbursement. She has conducted extensive
local HIV care continuum assessments throughout the US to improve their
efficiency. She is a National Quality Center faculty member, where she is
assigned to coach the Florida Title II program.
At GWU, she was PI of the SPNS-funded Center for Integrated HIV
Care Networks, a four-year initiative to develop multi-agency HIV networks in
four locations in the U.S. She currently is PI of the SPNS-funded YES Center, a
five-year TA and evaluation center supporting eight demonstration grantees. She
also conducted several HAB-funded national studies of ADAP and Title I Pharmacy
Assistance Programs. At POI, she has conducted many projects sponsored by HAB
and other federal agencies, health insurers, clinical programs, and
foundations. She recently completed a nationwide study of the impact of the
state and local economic downturn on the ability of HIV grantees and providers
to adhere to HAB payer of last resort (PLR) policies. She also has conducted
numerous HAB-funded PLR, managed care readiness, and related financing training
and TA projects across the US. She prepared HAB website materials and provided
to staff support related to federal Veterans Administration benefits.
Dr. Hidalgo’s research findings were published in the New England
Journal of Medicine, Inquiry, Medical Care, JAIDS, American Journal of Public
Health, Journal of the National Medical Association, and Pediatric AIDS and HIV
Infection. She holds a Doctor of Science (ScD) in operations research
and health services research from Johns Hopkins University School of Public
Health and Hygiene, an MPH in health planning and policy from the UC Berkeley,
an MSW in research and evaluation from San Jose State University, and a BA
degree from the UC at Santa Cruz in community studies.
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