Sue Rohan
Director
Office of Intergovernmental Affairs
Centers for Medicare and Medicaid Services
Ladies and gentlemen, good afternoon. My name is Charlie Brown and I've heard all of the jokes and that is my real name; that is what is on my birth certificate, Charlie Brown; not Charles Brown, not Chuck, but Charlie Brown and I've heard it all. When I was in college the song was very popular, "Fe, fe, fi, fi, fo, fo fum". When I pledged I had to sing that song over and over again. When I taught in public schools in Gary, Indiana, all the kids would sneak to call my name. I tell you, you should never distrust the wisdom of mothers because that name was worth a million bucks when I ran for public office. So I accept the fact that I am Charlie Brown and I tell all the kids that come to the State Capitol that I have a dog named Snoopy. If anyone knows where I can buy a stuffed snoopy dog, please let me know because I've been lying to all these children, because I do not have a dog, so I said at least I should try to get a stuffed animal, a snoopy dog, so I can at least have some truth in the comments I made to them.
This afternoon's segment is divided; this segment is divided in three parts. We have speakers that are going to impart some valuable information to us. The first is Miss Sue Rohan who is the Deputy Director for Public Affairs Office and the person that all of us as legislators would have to call if we had some issues about SCHIP and she's also the Director of the Office of Intergovernmental and Tribal Affairs. Without further adieu, Miss Rohan.
Thank you. It's a pleasure to be here. I was a legislator in Wisconsin for about 8 years and on city council before that and so it's nice to be back amongst the elected officials and NCSL was one of my favorite organizations back then. I appreciate their invitation to come and tell you a little bit about the work that we do.
I'm just going to give you a very brief overview of what our Intergovernmental Affairs office does and how we might be of assistance to you. Our mission basically is to be a liaison between all of CMS and elected officials, other officials in state and local government; this includes the 6 territories. I don't know if there's anyone here from the territories, but we work with them as well. We primarily deal with elected officials, representatives, senators, governors; we also deal with state health officials, Medicaid directors, insurance commissioners, so it's a variety of folks. Also with the American Indian and Native Alaska tribes and the Indian Health Services and many of the states represented here today interact with the tribes as well, so we're intimately involved with them.
We deal with intergovernmental associations such as NCSL and NGA, a variety of those; along with advocate groups that represent our beneficiaries and then designated individuals which, we don't necessarily deal with just any public citizen, we have another part of the organization that deals with beneficiaries. But anyone who is designated as a representative for your state we work with them.
We also serve as liaison in our office with the Administrator, Tom Scully; we meet with him on a daily basis to keep in touch on issues. We have the centers within CMS which are the Centers for Medicaid and State Operations; the Center for Medicare Management and then the Center for Beneficiary Choices. So we work closely with them. There are several other components within CMS; the quality area as well that we deal with, survey and certification.
And then around the country there are 10 regions that are composed of the various states and we deal directly with the regional offices as well. Within those regions they have representation for Medicare, Medicaid, SCHIP and so forth. Then those regions are divided into four consortiums; we deal with them as well.
We also interface with the Secretary's office, the Department of Health and Human Services; their Intergovernmental Affairs office which covers the entire department and we have a representative here from that office, B.J. Harris, who used to work for us and then just a couple of weeks ago went up to the Secretary's office officially and so many of you may have met him and he's a good liaison for us as well.
There are other agencies within the department that we work with, family and children, NIH, CDC and so forth and then there are other federal agencies and departments that we interface with; agriculture, transportation, education, departments of that sort. So when there are issues that cross boundaries, we try to work closely with them on your behalf.
Another aspect of what we do is to manage the communications for the department and this is again somewhat of a liaison process in that we work with different parts of the agency to bring together the information that's needed to be portrayed or conveyed to you as well as people on The Hill. We have an Office of Legislation that deals with congressional delegation, but we jointly put together a communication strategy and within that context a lot of the communication is letting the states and local governments know what it is that's happening within CMS. So for example when regulations, waivers and letters to the state Medicaid directors go out, we are responsible for making sure that the appropriate parties get notified and we coordinate that strategy as to how that might occur. So sometimes it might be that we'll simply send out a copy of a press release, sometimes we'll offer a briefing and the briefing is over at the Hall of States where NCSL is located so that they can participate in that. We offer the briefing to a variety of organizations and then they will take responsibility for communicating directly with you so that there's a coordinated effort and you know who the communication is coming from.
If at any time there's a request for a meeting with, for example Mr. Scully, or with our Medicaid director, Dennis Smith, or if it's a Medicare issue, we'll also coordinate those requests. So you can contact us directly and we can either set up a meeting with them or get in the appropriate people to talk about those specific issues that you're interested in. We also e-mail things and FAX things out to try to keep everyone informed. I'd like to give you a few examples of some of the things. This is just from this last week. We've met with a delegation from the State of Washington. They came into D.C. and they were concerned about Medicare costs and feeling that they were, well they are one of the lower reimbursed states per capita on Medicare. I attended a summit out in Wisconsin; again on Medicare reimbursement. They're another one of the states that is feeling disadvantaged in their reimbursement rates.
We had a large delegation from New Mexico come in, about 25 or 30 people from the business community, chambers of commerce, school districts, etc. concerned primarily about Medicaid. We met with them here; they also got into Medicare issues. Mr. Scully and I were out in Missouri a couple of weeks ago working on their Medicaid program and trying to get a more rational process in place for them so that we don't have to go back and take money away when things are not working smoothly. So that's going pretty smoothly in Missouri.
We've been working with Alabama. You may have seen some of the news about that that Alabama has some difficulties with their Medicaid program. We're trying to resolve that and we've been contacting folks; I've been on the phone with a number of people on that issue.
California, we're currently working on a joint press release on an initiative that involves Medicare and Medicaid fraud in that state. Texas, we have some border initiative work that's going on. Chicago, I'll be visiting the regional office next week. We had a group from Los Angeles come in to meet with Mr. Scully over at the White House yesterday and actually one of the reasons he had to leave here is he's meeting with a group to talk more in depth about their issues this afternoon.
I skipped over the Indian Health Services. We have a joint steering committee between CMS and Indian Health Services. In that context we try to resolve a number of issues that pertain to them. We meet with them on a quarterly basis but there are a lot of other activities that go on between that group as well.
Then we work with the various associations that you see listed here; NCSL, NGA, CSGL, and the others, the Public Human Services Association, the State Medicaid Directors, the State and Territorial Health Officials, Insurance Commissioners, Units on Aging, the mayors, county and city health officials.
So that gives you just sort of a smattering of some of the groups that we work with and I think our primary concern, because our part of the organization is not dealing with delegations on The Hill, but we do directly deal with people in the states and so our primary interest is really in legislators and to some extent governors as well. So we're very interested in hearing from you and if there's anything that we can help you with, some of these questions that Mr. Scully was addressing, those are exactly the sorts of things that you can give our office a call. I've got contact information on here for you. You can give us a call and we would be happy to either answer the question if we have the answer at hand or find out the answer and get you in touch with the right people. It's a large organization and it can be difficult to navigate and figure out who might best be able to respond to your question but that's our job to do so that you don't have to feel overwhelmed by who should I go to and am I getting the right answer and so forth. We will try to work that out for you and we would welcome any of your calls or questions.
I see one of my senior health specialists just came in, Linda Brown. She's one of the people that works with us in Intergovernmental Affairs and is most likely one of the people that you'd be in contact with as well to set up meetings and so forth. I'd be happy to answer any questions if there are; otherwise, that's it. Thank you.
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