Enhancing Health Care Access through Improved Outreach, Enrollment, Retention and Utilization Polici

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Enhancing Health Care Access through Improved
Outreach, Enrollment, Retention and Utilization
Policies and Systems

• Caroline Rivas, Policy Director
• Expansion Quality of Healthcare Coverage
• Community Health Councils, Inc.

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About Community Health Councils, Inc.

• Established in 1992
• Non-profit, community based health promotion,
  advocacy, and policy organization.
• Our mission is to improve health and increase
  access to quality healthcare for uninsured,
  economically-disadvantaged and underserved
  populations.
• Project areas Access Quality of Healthcare,
  Expansion Quality of Healthcare Coverage,
  Community Health Education.
• 3731 Stocker Street, Suite 201 ? Los Angeles, CA
  90008
• 323.295.9372 ? 323.295.9467 (fax) ?
  www.chc-inc.org

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Expansion Quality of Healthcare Coverage
Covering Kids Families

• California CKF Coalition
• Formed Coalition in 1998
• Represents over 80 organizations in 27 counties
• National CKF Network
• Formed Network in November 2006
• Represents 70 organizations in 30 states

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California CKF Coalition

• Improving Outreach, Enrollment, Retention and
  Utilization
• Background
• Policy Framework for Outreach, Enrollment,
  Retention and Utilization (OERU) for Health Care
  Coverage in California
• provides a blueprint for the state and counties
  to define and structure outreach, enrollment,
  retention and utilization policies, systems and
  strategies
• identifies effective strategies and examples
  Childrens Health Initiatives (CHIs) have
  utilized at the local level to support program
  integration and coordination among all health
  coverage programs.

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Defining the Policy FrameworkTen Components for
OERU Policies, Systems and Strategies
Strategic and collaborative partnerships
Strategic financing
Knowledgeable and competent workforce
Broad provider base
Full complement of OERU services
OERU Policies, Systems and Strategies
Broad community access and promotion of available
programs and services
Easy and transparent application and renewal
process
Communicating with and serving diverse
populations, including cultural and linguistic
competency
Access to technology and information systems
Assessing and evaluating OERU services
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Operationalizing the OERU Policy Framework

• Effective OERU Strategies at the Local Level
• Institutionalize and embrace the identified
  Standard Operating Practices
• Engage in further study, initiate dialogue and
  improve on the identified Promising Practices
• Address systemic issues to eliminate the need for
  Workaround strategies.

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Effective Strategies at the Local Level

• Full Complement of OERU Services
• Maintain communications with families to ensure
  enrollment, utilization and retention of
  services.
• Establish basic standards for follow-up with
  families at key points in time.
• Communicate with and Serve Divers Populations and
  Demonstrate Cultural and Linguistic Competency
• Utilize trusted community partnerships within
  communities to increase capacity to provide
  culturally and linguistically appropriate
  services to families.
• San Mateo CHI partnered with a CBO to meet the
  needs of the Filipino and Asian American
  communities in the county.

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Resources

• To View Report
• www.chc-inc.org
• www.calendow.org
• For more information, contact
• Caroline Rivas, Policy Director
• Phone [phone]
• Email caroline_at_chc-inc.org
• Community Health Councils, Inc.

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National CKF Network The Childrens Trust
FLORIDA

• Created in 2002 by voter referendumin
  Miami-Dade County
• One of 8 special taxing districts in Floridato
  improve childrens services
• Strategic plan includes a robust health
  initiative (HealthConnect)
• The Childrens Trust
• Diana Ragbeer, Director, Public Policy and
  Communications
• www.thechildrenstrust.org

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The Uninsured in Floridaand Miami-Dade County

• Miami-Dade County has the highest rate of the
  uninsured in Florida (28.7)
• This rate is particularly high among minority
  populations - uninsured rate for Hispanics (32)
  and for Blacks (23)
• Approximately 500,000 uninsured children in the
  State of Florida qualify for existing subsidized
  health insurance programs
• Over 100,000 of these uninsured children are in
  Miami-Dade County

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HealthConnect

• A comprehensive, quality-driven health initiative
  created by The Childrens Trust to
• Unify the fragmented health services of our
  community
• Improve access and use of quality health services
• Improve health awareness
• Has 3 components In the Early Years, In our
  Schools and In Our Community

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HealthConnect in Our Community

• Strategically places HealthConnect outreach
  coordinators and health navigators throughout
  neighborhoods in Miami-Dade County to help
  children and families navigate the complicated
  route to quality health care and services.
• Goal is to increase access to primary care
  physicians and other health services regardless
  of race, ethnicity or income.
• Health navigators receive referrals from
  community health workers, health providers and
  in-school health teams to ensure that every child
  has access to health services.
• Health navigators help enroll families in
  subsidized health and private health programs.

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State Enrollment

• In early 2004 Floridas SCHIP Program Florida
  KidCare was at a high of 336,000 children due in
  large to a robust outreach initiative.
• Later, during the 2004 Legislative Session the
  Legislature passed a very harmful bill (SB 2000)
  that prohibited state-funded outreach.
• By 2006, enrollment had plummeted to an all-time
  low of 111,000 children.
• After successful advocacy/lobbying efforts, the
  state agreed to restore the outreach program.
• 1 million to be distributed through a series of
  small grants to community organizations.

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State Efforts to Restore Outreach

• The Florida Healthy Kids Corporation (FHKC)
  released a two-phase call for grant proposals
• Back to School (July 1-Sept. 30, 2007)
• Hit the Mark campaign more comprehensive
  marketing and outreach plans for remainder of
  year
• Elicited support of all 67 school districts to
  distribute applications to school-aged children
• Elicited support of voluntary pre-k providers
  that served over 113,00 children last year

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Executive Branch Efforts

• Governor Charlie Crist led a high profile
  outreach effort
• Made personal community appearances
• Shrink wrap state vehicles with Florida KidCare
  logos
• Challenged the responsible state agencies (AHCA,
  DOH, DCF) to commit to boosting enrollment
• Engagement with targeted community partners DCF
  established relationships with 2,700
  community-based partners and enlisted assistance
  in info. dissemination within respective
  communities
• Chief Financial Officer (CFO) Alex Sink created
  an Administrative Simplification Task Force which
  also had a potent outreach component

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State Plan Efforts

• CFOs efforts resulted in engagement of FHKC
  health plans in outreach to renewing families
  which developed strategies
• Adding renewal date field to HK enrollment files
• Reminder letters timed to beginning of renewal
  period
• Personalized phone calls to promote renewal
  awareness and offer assistance as needed
• Follow-up letter close to coverage expiration
  date
• Inclusion of renewal information in periodic
  member newsletter
• On-hold messages related to timely renewals
  response
• Automated outbound messages

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The Good News Winning Through Sound Outreach
Efforts

• Enrollment growing (now at 232,000 SCHIP 1.4
  million for Medicaid)
• National and State advocacy efforts
• Coordination and planning through participation
  in the Florida Covering Kids and Families
  statewide coalition and local partners (HSC,
  Haitian Neighborhood Center, PHT)
• HealthConnect in Our Community
• Public Awareness and Community Outreach
• KidCare outreach materials in pediatricians
  offices,
• Dissemination of materials to employers Chamber
  of Commerces, including the Hispanic Chamber of
  Commerce
• Faith-based initiative in Haitian, African
  American and Hispanic communities
• Mobile Van (HealthConnect on Wheels) visits
  neighborhoods/events
• Participation at health fairs, provider expos,
  major family events
• Public Awareness Campaign 211 media buys
  (English, Spanish and Haitian Creole)
• Street/teen marketing materials in 3 languages