Californias Express Enrollment Program

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Californias Express Enrollment Program

• Lessons and Next Steps
• September 2006

The Childrens Partnership/ The 100 Campaign
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Express Enrollment Why Now?

• Three year pilot/evaluation complete
• Lessons learned/best practices revealed
• Incorporating those lessons now
• Taking those lessons to the next stage

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Express Lane Eligibility and Express Enrollment

• ELE Using Other Public Programs Application and
  Enrollment Processes to Enroll in Public Health
  Coverage Programs
• EE the term given to ELE program that expedites
  Medi-Cal (MC) enrollment for uninsured children
  who receive free school meals enacted by AB 59
  (Cedillo) in 2001 and SB 1196 (Cedillo) in 2004

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Piloting Express Enrollment

• Began July 2003 5 pilot school districts (70
  schools) LA, Fresno, San Diego, Redwood City
  (San Mateo) and Alum Rock (Santa Clara)
• 10 districts implemented by 2005-06 school year
• Deliberately small
• Evaluation by USC focused on data from 7 school
  districts

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Express Enrollment How it Works

• School Lunch Application modified to include
  information required to make initial MC
  eligibility determination and to request consent
• Applications with consent and FREE school
  lunch-eligible are processed for EE
• Schools make presumptive MC certification and
  sends applications to county
• Schools send families a letter informing them of
  status

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Express Enrollment How it Works

• Counties provide temporary coverage within 5
  working days
• County sends all families one page form
• County makes final eligibility determination
• Childrens applications where income is too high
  are forwarded to Healthy Families (HFP)
• Childrens whose applications appear to make them
  eligible for a local Healthy Kids program are
  forwarded to Healthy Kids

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Express Enrollment Results

• Express Enrollment was successful in reaching and
  connecting uninsured children to temporary
  coverage
• Challenges to the process and linking children to
  ongoing coverage
• The Numbers
• 11,500 children applied for EE over 3 years
• 7,000 processed by counties
• Of these, 44 already enrolled in MC or HFP
• 68 of the rest received temp. coverage
• 40 of children that received temp. coverage
  received ongoing coverage

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Express Enrollment Results

• School districts like the program
• Families like the process
• Children accessing needed care during temporary
  coverage period
• Clinical, dental, pharmacy, lab/x-ray and
  specialty care

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Express Enrollment Lessons Learned

• What Worked
• School Lunch Program is a fruitful gateway to
  health insurance and enrolling children in
  Medi-Cal
• If EE were applied statewide, it could reach up
  to 500,000 uninsured children
• Reached hard to reach children
• Helped families
• Temporary coverage until determination
• Because the SL application is a MC application
• Self declaration of income
• County/School Relationships

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Express Enrollment Lessons Learned

• What would make Express Enrollment and other
  Gateways work better to enroll uninsured children
  into immediate and continued health coverage?
• Technology to screen for insured children
• Information collected in one step
• Inclusion of Healthy Families and county programs
• Financing
• Federal flexibility

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Express Enrollment Next Steps

• School districts can implement now
• Moving toward a statewide unified enrollment
  system--Building on the best policies of EE and
  harnessing available/new technology to truly
  streamline health insurance enrollment for all
  children through gateways such as SL, CHDP, and
  WIC
• Proposition 86
• SB 437
• Center for HealthCare Access/SB 1948
• Moving federal policy

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Express EnrollmentMore Information

• Express Lane Eligibility Web Site
• http//www.expresslaneinfo.org
• 100 Percent Campaign
• http//www.100percentcampaign.org