HHS AWARDS $40 MILLION IN GRANTS TO SIGN UP CHILDREN FOR HEALTH COVERAGE
SECRETARIES SEBELIUS AND DUNCAN ENCOURAGE GOVERNORS TO SUPPORT BACK-TO-SCHOOL ENROLLMENT
WASHINGTON, D.C. – The U.S. Department of Health and Human Services (HHS) today announced $40 million in grants for efforts to identify and enroll children eligible for Medicaid and the Children’s Health Insurance Program (CHIP). Grants were awarded to 39 state agencies, community health centers, school-based organizations and non-profit groups in 23 states. The two-year grants are authorized under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009.
“Today’s grants will help us identify and enroll children in Medicaid and the Children’s Health Insurance Program, ensuring that more children have the health care they need,” said HHS Secretary Kathleen Sebelius. “Keeping Americans healthy from a young age is the right thing to do, and it saves money by avoiding preventable diseases and conditions as they get older. The activities we are funding will help eligible children get covered, stay healthy and prepare them to succeed in school.” The grants will build on the Secretary’s Connecting Kids to Coverage Challenge to find and enroll all eligible children and support outreach strategies that have been shown to be successful. Grants were made in five focus areas:
1) Using technology to facilitate enrollment and renewal (approximately $20 million to ten grantees)
2) Retaining eligible children in coverage (approximately $3 million to four grantees);
3) Engaging schools in outreach, enrollment and renewal activities (approximately $5 million to seven grantees)
4) Reaching children who are most likely to experience gaps in coverage (approximately $10 million to fourteen grantees)
5) Ensuring eligible teens are enrolled and stay covered (approximately $3 million to four grantees).
Grant amounts range from $200,000 to $2.5 million with the largest grants going to the technology focus area. For a list of grantees, please visit: http://www.insurekidsnow.gov/professionals/reports/chipra/CHIPRA-Cycle-II-Grant-Summaries.pdf
“We are making great progress enrolling eligible children in Medicaid and CHIP and the grants released today help keep these important efforts moving forward. They are a part of our commitment to help all eligible children get the health coverage they need,” said Cindy Mann, CMS deputy administrator and director of the Center for Medicaid, CHIP and Survey & Certification.
A new study just released by the Urban Institute and the Robert Wood Johnson Foundation found that, despite an increase in eligible children between 2008 and 2009, the total number of eligible but uninsured children declined from 4.7 million in 2008 to 4.3 million in 2009, in part due to outreach and enrollment efforts.
Efforts to streamline Medicaid and CHIP enrollment and renewal practices, combined with robust outreach activities, have helped reduce the numbers of uninsured children. For example, Oregon, a previous CHIPRA outreach grantee, has cut its percentage of uninsured children in half, from 11.3 percent in 2009 to 5.6 percent in 2011. In the past two years, Oregon enrolled 94,000 eligible children in Medicaid and CHIP. In addition to its efforts in reducing paperwork for families and establishing a timely and cost-effective online application process, Oregon used its grant funding to provide direct one-on-one enrollment assistance to families and conduct vigorous outreach activities throughout the school system.
“We want to help others achieve what Oregon has accomplished and more,” said CMS Administrator Donald M. Berwick, M.D. “Simplifying enrollment and renewal systems and ensuring that signing up for health coverage is standard practice in schools and health centers are central to sustaining the progress we’ve made. The CHIPRA grants are designed to support these efforts that will have lasting effects.”
Today’s CHIPRA outreach grant announcement follows the August 12, 2011 release of a joint letterfrom HHS Secretary Kathleen Sebelius and Education Secretary Arne Duncan to the nation’s governors urging them to encourage schools to “undertake children’s health coverage outreach and enrollment activities when classes begin this fall.” The letter suggests promising strategies such as enlisting school athletic coaches to help promote enrollment. HHS is supporting such efforts by providing a strategy guide to states, schools, community groups, and other stakeholders as part of the “Get Covered, Get in the Game”initiative the agency conducted in 2010 with CHIPRA funding.
CHIPRA, together with the Affordable Care Act, allocates a total of $140 million for enrollment and renewal outreach, including $112 million in grants to states, community groups and health care providers, $14 million specifically for organizations serving American Indians and Alaska Natives (AI/AN), and $14 million reserved for national enrollment campaign activities. The first $40 million in grants, as well as $10 million in AI/AN grants, were awarded in 2009 and 2010, respectively.
Summary of Cycle II CHIPRA Grant Awards
Focus Area 1: Using Technology to Facilitate Enrollment and Renewal (10 grants)
CA ($1,259,565) Fresno Healthy Communities Access Partners represents 41 health center sites in five Central California counties. Using a web-based application, called One-e-App, the grantee will facilitate enrollment and renewal in Medicaid and CHIP. Trained multilingual, multicultural Certified Application Assistors will conduct community outreach to promote health coverage enrollment and link children to health services through a medical home.
FL ($754,200) Sacred Heart Health Systems Inc. will promote program awareness and enrollment and retention of children in Medicaid and CHIP in six northwest Florida counties, Escambia, Santa Rosa, Okaloosa, Walton, Gulf and Franklin. In collaboration with community coalitions, school districts, employer/business organizations, social service agencies, churches and health care providers, the grantee will identify potentially eligible children and will use the internet, social media, mobile technology and incentives to help families apply for and maintain coverage, as well as obtain needed health services for their children.
GA ($2,500,000) Georgia Department of Community Health will use a combination of technology solutions to simplify, streamline and better coordinate enrollment and renewal for Medicaid and PeachCare for Kids, Georgia’s CHIP program. The grantee will introduce a pre-populated Medicaid renewal form and redesigned notices; enhance electronic datamatching capacity to verify citizenship; provide portable scanners and laptop computers to facilitate off-site enrollment and verification; implement an on-line renewal module and develop an electronic referral from Medicaid to PeachCare for Kids so children do not lose coverage when their family circumstances change.
ME ($1,819,633) State of Maine Department of Health and Human Services will build upon the web portal created with its Cycle I CHIPRA outreach grant. Enhancements to be implemented under the Cycle II grant include systems to permit families to update eligibility information and other data on line; to receive notices electronically; to communicate online with their eligibility worker in a secure environment; and to allow them to submit premium payments online.
NY ($2,476,500) Hudson River Healthcare Inc. will improve and expand the use of online applications for health coverage in a 17-county region in New York State. As a result, the grantee expects to boost the number of applications and renewals successfully completed and reduce errors and delays in processing. The grant also will be used to increase the number of individuals trained to assist families with the application process.
NM ($2,484,430) New Mexico Human Services Department will modernize the State’s application, enrollment and renewal process using web-based technology to reduce paperwork, speed processing and increase overall efficiency. The grantee also will focus on improving the State’s Presumptive Eligibility/Medicaid On-Site Application Assistance process.
ND ($1,690,867) North Dakota Department of Human Services will adapt the “e-Find” system so that multiple databases for wage, unemployment insurance, child support enforcement, Social Security data and other information can be electronically checked for the purpose of determining eligibility and renewing coverage for Medicaid and CHIP. E-find can be used from any location with internet access and can help standardize decision-making across all county and State offices. As a result, the State expects to see a decrease in the number of individuals that lose medical coverage at renewal, a decrease in the amount of time spent following up with families on verification issues and less reliance on paper verification.
SC ($2,336,959) South Carolina State Office of Rural Health, working with The Benefit Bank of South Carolina (TBB-SC), will connect the existing TBB-SC technology to the South Carolina Department of Health and Human Services eligibility determination system. The grantee also will introduce the use of hand-held tablets with camera capability to capture applications and supporting paperwork electronically and then submit applications electronically. Using these tools, the grantee will expand its recruitment strategies to include work with fast food restaurants, faith based sites and schools.
SD ($1,704,789) South Dakota Department of Social Services will develop a web-based application that will enable families to enroll and renew coverage at home or using public computers. The grantee also will install kiosks at Indian Health Service (IHS) facilities and other sites on reservations, in consultation with stakeholders in Native American communities, to increase access to the web-based application. Application assistors will provide families with direct help with enrollment and renewal at schools and IHS facilities.
WA ($2,402,449) Washington Department of Social and Health Services will use technology to simplify the enrollment and renewal process. The grantee will implement a system that automatically enrolls newborns of mothers on Medicaid; attaches verification documents to online applications and renewals; and auto-populates online renewal forms. Through this project, the grantee expects to reduce the percentage of eligible children who lose coverage at renewal and reduce the rate of “churning,”( the rate at which eligible children whose coverage is terminated return to the program within a short period of time.)
Focus Area 2 – Focusing on Retention (4 grants)
CA ($850,000) Alameda Health Consortiumwill work with eight Federally Qualified Health Centers (FQHCs), as well as school-based clinics, to improve the retention of Medicaid and CHIP benefits for children in Berkeley, Oakland, Haywood and Freemont, California. The grantee will use a variety of methods to alert families about the need to renew their coverage and to provide renewal assistance. Materials and assistance will be available in five languages --English, Spanish, Chinese, Vietnamese and Cambodian – reflecting the diversity of the community.
MI ($814,801) Michigan Primary Care Association will use a technology-driven model to deliver renewal assistance to families with children enrolled in Medicaid and CHIP who are served through nine community health centers in eight Michigan cities. Working with data from the State data warehouse, health centers will use text messaging and voice message broadcasting to remind families coming up for renewal. They will assist them with the renewal process online and over the telephone.
NV ($547,442) Access to HealthCare, Inc. will focus on providing bilingual (English and Spanish) enrollment and renewal assistance. The grantee will develop and produce English- and Spanish-language informational materials, PSAs, and videos that will be used in its outreach efforts and will enhance its existing Website. The grant will also fund training to expand the network of individuals able to assist families in applying for Medicaid and Nevada Checkup (CHIP) coverage. Application and renewal assistance will be made available through the existing toll-free Help Line and with the use of Skype capability to help families in rural Nevada communities.
NY ($1,000,000) Community Service Society of New York will use grant funds to hire additional “facilitated enrollers” to provide direct enrollment assistance to families and will designate 8 to 10 as “retention specialists.” Efforts will be focused on African American and Hispanic families, which have the lowest retention rates. Outreach methods such as the use of customized reminder postcards in five languages, emails, text messaging and direct person-to-person contact will be used. The State’s internet-based tracking system for community-based facilitated enrollers will be used to monitor and advance the performance of retention specialists.
Focus Area 3 – Engaging Schools in outreach, enrollment and renewal activities (7 grants)
Multi-State ($1,000,000) American Association of School Administrators, working in collaboration with the Children’s Defense Fund, will conduct outreach in four states — California, Georgia, Louisiana and Mississippi. Eight school districts, all of which have strong support from high-level school administrators, have been selected for the project. The goal will be to build the capacity of the selected school districts to incorporate children’s health outreach and enrollment activities into routine school operations. Various strategies will be used to target eligible children and help them enroll in health coverage, including adding questions about insurance status to school enrollment documents and providing training on Medicaid and CHIP enrollment procedures.
CO ($729,348) Colorado Association for School Based Health Care will reach out through school-based health centers to children in nine school districts who are eligible for public health insurance programs but are not enrolled. Data from free and reduced-price school meal programs and school registration forms will be used to help identify eligible children and assist their families with Medicaid/CHIP applications. Outreach activities will be coordinated with efforts to provide oral hygiene education, fluoride varnish and dental sealants through school-based programs.
FL ($1,000,000) University of South Florida will engage school districts in outreach and enrollment activities. Rural school districts will receive special attention, as well as school districts with large populations of limited English proficient (LEP) students. A multi-media teen marketing campaign and curriculum will target uninsured adolescents in high schools. The grantee also will work with the Florida Association of Children’s Hospitals to increase the number of school professionals trained to identify and assist eligible families with applications.
CA ($982,170) Los Angeles Unified School District will expand the capacity for outreach and enrollment in health coverage in 13 wellness center school complexes. School and district data will be used to identify and target services to children who are eligible for health insurance but uninsured. District application assistors and health care advocates will alert families of eligible children to health coverage opportunities and help get eligible children enrolled, using the online application. One-e-App. Application assistors also will be linked to health care providers at the district wellness centers so eligible children can be enrolled in coverage when they seek care.
CA ($769,313) Mendocino County Office of Education heads a consortium of eight organizations that will collaborate to implement strategies to increase enrollment and retention of children in MediCal and Healthy Families (California’s Medicaid and CHIP programs). The project will focus attention on helping children stay covered when they move from primary to middle school and from middle school to high school. A toolkit of promising practices will be disseminated statewide through Teachers for Healthy Kids, California School Boards Association and the California Children’s Health Initiatives.
NY ($505,370) Mothers & Babies Prenatal Network of South Central New York will work with school districts in an eight-county region of south central New York to identify eligible children and provide assistance with enrollment and renewal in Medicaid and CHIP. A variety of school-focused outreach strategies will be used in an educational program for middle and high school students on the value of health coverage and health care.
OH ($360,000) Legal Aid Society of Cincinnati will work with two school districts and their respective county Departments of Job and Family Services agencies. Children likely to be eligible for health coverage will be identified using free and reduced-price school lunch data, school sports physical forms, emergency cards and health history updates. School nurses will help engage families and refer them to the grantee for application assistance. The grantee also will work with the Ohio Department of Education, the Ohio School Athletic Association, the Ohio Department of Job and Family Services and others to encourage use of successful strategies statewide.
Focus Area 4—Reaching Out to Groups Likely to Experience Gaps in Coverage (14 grants)
Multi-State ($1,000,000) Structured Employment Economic Development Corporation, SEEDCO, will reach out through a diverse range of faith-based and community partners to low- income and non-English speaking communities in four cities — Atlanta, Memphis, Baltimore and New York City— to enroll eligible uninsured children in Medicaid and CHIP. SEEDCO will customize its existing online tools and materials so they can be used for enrolling legal immigrant children whose families speak Korean, Vietnamese, and Spanish. The organization will also continue to support state efforts to streamline the application process.
AK ($700,510) Southcentral Foundation, an organization that oversees primary care and rural health clinics in south central Alaska, will reach out to Alaska Native and American Indian children and enroll them in Denali KidCare, the State’s children’s health coverage program. The multi-pronged effort will include outreach, enhanced training for employees and the use of social marketing strategies.
AZ ($1,000,000) Pima Community Access Program will work with fifteen partners in four counties (Pima, Santa Cruz, Pinal and Maricopa) to enroll and retain children in Medicaid using Health-e-Arizona, the online application. The grantee will engage schools with high percentages of children eligible for free school lunches and will focus on adolescents. The grantee intends to use Facebook and Twitter in English and Spanish to communicate with youth and their families. A total of 36 teens will be trained to conduct peer-to-peer outreach.
CA ($1,000,000) California Primary Care Association will strengthen outreach and enrollment in community clinics and health centers across California. The grantee will increase the number of Certified Application Assistors and will conduct training to build the capacity of outreach staff to reach uninsured Latinos. An earned media campaign will be implemented to connect families to enrollment and work will continue to ensure that individuals in the target population are connected to a health home.
CO ($541,330) Denver Indian Health Family Services Inc. is an urban Indian organization that serves the metro-Denver area. The grantee will identify Native American children who are eligible but not enrolled in Medicaid or CHIP and help get them enrolled. Outreach will be conducted at community events, and enrollment and renewal assistance will be provided during home visits. Case management strategies will be used to help families complete the process. The grantee will work with partners trusted by the community, and culturally sensitive materials will be developed and distributed.
GA ($1,000,000) West End Medical Centers, Inc., a Federally Qualified Health Center that has been providing primary health care services to the residents of southwest Atlanta for 35 years will focus on enrolling eligible African-American and Hispanic uninsured children in four counties—Fulton, DeKalb, Clayton and Cobb. The grant will enable English-speaking and bilingual staff to conduct a direct mail and telephone campaign, as well as use social media such as Facebook and Twitter, to assist families in enrolling and renewing their children’s coverage under Medicaid or PeachCare for Kids, Georgia’s CHIP program.
ID ($496,200) Mountain States Group, Inc. will reach out to Hispanic children and children living in rural Idaho. Working with the Idaho Primary Care Association, the Mountain States Group will engage five part-time Regional Children’s Coverage Coordinators to train and support clinics in an efforts to enroll uninsured children in coverage and assist families in renewing coverage.
IL ($341,490) Sinai Health System, working with the Mexican Consulate in Chicago and the Mid-West Asian Health Association, will organize outreach, communications, enrollment and monitoring efforts targeting Hispanic and Asian communities with high rates of eligible but unenrolled children in Chicago. Sinai and its partners will engage volunteers and outreach staff to help families in applying. They will also use a web-based information system to facilitate the registrations, track the success of various outreach efforts and identify areas for improvement.
OH ($200,000) Economic and Community Development Institute is a non-profit microenterprise development organization. ECDI will create an outreach and enrollment program to target children of low-income micro-entrepreneurs and their employees who are eligible for Healthy Start, Ohio’s Medicaid and CHIP Program. ECDI will reach out to 3,000 small businesses and build on existing partnerships with Central Ohio’s Hispanic, Somali, and Ethiopian communities. The project will perform initial eligibility assessments and provide one-on-one application assistance. A retention component will be included, as well.
OK ($388,190) Morton Comprehensive Health Center, Inc. is a Federally Qualified Health Center serving patients in the city of Tulsa, Oklahoma, and in Nowata County. Through this project the organization will reach out to populations of children with gaps in coverage and enroll them in SoonerCare (CHIP and Medicaid in Oklahoma). Outreach efforts will target schools, apartment complexes, day care programs, churches and community events to find families in need of screening services and health care coverage. When families come for vision, oral health, nutrition, behavioral health and other screenings they will be guided through the SoonerCare enrollment process by trained program Navigators.
PA ($875,814) Maternal and Child Health Consortium of Chester County will target the uninsured children of immigrants living in the Delaware Valley. The goal is to expand a successful outreach and enrollment model in Chester County to Philadelphia, Delaware and Montgomery counties through a partnership with the Maternity Care Coalition, comprised of 11 partner organizations across the 4-county area.
TX ($978,714) Texas Association of Community Health Centers, Inc. will lead a coalition, including Federally Qualified Health Centers and various partners, in conducting community-based outreach and enrollment activities targeting low-income Hispanic children, including the children of migrant and seasonal farm-workers. The activities will be concentrated in a four-county area in the Lower Rio Grande Valley along the US-Mexico border. Outreach staff, including experienced FQHC staff, promotoras and Americorps volunteers with existing relationships in the community will conduct outreach and provide application assistance at locations such as schools, public housing, WIC offices, migrant camps and migrant Head Start centers. The FQHCs participating in the project are pilot sites for the Texas Human Services Commission’s on-line enrollment program and the new system will be used with families they serve. This project will also help migrant children maintain their Medicaid and CHIP coverage while they are temporarily traveling out of state with their families.
TX ($898,954) Community Council of Greater Dallas will partner with the WIC offices managed by the City of Dallas and Outreach Health Services to form the North Texas CHIP and WIC Project. The grantee will assist eligible north Texas families, especially Latinos, in applying for and retaining Medicaid and CHIP coverage for their children. Six full-time application assistance workers will be placed in WIC offices to provide one-on-one enrollment assistance to families. Children on WIC and their siblings will gain coverage.
WA ($300,000) Neighborcare Health focuses on low-income Seattle area families. The grantee, which runs health clinics connected to medical and dental schools, will work with schools that serve children in the ethnically diverse communities in Seattle and King County where many families originate from Latin America, Somalia, Vietnam, Thailand, and Ethiopia. The project will screen children for potential eligibility and provide enrollment assistance at schools and other locations in the community.
Focus Area 5—Ensuring Eligible Teens Are Enrolled and Stay Covered (4 Grants)
IA ($681,773) Iowa Department of Public Health will implement targeted grassroots outreach by engaging uninsured teens and their families through creative activities that reflect the interests and needs of teenagers. The State will develop and disseminate outreach materials and offer in-person assistance applying for Medicaid and CHIP coverage. It will also conduct a teen media, marketing and text- messaging campaign and use a statewide outreach network to build the capacity of local coalitions, create teen advisory councils, and conduct an evaluation of the project’s effectiveness.
IL ($409,958) Beacon Therapeutic Schools targets teens in Cook County and in the Chicago suburbs with a focus on enrolling uninsured and homeless youth in Medicaid or CHIP. The proposal targets teens in a range of situations where they may be at risk, including teenagers who are doubling up with friends (known as “couch surfers”) and those living on the street and in shelters. The project will focus on identifying eligible teens at homeless shelters and drop-in centers, schools, community events, as well as in their homes. The goal is for this work to be adopted and expanded as a statewide initiative through the Illinois Department of Healthcare and Family Services.
TX ($1,000,000) Texas Leadership Center targets at-risk adolescents and their families in 17 high schools in five school districts in Hildago and Harris counties. The project will focus on youth leadership development and peer-to-peer connections as a way to improve the health of the communities. Strategies will include capturing data from a question about insurance coverage on school enrollment forms, assigning trained outreach staff to schools to conduct on-site enrollment, and referring teens and their families to medical homes.
WA ($596,464) HIP of Spokane County dba/Community-Minded Enterprises will approach the project with four goals: simplify enrollment, enhance retention, better integrate and coordinate services with partners, and employ digital communication strategies and enrollment tools. The grantee will send outreach workers across the state to develop and support networks of professionals and volunteers who interface with “disconnected” teens and with parents of “connected but uninsured teens.” The grantee will also create youth-oriented videos designed to promote peer-to-peer social marketing and will use a phone center to streamline the enrollment process, and remove barriers to coverage.One-on-one phone and internet support will be offered to teens, parents and youth-service professionals.