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Local Outreach Key to Enrolling Children in Public Health Insurance
Schools, Community Groups, Employers Increasingly Involved in Targeting Hard-to-Reach Children
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ASHINGTON, D.C.—Local outreach efforts led by health care providers, schools, employers and community and religious groups can play important roles in identifying children who are eligible for public health insurance but not enrolled, according to a study released today by the Center for Studying Health System Change (HSC).
While millions of children have gained coverage since Congress passed the State Childrens Health Insurance Program (SCHIP) in 1997, more than 2 million low-income children are likely eligible for SCHIP but not enrolled. Despite ambitious state mass-media campaigns to encourage SCHIP enrollment, studies have shown that lack of information, confusion about eligibility requirements and administrative hassles continue to pose significant barriers for families with children eligible for SCHIP.
Over the past two years, states increasingly have enlisted local organizations to mount outreach efforts to raise awareness about SCHIP and target hard-to-reach children, according to the HSC study, which was based on interviews with state and local leaders, consumer advocates, health care providers and others in 12 nationally representative communities. The findings are detailed in an HSC Issue Brief, Communities Play Key Role in Extending Public Health Insurance to Children.
"What we found is that local people know their communities best and can customize SCHIP outreach efforts to enroll eligible children in their communities," said Laurie Felland, M.S., an HSC health research analyst and lead author of the study. HSC is a nonpartisan policy research organization funded solely by The Robert Wood Johnson Foundation.
While health care organizations, including hospitals and health departments, traditionally have played important roles in identifying children who are eligible for public insurance, other organizations—schools, employers and community and religious groups—are increasingly helping children gain coverage.
In Indianapolis, state officials have provided funding to local churches to help their members apply for Hoosier Healthwise. Similarly, the United Methodist Church of New Jersey plans to identify leaders in 300 churches to raise awareness about SCHIP.
In Cleveland, the county health department contracted with a private firm to work with several hundred small businesses to help their workers apply for SCHIP. While local outreach efforts are generally considered successful, the downside is that intensive one-on-one outreach tends to be costly. The Cleveland employer project, for example, signed up 590 people for public insurance at an estimated cost of $157 for each enrollee.
Other communities specifically target racial and ethnic minorities by translating SCHIP enrollment information into native languages and hiring outreach workers of the same racial, ethnic or cultural background as target groups.
"Community outreach efforts can offer valuable experience to policy makers who want to remove barriers and increase childrens enrollment in public health insurance," said HSC President Paul B.Ginsburg, Ph.D.