Wednesday, 15 July 2009 Identification and Outreach Present: Jackie Berry (Healthy Mothers Healthy Babies), Natalie Cook (Olomana Marketing), Karen Gardner (Scott Gardner & Associates), Angela Goodbody (Hawaii State Department of Health Child Wellness Program), Chris Jackson (Head Start State Collaboration Project), Noella Kong (Hawaii State Department of Health Adolescent Health Coordinator), Barbara Luksch (Hawaii Covering Kids), Rich Melendez (Aloha United Way 211), and Nina Smith (Outreach Services). Could Not Attend But Sent Information: Esme Nakamura (Kapiolani Medical Center for Women and Children) and Kathy Sthay (American Academy of Pediatrics Hawaii Chapter). Background The Department of Health and Human Services announced the first round of CHIPRA grants for children's health insurance outreach, enrollment, and retention. It will fund $40 million worth of grants. It is looking for innovative grant proposals ranging from grassroots efforts to reach eligible but uninsured children to technology-driven initiatives to modernize and streamline enrollment systems. Basic CHIPRA Grant Information * Funding for Two Years: 09/30/09-09/29/11 * Application Submitted: 07/31/09 * Funds cannot be used supplant existing state expenditures for Medicaid and CHIP outreach activities * Governor’s Letter: Supports outreach efforts to enroll more children * Med-QUEST Letter: (1) state funds available for proposed enrollment increase, (2) certify federal grant funds will not supplant existing state expenditures, and (3) agree to data sharing with grantee. * Support Letters from Hawaii Covering Kids Task Force members. * Looking for best practices that can be replicated and sharing about lessons learned. * Results driven outreach connected to actual enrollment and retention of children * Must provide sound data demonstrating the connection between proposed outreach efforts and enrollment and retention * Target Groups for Eligible Uninsured Children and Youths: teens, lawful permanent residents (have “green cards”), rural areas, racial and ethnic minorities, health disparity populations, populations with cultural and linguistic barriers to enrollment, and parents or guardians lack awareness about eligibility. 1. Welcome and Introductions Barbara welcomed the participants and thanked everyone for bringing their expertise to the meeting. It was explained Med-QUEST must decrease its budget by $42 million, however the Governor will not allow cuts in the children’s programs. 2. Previous Statewide Media Outreach Campaigns Copies of these reports were available for reference: * Kids Health Insurance Week: Our Successful Marketing and Media Outreach Campaign, December 2001. * Get Teens Covered by Health Insurance: A Campaign to Enroll Adolescents, December 2002. * March Madness 2007 Media Campaign, July 2007. * Immigrant Media Campaign: Phases 1, 2, and 3, December 2007. QUEST Is Best 2008 Media Outreach Campaign, December 2008. 3. Current Hawaii Covering Kids Simplification Activities Improving notices sent by Med-QUEST to applicants and recipients, reducing number of applications denied due to missing documents, and electronic application for outreach workers. We discussed the possibility of recipients reporting address and telephone number changes through Med-QUEST’s web site. It was noted approximately 5,200 Med-QUEST applications are downloaded monthly from www.coveringkids.com, including 2,500 regular forms (1100) and 2,700 children and pregnant women forms (1108). 4. Available Data * Hospital Emergency Room Visits: Insured and Uninsured * Newborns: Insured and Uninsured * Hawaii Covering Kids Web Site Visits, Pages Viewed, and Downloads * AUW 211: Quarterly (Monthly If Necessary) by caller demographics (gender, age, calling for self/family/friend/client), how heard about children’s health insurance, referrals to agencies, and applications mailed by zip codes). * School Lunch Enrollment by School * Med-QUEST Enrollment: Monthly by Program, Age Group, and Gender * Med-QUEST Enrollment: Annually in July by Census Tract, Program, Age Group, and Gender 5. Who Are the Uninsured Kids? Barbara posed this question to community health center, hospital outstationed eligibility workers, and task force members. Responses included: (1) parents laid-off or furloughed, (2) parents uninsured so cannot add children to dependent coverage, (3) families don’t inform Med-QUEST about address and telephone number changes, (4) hanai Micronesian children and parents are not in the United States to apply for a social security number, (5) newly arrived lawful permanent residents, (6) graduated from mainland college and moving family back to Hawaii, (7) problem home without a responsible adult, (8) transitioning from foster care to home, and (9) parents mistakenly believe assets such as a home or car make their children ineligible. The hospitals and community health centers also recently helped these children who are uninsured but ineligible for Med-QUEST’s programs: (1) undocumented immigrants (mostly Latinos) and (2) visitors from Japan and Canada. 6. Possible Media, Outreach, and Simplification Activities In addition to ongoing outreach activities at natural points of contact (schools, child care centers, pediatricians, WIC, Head Start, community health centers, immunizations, Native Hawaiian Health Care Systems, etc.), our two-year plan could include: a) Mailout Campaign. Colorful 8.5” x 5.5” postcards mailed to each home. Target Groups: Parents who lack awareness about children’s health insurance eligibility, especially those who have been laid-off or furloughed. Message could target teens, younger children, and pregnant women. b) Radio Campaign. Target Groups: Immigrants and Pacific Migrants c) Movie Theatre Advertising. d) Grocery Store Giveaways. Buy promotional recyclable bags and distribute. e) Pharmacy Outreach. Last campaign was September 2004-February 2005 with 129,000 half-page flyers (bag stuffers) distributed by 151 pharmacies on six islands. f) Print Information on State Pay Checks. g) Shopping Mall Advertising. h) Distribute Flyers and Hang Bus Posters: libraries, satellite city halls, Department of Motor Vehicle locations, consulate offices, churches, and temples. i) Create a simple eligibility calculator available through Hawaii Covering Kids web site. j) Data map Med-QUEST’s census tract enrollment and Hawaii State Department of Education’s school lunch enrollment. k) Sponsor a community form featuring Louisiana’s Medicaid eligibility specialist to highlight simplification best practices to enroll and retain eligible children and youths. This event will promote positive reinforcement and help create an environment of positive rewards for helping Med-QUEST’s customers. l) Organize a major statewide media outreach campaign similar to Kids Health Insurance Week in 2001. Involve federal, state, and community partners to create a children’s health insurance frenzy on all islands. Follow-Up After the Meeting a) Barbara spoke to Roxanne Spark at the Foodbank and Hawaii Covering Kids will participate in their 10/26/09 networking conference. b) Rich sent Barbara a list of 626 church and temples, including headquarters that could be primary contacts. c) Barbara talked with Rich’s contact at Salvation Army, Daniel Decastro, and emailed him a flyer for posting at their locations. d) Barbara contacted Scott Ching at National Cinemedia. He suggested movie theatre advertising during the December holiday season and will send an updated pricing list for nonprofit organizations. e) Barbara spoke with Matt Okahata, Hawaii Primary Care Association IT Coordinator, about data mapping Med-QUEST’s census tract enrollment and Hawaii State Department of Education’s school lunch enrollment. f) Barbara emailed Kupuna Connections to participate in one of its Olelo Television segments to educate grandparents raising grandchildren. g) Hawaii State Department of Health Immunization Branch contacted Barbara and will meet in mid-August to coordinate outreach activities. h) Barbara spoke with Garance Gorman, outstationed eligibility worker at Waikiki Health Center, about its Longs Drugs and UHA campaign to raise funds for uninsured kids who need physicals and immunizations. Most children and youths need school or sports physicals immediately (Med-QUEST application not yet completed or approved) and others are ineligible for QUEST/QExA.