Methods The purpose of this NYS initiative was to create an enrollment infrastructure among non-governmental agencies that already provided services to families or children at high risk of being uninsured. The local county health department chose to finance its initiative in two ways: a small grant, of a fee-per-child successfully enrolled in Medicaid or SCHIP. The proposal identified six target populations of children (adolescents, African-American, Hispanic, homeless, transient, rural) and four target populations of parents (TANF/Welfare to Work, employed at 250% FPL, single parents, recently unemployed). Key informant interviews were used to gain the perspective of community-based organizations participating as “facilitated enrollers” in a county health department administered initiative. Results Participants reported the planners underestimated the costs of enroling an uninsured child; therefore, the major CBO barrier to effective outreach and enrollment was inadequate funding, particularly the fee-per-child approach. Respondents also reported the time and cost per child of enrollment, the financial 'cut point' in the CBOs' decision to participate, number of children enrolled per grant, and special barriers for CBOs serving immigrants and adolescents.
Learning Objectives: To describe implementation issues that create barriers for community-based agencies to effectively enroll uninsured children and adolescents in Medicaid and SCHIP.
Keywords: Policy/Policy Development, Child/Adolescent
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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