The New Mexico Human Services Department is receiving nearly $1 million for 2009 to 2011 to design and install standalone kiosks that consumers can use to electronically apply for CHIP and Medicaid at community centers and schools, rather than visiting enrollment offices. The state will train application assistors to help with the enrollment process, and will conduct outreach to raise awareness of the new opportunities to enroll, tailoring their strategies based on input from the communities where eligible children are most difficult to reach. The efforts are intended to increase enrollment among children in rural areas, particularly Native American and Hispanic children. The award is one of 69 CHIPRA grants for outreach in 41 states and the District of Columbia that were announced in September 2009.
New Mexico saw the CHIPRA grant funding as a unique opportunity to expand its outreach and enrollment efforts in an economically challenging time. "We do not have dedicated funding in our budget for outreach, and usually do projects from general administrative funds, so this was the first opportunity to make a significant investment. We thought it would help tremendously," said Bob Beardsley, deputy director of the Medical Assistance Division at the Human Services Department.
"Part of the purpose of the grant is to find innovative ways to identify eligible children who are underserved, and for us, making the system accessible for rural populations is a major issue," said Kathy Slater-Huff, marketing and outreach manager for the Human Services Department, who is managing the development and implementation of the electronic application kiosks.
The Department plans to install 12 kiosks, which will be operational by August 2010. The majority will be located on reservations in order to reach Native American children and families, for whom an application office may be prohibitively far away. On some reservations, the kiosks will be in chapter houses, which are community centers that provide vital services, including water and sometimes meals, tribal benefits, and other resources. Kiosks also will be installed near the state's border with Mexico, another area in which children are underrepresented in Medicaid and CHIP. In addition to increasing access to enrollment in remote rural areas, providing opportunities to enroll at a location that is not a government office may help reach eligible children whose parents are undocumented immigrants and therefore unlikely to visit an enrollment office. The state hopes that locating enrollment kiosks in schools or other community locations will encourage more families with eligible but uninsured children to use them.
The kiosks will be standalone units with a scanning station for documents and the ability to capture signatures, making the application or renewal process fully electronic. Applicants will be able to enter basic information to determine whether they are eligible, then complete an application that will go directly to the Department. Many likely sites do not have internet connectivity, so the kiosks will use USB broadband cards or satellite services. The kiosk software is being adapted to make it possible for consumers to initiate the process themselves, though the Department plans to train people who already work at community centers or other locations where kiosks will be available to assist applicants.
"The outreach specific to this grant relies heavily on community organizations to let us know what the best ways to reach people are. We'll be using radio and print marketing to get the word out, based on their guidance," said Slater-Huff. The grant activities will focus on implementing the kiosks and conducting targeted outreach to make them effective, with other efforts limited by the state's budget situation. "We are seeing very rapid enrollment growth in Medicaid and CHIP right now," said Beardsley, "we hope to be able to do more aggressive outreach when the economic climate improves." In addition to the outreach grant, New Mexico was one of nine states to receive bonus payments for streamlined enrollment and renewal processes (it uses six of the eight possible strategies), and was awarded about $5 million in bonus payments for 2009.
One challenge the state faces in strengthening CHIP—and soon in implementing health reform—is its 25-year-old electronic eligibility system, which it is working to replace in time to handle the new requirements of running a health insurance exchange and expanding the Medicaid program starting in 2014. As in other states, these needs come at a time when cost containment is an urgent priority, though no current cost-containment measures will affect children's coverage in New Mexico. The Department is hopeful that the extra support for Medicaid that was included in the stimulus package will be extended.
In addition to the Department's work, a separate grant was awarded to First Nations Community Health Source, an Indian health center for the homeless in Albuquerque. This federally qualified health center received $355,000 for outreach, with the goal of enrolling 2,300 uninsured children. Outreach and enrollment will take place at the center and in the community, targeting children who are racial and ethnic minorities, in both urban and rural communities, and the homeless.