Community-Based Programs Help NYC Children Get Health Coverage

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Two pilot programs have succeeded in enrolling uninsured children in New York City in Medicaid and Child Health Plus (CHP), according to new studies commissioned by The Commonwealth Fund. Nearly 710,000 children are uninsured in New York State, but approximately three-quarters of them are eligible for these public insurance programs. The pilots reach out to parents of low-income children, help them overcome enrollment barriers, and have so far signed up nearly one thousand youths. Implemented on a larger scale, evidence suggests they could significantly reduce the number of uninsured children across the state. "The results of these pilot programs are encouraging because they demonstrate how bringing some creativity to the table enables people to overcome obstacles that might prevent them from getting health insurance for themselves or their children," said Karen Davis, president of The Commonwealth Fund. "These kinds of programs should be emulated and expanded if we hope to make inroads toward eliminating the problem of children not getting the health care they need." A report by the Medical and Health Research Association of New York City (MHRA) evaluates efforts to assist low income families in Brooklyn who were applying for or receiving nutritional services at sites operated under the Women, Infants, and Children (WIC) program. Parents were assisted with filling out applications, gathering necessary documents, and filing applications. During the seven-plus months of the MHRA project, 472 children enrolled in CHP and 262 children and adults signed up for Medicaid. Awareness of CHP among WIC parents increased from 46 percent to 65 percent at the MHRA enrollment-assistance sites, compared with an eight-point increase (52% to 60%) at comparison sites in Queens where no assistance was provided. Actual CHP enrollment at the Brooklyn sites increased from 12 to 16 percent compared with an increase from 8 to 10 percent at the Queens sites. Medicaid enrollment at the Brooklyn sites also increased slightly, while it declined elsewhere. A second study by the Children's Defense Fund–New York describes how student volunteers were placed in organizations serving northern Manhattan to enroll uninsured children. The strategy used in this pilot program represents a major change from past practices in that it shifts a crucial part of the application process—the family visit—from the Medicaid office to an accessible location within the community. The Student Health OUTreach Project (SHOUT) sponsored by CDF–NY successfully enrolled 175 children and adults in Washington Heights who initiated the application process, with a 97 percent acceptance rate for completed applications. "Enrolling in Medicaid or Child Health Plus can be a daunting process for low-income families. Facilitating community-based enrollment and providing culturally sensitive one-on-one assistance can make a difference in whether or not children get the health insurance coverage they are eligible for," said David Sandman, program officer at The Commonwealth Fund. "With new programs like Family Health Plus on the way, these innovative strategies can turn eligibility for insurance into actual coverage and potential into reality."

Publication Details

Publication Date: March 21, 2000

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