Roles for Partner Organizations in a CHIP/Medicaid Enrollment Initiative
How Partners Fit In
There are many reasons why any community has so many kids potentially eligible for CHIP/Medicaid but not enrolled.
It’s not just a matter of awareness or providing information, although that’s an important first step.
There is no single organization with responsibility for increasing coverage for children, so we have to pull together.
The final goal is a child who gets access to a full range of services, including regular primary care, and who remains enrolled (gets recertified) on schedule as long as the family falls within income eligibility guidelines. Many families go on and off Medicaid because they simply don’t get recertified (although some legitimately rise above income cutoffs or otherwise change eligibility status).
"Partners" can play a role in any aspect of this process. The attached diagram shows how it can work, in five steps.
1. Awareness: Out of the target population (general families living below poverty, we need first to make families aware that CHIP or Medicaid may be available for their child. There’s a lot of misinformation out there. As families become aware, they move into the first (largest) circle.
2. Motivation: Even families who know about these programs may feel that their child "doesn’t need it," or "it’s too much of a hassle when my child is basically healthy." Other families may be fearful, or regard Medicaid as "welfare." Showing how even healthy kids can benefit by regular medical care, and/or relieving some of the hassle, we can move families into the second, smaller circle of those who are motivated to apply, or at least find out if it would be "worth it."
3. Overcoming barriers: Motivated families may still have problems understanding the process, finding ways to get to a TDHS office for an appointment, or preparing the proper documentation. We can help them move into the third circle, "taking action," by helping remove some of those barriers. Understanding the process, especially income guidelines and documentation requirements, may require help.
4. Completing the process: In Texas only a TDHS eligibility worker (a State employee) can determine whether a child is eligible for Medicaid. CHIP in Texas and elsewhere requires other steps (such as an initial premium payment) to complete enrollment. It is usually up to the applicant (typically a parent) to fill out the application. We can help them move into the fourth circle by helping the parent complete the form and assemble documentation. They still have to have their appointment (if required), but at least they can come with most of the paperwork already done, and hopefully avoid having to make a second follow-up appointment because of incomplete documentation.
5. Using and keeping benefits: this may be most challenging step. We know that many families do not fully understand the system once they’re in it. More can be done in this area, and we’re working toward a regular program of assistance to help Medicaid families become empowered consumers and full partners in their own health. We’re not ready for Step 5 yet, but we’re getting there!
Each organization or agency can create its own customized role.
Community organizations and service providers:
If you have regular contact with families (adults and/or children) in the target population, we ask that you find an activity or a series of activities that you can make a regular part of your business with these families.
You can receive training for your staff on how to play a role in Steps 1 thru 5, which they would do during normal service hours
and/or
you can make space available in your facility where others can work with families on CHIP/Medicaid issues (these may be your members or clients, or they may be other families in your neighborhood who are invited to come to your facility for this purpose).
Businesses, employers and non-provider volunteer groups
If you have a consumer-oriented business serving a neighborhood where potential Medicaid-eligible children live, you can
 | distribute information and display graphics promoting Medicaid benefits |
| host special events and/or regularly-scheduled presence of agency personnel or volunteers to assist families with screening and/or completing application’s |
If you are an employer with part-time workers or other employees who are not eligible for dependent health benefits, many of them may have children who could be receiving Medicaid benefits. You can
| distribute information and display graphics promoting Medicaid benefits |
| receive training for managers and HR staff on how to advise employees about Medicaid benefits for their children |
| provide space for visiting agency personnel who can coach or assist your employees considering Medicaid coverage |
You can receive training for your staff and/or volunteers to perform any of the activities below on a regular or one-time basis.
See the attached survey form as an example of a means of soliciting partner participation (this attachment is an Adobe Acrobat PDF file and requires Acrobat Reader to open it).