Job creation
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The following is a project description which stresses the job development aspects and benefits.

Medicaid is one of the largest public funding streams in most communities, but it has never been tapped for its job-creation potential in the low-income community. Medicaid Managed Care presents an opportunity to create meaningful jobs which provide valuable work experience and an entry point into the huge health care job market. The rapid implementation of managed care has produced major negative side effects. The proposed project can remedy these side effects, improve health care and save public funds – while at the same time creating as many as 5,000 jobs for welfare recipients in Texas. This outreach network can also support both enrollment outreach for new children’s coverage plans (CHIP/THKC) and managed care plan/provider selection (enrollment brokering)

Project Description

FHF has proposed a two-year project to demonstrate leading-edge methods in peer coaching/mentoring under Medicaid managed care. This project will show how Medicaid recipients can be recruited and trained to provide family-centered coaching and support in the basics of accessing health services. This initiative can also significantly improve the performance of the Medicaid system, reducing net costs long-term. The jobs developed can be sustained long term as a Medicaid carve-out contract. The basic model can be extended to Medicare and commercial HMOs as well. A minimum demonstration would involve 15-25 outreach workers serving about 5-10,000 Medicaid eligibles. Full scale operation in Bexar County alone would generate 250-300 full time jobs.

Methods: Locally-recruited, neighborhood-based peer outreach personnel ("Community Resource Advisors") make periodic home visits to educate families on how to access services under managed care; schedule, reconfirm and follow up on appointments; help families learn to solve problems which create barriers to care; reinforce value of preventive care. Based on over 30 years of experience with "community health advisors" or promotores, high success rates can be achieved by careful recruitment, closely supervised OJT and ongoing nurturing and support. A work-team model encourages peer support and development of responsible work behaviors.

	Demonstrate success of neighborhood-based peer educator jobs as entry point to employment in health care
	Improve access to primary care, use of "medical home" and appropriate use of services by Medicaid eligibles and uninsured family members
	Increase Medicaid/CHIP enrollment among eligible children and overall stability of enrollment
	Increase use of preventive procedures under Medicaid, especially for young children
	Increase stability/predictability of Medicaid expenditures; reduce acute care expenditures (long term)
	Reduce rate of missed appointments; improve patient compliance (especially with medications)
	Reduce inappropriate emergency room (ER) workload and costs of inappropriate service seeking behavior among both Medicaid and uninsured population