Working With Your City or Public Health Departments to Get People Covered
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Transcript of Working With Your City or Public Health Departments to Get People Covered
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Working with Your Public Health Departments to Get People Covered
Jennifer Roniger, MPH, Enroll America Malcolm Williams, Ph.D., RAND
Daphne Pie, Seattle & King County Public Health Department Maria De La Cruz, Houston Department of Health and Human Services
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Daphne Pie, Manager-Public Health-Seattle & King County-Access & Outreach | 06.05.15
Enroll King County! What Did We Do & How Did We Do It?
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Who Are We? King County, Washington State
State-based exchange—Wahealthplanfind.org Expanded Medicaid—Apple Health
1.8 million people; 39 cities Public Health-Seattle & King County:
10th largest health department Lead In-Person Assister Organization for King County region
14% Uninsured Rate before the Affordable Care act
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
2%
26%
0% 5% 10% 15% 20% 25% 30%
Mercer Isle/Pt Cities
Bear Creek/Carnation/Duvall
Vashon Island
Sammamish
Issaquah
Newcastle/Four Creeks
Snoqualmie/North Bend/Skykomish
Shoreline
Kirkland
Redmond
Covington/Maple Valley
Kenmore/LFP
Bellevue
Seattle
Bothell/Woodinville
Renton/Fairwood
Black Diamond/Enumclaw/SE County
East Federal Way
Kent
Burien
Auburn
Federal Way
North Highline
SeaTac/Tukwila
Des Moines/Normandy Park
Lack of health insurance by Health Reporting Area, age 18 to 64, King County, 2007-2011 average Source: BRFSS, produced by PHSKC, APDE, 9/2012
13X difference
Lack of Health Insurance Common
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Snap Shot of the Uninsured in King County
Deeper Dive of the Uninsured
26% American
Indian/Alaskan Native
44% Hispanic
Uninsured Adults by Race/Ethnicity
15% Asian
19%
Pacific Islanders
King County, Washington
State
25% Black
16% White
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Overview of Enrollment Efforts
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How Did We Roll Out Our Strategies?
Slide and Content Source: Hutchinson, “Three Innovative Strategies: King County’s Quest to Cover the Uninsured”
Solicit active support from
local leaders and create
opportunities for them to lead
“Top down approach”
Defer detailed decision-making
to grassroots organizations
“Allow your community
experts to drive the work—cover
the gaps”
Frame enrollment in terms that will resonate with the
community
“We don’t use terms that are foreign to our communities”
Invite participation
from organizations
outside of health-care
“In our network we had various
types of agencies”
Utilize existing partnership
networks and bring all
organizations to the table—especially
smaller ones “DSHS, Health Care Authority, City of Seattle,
various networks”
Convene a regular forum to
address technical issues and share
solution
“First Friday Forum”
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Helping Our Community Partners
GOAL: Always achieve system-wide changes that improve access to health care among the most vulnerable people by encouraging community
stakeholders to participate in this effort.
We asked our partners to help us with following for HCR implementation: 1. Analysis (Outreach, enrollment process, training issues) 2. Identify (Problems, gaps, barriers) 3. Educate (Help us educated the community—King wide blitz) 4. Advocate (For change with DSHS, Exchange & Health Care Authority)
How Did We Help Our Community Partners Through System Building?
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Assure Access to King County Residents
We collaborate with our community partners to design outreach strategies! Ø Reviewed data of the uninsured in 39
cities. Determined current outreach partners & looked at the gap areas to determine if we could get non-traditional help
Ø Focused on race/ethnicity/special populations and provided outreach assistance at 34 of the 39 cities.
Ø Manages the In-Person Assister network which has 310 certified navigators and over 40 partners.
Ø Developed outreach strategies specific to community colleges, technical colleges, universities and the Promotora programs.
Ø Designed a separate outreach model for large housing complexes.
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Outreach
1. Allow community partners to determine how and where they do their outreach.
2. Provide outreach in “gap” areas with little or limited outreach.
3. 50+ outreach locations in rural and underserved communities.
4. When outreach isn’t possible in an area, determine how to assure access:
a) develop Promotora programs b) outreach at libraries c) community fairs including Apple Health insurance providers d) Community blogs & working with local government
Provide services to the most vulnerable 5. Translate materials into various
languages (Somali, Arabic, French, Burmese, Samoan, Purepecha)
6. Maintain an outreach calendar and coordinated outreach in King County.
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Four enhanced users, allows us to clear our
network partners system errors
Work with the Exchange on unresolved tickets and provide more support and
training
Outreach at the United Way Tax Preparation sites to educate clients about
the tax penalty and enroll
Fewer outreach events Enhanced outreach in the rural area’s of King County
Update our events/enrollment calendar
Distribute materials in 8 additional languages: Purepecha, Japanese,
Arabic, Punjabi, French, Tigrigna, Burmese &
Swahili
Reviewing the data to determine whose left for
enrollment
Open Enrollment 2 Objective: What Did We Do?
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Did King County Achieve Their Goals?
47,706 44,431 43,594
52,754
10/31/2014 11/30/2014 1/31/2015 3/6/2015 10/31/2014 11/30/2014 1/31/2015 3/10/2015
Everyone else New adults
125,
373
130,
625
123,
714
139,
398
304,561 307,403
During Open Enrollment 1 & 2 the In-Person Assister Network enrolled 134,028 people into health insurance. Overall it’s estimated that King County reduced the uninsured rate to about 9%.
Qualified Health Plans Apple Health
Apple Health
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Enrollment-Based Estimates of Uninsurance by Age
4.3%
16%
14% 12%
3.6%
9% 8%
7%
Age 0-17 Age 18-64 Age 18+ All ages
2013 March 31, 2014 Notes: 1. 2013 uninsurance estimates from US Census Bureau, American Community Survey, 2013. 2. March 2014 uninsurance estimates based on number of uninsured individuals who enrolled in insurance between October 1, 2013 and March 31,
2014 and population estimates from American Community Survey, 2012. 3. For age 0-17 enrollments, proportion of enrollees assumed to be previously uninsured set equal to the ratio of the 2012 King County child
uninsurance rate to the non-elderly adult insurance rate, which is 30% (ACS, 2012). 4. Uninsurance rates for ages 18+ and all ages incorporate number of Medicare enrollments and number of uninsured adults age 65+ in 2012, and
assume no change between 2012 and March 31, 2014.
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
What’s Happening for the 3rd Open Enrolment Period?
Formulate strategies with our partners with a target on Qualified Health Plan Enrollments
Target outreach to zip codes that appear to have high numbers of uninsured
July = Roll out new outreach for small minority owned businesses
Planning another large summer enrollment event in one of the highest uninsured areas in King County.
Incorporating the new Orca LIFT transportation program
*Still waiting for race/ethnicity data
Although we did a good job in network, we have much work to do!
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Data Source: Enrollments – Health Care Authority; Adults age 18-64 with income less than 138% of Federal Poverty Level – American Community Survey 2008-2012
ZIP Code Number not enrolled
98002 2,313 98003 2,636 98004 1,164 98007 1,308 98011 1,251 98023 1,782 98030 2,396 98032 1,838 98052 1,658 98102 1,176 98115 1,568 98118 2,137 98119 1,901 98121 2,123 98122 2,594 98125 1,841 98133 1,581 98146 1,333 98168 1,301 98198 2,331 TOTAL 36,232
Top 20 ZIPs with the largest estimated number of income-eligible adults not enrolled in Apple
Health
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ZIP Code Number not enrolled
98002 8,593 98003 11,222 98023 10,004 98030 8,013 98031 9,668 98032 8,296 98034 7,298 98042 7,451 98052 7,303 98056 7,972 98058 8,215 98092 8,090 98103 10,858 98115 7,327 98118 8,533 98122 7,570 98125 8,165 98133 10,884 98168 9,515 98198 8,625 TOTAL 173,602
Top 20 ZIPs with the largest estimated
number of QHP tax credit-eligible adults not enrolled in Qualified Health Plans
Data Source: Enrollments – Health Benefit Exchange; Adults age 18-64 with income between 138 and 399% of Federal Poverty Level – American Community Survey 2009-2013
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
QUESTIONS?
© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org
Daphne Pie Manager [email protected] 206-263-8369
www.kingcounty.gov/health/access 1-800-756-5437
Callista Kennedy (206) 263-‐8368 Callista.kennedy@kingcounty Outreach Specialist
Carmen Olvera (206) 296-‐3948 [email protected] Outreach Specialist-‐Spanish
BreF Downey (206) 263-‐8373 [email protected] Outreach Specialist-‐Spanish
Luis Salazar (206) 263-‐8261 [email protected] Outreach Specialist-‐Spanish
Penny Lara (206) 263-‐8372 [email protected] Project Manager/Health Care Reform
Miguel Urquiza (206) 296-‐9875 [email protected] EducaXon Consultant I
Cindy Mai (206) 296-‐3949 [email protected] Outreach Specialist-‐Vietnamese
Javier Amaya (206) 263-‐8311 [email protected] EducaXon Consultant Ii
Willie Allen (253) 874-‐642 [email protected] Educator Consultant II/Program Supervisor
Bishaw Gezie (206) 296-‐3943 [email protected] Outreach Specialist-‐Amharic
How to Connect
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How to Connect
Enrollgulfcoast.com
Maria De La Cruz [email protected]
Rosy Mota