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CHIP
2000 Program Abstract
Project Director: E. Roberta Ryder, CEO
Contact Person: Sylvia Partida, Chief Operations Officer
Coordinator Grantee: National Center for Farmworker
Health
Address: 1770 FM 967, Buda TX 78610
Phone Number: 512-312-2700, ext. 213
Fax Number: 512-312-2600
E-mail address: )
World Wide Web Address: www.ncfh.org
Project Period: 4 years; May 1, 1999 through
April 30, 2003
Problem
Farmworkers are a mobile high risk, high need and hard to
reach working poor population thought to have the worst overall
health status in the nation. Although eligible to participate
in safety net programs, including Medicaid and the Child Health
Insurance Program, farmworkers under utilize these programs.
The low rate of farmworker participation is due to health
systems problems in the regulation and administration of child
health insurance programs that make it difficult for farmworkers
to obtain or retain access to benefits.
State regulatory policies often contribute to the problem
by failing to accommodate the special access needs of farmworkers
in their planning processes. Farmworkers could benefit greatly
from the outreach and enrollment effort currently surrounding
the State Children's Health Insurance Program (SCHIP). However,
special efforts to remove access barriers are required at
the national, state and community levels if the enrollment
efforts are to be successful in allowing farmworker participation
in both the SCHIP and Medicaid programs.
Goals
and Objectives
The overall goal of this initiative is to facilitate enrollment
and successful participation of eligible farmworkers in the
Medicaid program and SCHIP.
Objective 1. Promote awareness of child
health insurance issues via dissemination of existing resources
to facilitate enrollment, as well as development by NCFH of
resources appropriate for use with farmworkers, among direct
service providers who work with farmworkers nationwide.
Objective 2. Provide Child Health Insurance
referral information to farmworkers via the Call For Health
toll free line, the National Migrant Education Hotline and
the Farmworker News.
Objective 3. Develop a National Profile
of State Child Health Insurance Implementation Plans, as applied
to farmworker enrollment in order to a) identify technical
assistance needs of service providers, b) conduct an analysis
for policy purposes, and c) refine the data base for referral
of farmworkers calling for toll free assistance from Call
For Health and the National Migrant Education Hotline.
Objective 4. Develop and implement a communication
plan with selected states to establish dialogue with appropriate
state regulatory agencies in order to facilitate removal of
barriers to farmworker participation in child health insurance.
Methodologies
NCFH is a national non-profit organization dedicated to improving
the health status of farmworker families. NCFH provides technical
assistance and information services to the nation's migrant
and community health centers, as well as other organizations
that work on behalf of farmworkers. NCFH develops and disseminates
educational materials and programs designed for farmworkers
and service providers. NCFH will utilize its many programs,
resources and contacts to promote farmworker participation
in child health insurance.
Objective 1 - 1. Develop a train the trainer
Power Point presentation (to be updated based on policy changes)
on child health insurance issues, enrollment and resources
for use with farmworker service providers and peer educators.
2. Develop and distribute 2 bilingual factsheets
regarding child health insurance enrollment for farmworkers,
one for farmworkers and one for providers.
3. Develop conference presentations and workshops
incorporating new information pertinent to farmworker barriers,
policy changes, and program outcomes.
4. Incorporate child health insurance information
into conference planning activities for the three Farmworker
Stream Forums through presentations, round table discussions
and/or informational exhibits.
5. Coordinate presentation focused on the Texas
portability and California reciprocity models at conferences/meetings
of sister organizations and collaborators.
6. Publish and disseminate two articles in the
Migrant Health Newsline.
7. Collect SCHIP/Medicaid related case studies
through the Call for Health program for use with the Texas
portability and California reciprocity projects.
Objective 2. Provide Child Health Insurance
referral information to farmworkers via the Call For Health
toll free line, the National Migrant Education Hotline and
the Farmworker News.
1. Provide SCHIP/Medicaid information, eligibility
screening, referrals, and information regarding the Medicaid
appeal process through the Call for Health program.
2. Measure collaborative activities, and monitor
relationship between NCFH and ESCORT.
3. Include a notice in each issue of the Farmworker
News (6), and one article per year, providing SCHIP enrollment
and referral information.
4. Increase the number of organizations and State
Health Department programs participating in the Call for Health
Network.
5. Expand the Call for Health Network, targeting
providers in states selected to participate in the Texas portability
pilot.
Objective 3. Develop a National Profile
of State Child Health Insurance Implementation Plans, as applied
to farmworker enrollment in order to a) identify technical
assistance needs of service providers, b) conduct an analysis
for policy purposes, and c) refine the data base for referral
of farmworkers calling for toll free assistance from Call
For Health and the National Migrant Education Hotline.
1. Provide technical assistance, and disseminate
information to states and providers participating in the Texas
portability pilot and California reciprocity model so that
farmworkers in those states can effectively participate in
these efforts. Technical assistance includes: a) identification
of technical assistance needs of service providers, b) analysis
of the portability pilot and reciprocity model for policy
purposes, and c) refinement of data base for referral of farmworkers
calling for toll free assistance from Call for Health.
2.Write a paper documenting the portability and
reciprocity approaches used by Texas and California respectively,
including recommendations for organizations and states interested
in making SCHIP and Medicaid access to possible for farmworkers
through systems changes.
3. Develop a concept paper for establishing a
provider network to support the Texas portability pilot.
Objective 4. Develop and implement a communication
plan with selected states to establish dialogue with appropriate
state regulatory agencies in order to facilitate removal of
barriers to farmworker participation in child health insurance.
1. Establish, monitor and moderate a SCHIP/Medicaid
e-group. The e-group focus will be on interstate communication
regarding the Texas portability pilot and the California reciprocity
model.
2. Foster and establish relationships with organizations
such as the National Governors Association, the National Council
of State Legislatures, and the National Association of Community
Health Centers to heighten policy maker awareness of farmworker
participation barriers and solutions.
3. Support the Texas portability pilot and California
reciprocity model by providing logistical and financial support
to host a meeting (one each in Year 4) with PCA/PCO and State
Medicaid officials from the states participating in their
respective efforts.
4. Serve as a liaison between Texas and Michigan
coalitions as Michigan is integrated into the Texas portability
model.
A partner in this initiative will be the Eastern Stream Center
on Resources and Training (ESCORT). ESCORT is a national organization
that provides technical assistance and training to Migrant
Education Agencies. ESCORT also administers the National Migrant
Education Hotline. ESCORT will conduct workshops and trainings
of Migrant Education personnel to encourage them to facilitate
farmworker enrollment in children's health insurance. ESCORT
will also promote distribution of the resource tools among
migrant education personnel. The National Migrant Education
Hotline staff will also use the Start Health Stay Healthy
eligibility assessment tool to offer initial eligibility screening
and referral for farmworker callers.
Coordination
Activities will be coordinated with ESCORT, and with the
135 Migrant Health Center Grantees, as well as the more than
200 organizations across the country that actively participate
in the Call For Health program. In addition, coordination
with the National Association of Community Health Centers,
the Texas Association of Community Health Centers, the California
Primary Care Association, and the Michigan Primary Care Association
is conducted to ensure that national and state levels work
in cooperation of efforts geared at policy and systems changes
at national and state levels.
Evaluation
In addition to a process and quantitative evaluation, the
project will serve the valuable qualitative function of establishing
a national health systems baseline in regard to farmworker
access to participation in Medicaid and CHIP. An evaluation
consultant versed in public health administration and state
and federal policy will assist in the drafting of the baseline
report in Year 2, as well as the final impact analysis of
the education and advocacy efforts conducted with states through
Year 4.
Experience
to date
During the third project year, the NCFH project:
1. Actively participated in the Texas Migrant
Care Network Coalition; the Michigan Coalition on Migrant
Health to secure that farmworker access to SCHIP and Medicaid
is noted as a high state priority; and we have worked in collaboration
with the California Primary Care Association to promote a
three state SCHIP and Medicaid reciprocity model.
2. Provided technical assistance to Texas Association
of Community Health Centers which resulted in the effective
passing of Texas House Bill 1537, to establish a SCHIP/Medicaid
Portability Pilot for farmworkers migrating from Texas.
3.Worked in collaboration with the National Association
of Community Health Centers in preparation on Federal legislation
regarding farmworker access to SCHIP and Medicaid.
4. Provided farmworkers, and health center staff,
with information regarding enrollment, eligibility and the
appeal process for SCHIP and Medicaid through our Call For
Health toll free line.
5. Conducted and coordinated conference presentations
regarding the Texas portability, Michigan Migrant Health Plan,
and California reciprocity projects.
Keywords
Access to Health Care, Advocacy, Bilingual Services, Case
Management, Data Analysis, Data Collection, Farm Workers,
Hispanics, Migrants, Minority Groups, Public Policy
Annotation
Farmworkers are a high need population impeded from access
to participation in child health insurance by logistic and
policy barriers. This project is designed to provide immediate
technical assistance and referral services to farmworkers
and to service providers who work with farmworkers in order
to facilitate farmworker enrollment. The program is also designed
to document and evaluate state policy regarding farmworker
access to child health insurance.
For more information, contact Sylvia Partida (
).
This is a NCFH project with support from US Department of Health and Human Services (HRSA) Maternal and Child Health Bureau (MCHB).
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