Outreach & Enrollment

1. Outreach & Enrollment Effective Strategies Leticia Cazares, MPH Director of Outreach San Ysidro Health Center

2. SYHC PATIENT DEMOGRAPHICS • South (near U.S./Mexico border) and Southeast San Diego • 85,731 patients (9 primary clinic sites) • 76% Latino • 90% below 200% Federal Poverty Level • 82% better served in a language other than English • 50% under age of 24 • 53% Uninsured (2013)

3. SYHC O/E PROGRAM • Funded by Covered CA and HRSA • 6 Certified Educators • 18 Certified Enrollment Counselors (Eligibility Specialists) • 13 clinic-based • 4 community-based* • 3 Retention Counselors *Will hire additional 4 counselors in October 2014 – stationed at storefronts and partner sites

4. KEY LESSONS LEARNED • Training and technical support must be customized to meet the needs and literacy levels of the O/E staff. State training and support is not enough! • O/E implementation requires everyone in the organization to be engaged, educated on basics, understand their role, updated on changes to be successful and sustainable. • O/E materials must be culturally-appropriate and tailored to address myths, priorities and literacy needs of the target population. • Health literacy is very low, requiring longer appointments. More educational opportunities are needed outside of the individual face-to-face enrollment appointment. • An efficient data collection process/system is critical

5. EFFECTIVE O/E STRATEGIES • Train/educate all possible “messengers” • Customize training for Enrollment Counselors • Tailor outreach materials and talking points for messengers (relevant, clear and simple!) • Find more ways to inform and educate instead of just flyers! • Develop a Pre-Screening & Enrollment Protocol to improve productivity, quality and customer service • Partner with just about anyone!

6. ACTIVITIES • Cross-train front-line staff and providers to do pre-screening and referral using simple method and key messages • Conduct effective 101 presentations to teachers, counselors, business associations, library staff etc. to serve as messengers • Modify existing or create new job aids and tools for counselors to ensure they are prepared (i.e., immigration or taxes) • Provide on-going training for staff using various learning methods including role-play, videos and best practice sharing

7. ACTIVITIES (continued) • Reduce burden on counselors to educate by doing more group education at career centers, community colleges; show videos to captive audiences (waiting rooms) • Distribute easy pre-screening forms that list key eligibility criteria, required info and documentation needed for application • Host “one-stop shop” enrollment events with partners

8. ENROLLMENT EVENTS

9. PRESS CONFERENCES

10. PREPARING FOR NEXT OPEN ENROLLMENT • Focus groups/surveys with recently and remaining uninsured • Focus on “retention” strategies (i.e. tickler system to remind patients with upcoming renewals) • Prepare enrollment counselors with job aids in key areas such as immigration and taxes • Offer more educational opportunities around Health Insurance 101 • Develop stronger partnerships with media

11. RESOURCES • California Endowment (Asegurate campaign) • Insure the Uninsured Project • National Immigration Law Center • California Immigrant Policy Center • ACLU • Latino Coalition for a Health California • Kaiser Family Foundation • Enroll America • National Council of La Raza

12. CONTACT acainfo@syhc.org