Opinion Research and Strategic Plan for the Department of Health and Human Resources

1. Opinion Research and Strategic Plan for the Department of Health and Human Resources

2. Table of Contents Page Overview 3 Quantitative Methodology 5 Quantitative Findings 9 Focus Group Methodology 45 Focus Group Findings 48 Target Audience 60 Conclusions 70 Marketing Strategy 73

3. Overview • In March 2000, RMSR completed 523 telephone interviews with “participants or eligibles” • From December 1999 through February 2000, RMSR conducted 8 focus groups with participants, eligibles and workers • The results provide insights toward encouraging enrollment

4. Existing Situation • Since July 1998, the CHIP program has enrolled 8,806 children in Phase II and 1,206 children in Phase I • Some estimate there are 32,000 children without insurance • Goal to reach an enrollment figure of 11,000 by September 2000

5. Quantitative Methodology

6. Quantitative Methodology • Conducted March 6 - April 4, 2000 • 523 completed interviews • + 4.3% margin of error at the 95% confidence level. • Average length: 17.5 minutes • Screened Out: Households without age 18 and younger, and households in which no one has been or is enrolled in a federal or state insurance program for 2 years. • Sample - Households in WV earning less than $25,000 annually.

7. Sampling Criteria Households With Children 6 Through 18 years Potential CHIP Eligible Medicaid Eligible CHIP Eligible 100% FPL 150% FPL 200% FPL Family of Four: $16,700 $25,050 $33,400 FPL Guidelines FPL = Federal Poverty Level

8. Sampling Criteria Households With Children Birth Through 5 years Potential CHIP Eligible Medicaid Eligible CHIP Eligible 133% FPL 150% FPL 200% FPL Family of Four: $22,210 $25,050 $33,400 FPL Guidelines FPL = Federal Poverty Level

9. Quantitative Findings

10. WV Household Statistics Households with Persons Age 18 or Younger Without Health Insurance Households with Persons Age 18 or Younger 22% Yes 32% Yes 68% No 77% No 1% Dk/Na [N=923] [N=2859]

11. Program Participation [N=425] Medicaid [N=218] TANF [N=62] SLMB [N=52] QMB [N=50] 29% participated in more than one federal or state program in the past two years CHIP [N=43]

12. Classification of Respondents 19% Eligibles N=98 81% Participants N=425 [N=523]

13. Awareness of Programs Medicaid 13% 32% 29% 25% 1% CHIP 47% 24% 17% 2% 10% TANF 22% 54% 9% 13% 3% SLMB 17% 69% 2% 7% 4% QMB 9% 78% 3% 5% 4%

14. Rating the Programs QMB (N=45) 18% 47% 18% 7% 11% Medicaid (N=319) 17% 46% 12% 22% 3% CHIP (N=142) 18% 18% 38% 8% 18% SLMB (N=51) 16% 39% 29% 6% 10% TANF (N=113) 13% 22% 40% 8% 17%

15. Program Satisfaction 88% of CHIP participants are satisfied or better CHIP QMB Medicaid TANF SLMB

16. Program Aspects (Aggregate) [N=406] Completing the Application Process 11% 14% 75% Number of Health Care Providers 14% 17% 69% Level of Benefits Provided by the Programs 11% 18% 71% Information provided on Rules and Regulations 18% 12% 70% Fairness of Eligibility Requirements 11% 22% 66% Helpful and Courteous DHHR Personnel 23% 14% 65%

17. Level of Benefits 85% of the participants in CHIP were very/ somewhat satisfied with the program benefits

18. Helpful and Courteous DHHR Personnel Overall, two out of three households (65%) find the DHHR personnel helpful and courteous

19. Information on Rules and Regulations 86% of the participants in QMB were very/somewhat satisfied with the information they received on the program

20. Fairness of Eligibility Requirements One out of three participants (32%) in TANF are very/somewhat dissatisfied with the fairness of the programs eligibility requirements

21. Previous Experience [N=523] 52% Income too high 76% No 19% Yes 5% Dk/Na Asset level too high 10% They didn’t tell you 6% 4% Didn’t understand Info 1 out of 5 households have been denied enrollment in a federal or state program

22. Program Concerns (Aggregate) Fairness of financial eligibility requirements Not enough outreach Low household asset eligibility Lack of privacy and confidentiality Limited DHHR office hours Applications are completed in same office

23. Fairness of Eligibility Requirements 74% of respondents from the Southern region have a lot or some concern

24. Not Enough Outreach 70% CHIP participants have a lot or some concern about lack of outreach efforts

25. Low Household Asset Eligibility 38% of QMB participants have very little or no concern at all about asset eligibility

26. Barriers (Aggregate) Too much red tape Lack of awareness Previously denied Required to find work Resistant to utilize “welfare” programs Limited number of years

27. Barrier - Too Much Red Tape 69% of eligibles believe that too much red tape is one of the major reasons why people are not enrolling Aggregate Mean = 3.79

28. Barrier - Lack of Awareness 62% of respondents believe that people are not enrolling due to lack of awareness. Aggregate Mean = 3.73

29. Barrier - Previously Denied Benefits 63% of eligibles believe that households who were previously denied benefits will not enroll again. Aggregate Mean = 3.61

30. Benefits (Aggregate) No one should be without health insurance, especially children 95% 1% 2% Many West Virginia families do not have access to affordable health insurance 92% 1% 4% Many West Virginians truly need and depend on the state 90% 3% 4% A partial assistance or co-payment plan should be available for purchase 84% 5% 5% The CHIP program in an insurance program, not a welfare program 56% 10% 4% The welfare reform program has been a success in West Virginia 56% 25% 9%

31. Benefits The welfare reform program has been a success in West Virginia

32. Benefits The CHIP program is an insurance program, not a welfare program

33. Benefits A partial assistance of co-pay plan for state health insurance programs should be available to households for purchase

34. Disseminating Information 28% 23% 24% 19% 17% 9% 14% 13% 16% 12% Direct Mail 11% Outreach Worker 10% TV Advertisement School System Aggregate Eligibles Participants

35. Messenger (Aggregate) WV DHHR County Health Department Local DHHR Office Social Service Organizations WV Healthy Kids Coalition

36. Messenger - WV DHHR 82% of QMB participants have a favorable opinion of the DHHR Aggregate Mean= 4.00

37. Messenger - Local DHHR Office 73% of the participants have a favorable opinion about their local DHHR office Aggregate Mean= 3.88

38. Messenger - County Health Dept 83% CHIP participants have a favorable opinion of the county health department Aggregate Mean= 3.95

39. Trust & Confidence (Aggregate) Physician Minister Person who works at a health care facility School Health Nurse Program Enrollee

40. Media Habits - Television Three out of five households or 60% watch TV between the hours of 4:00 pm and 11:00 pm Aggregate 11% >3 days 9% 1-2 days 75% Every day Eligibles 10% > 3 days 13% 1-2 days 71% Every day Participants 11% >3 days 8% 1-2 days 76% Every day

41. Media Habits - Weekly Newspaper Two out of three households read the weekly newspaper frequently or occasionally Occasionally Frequently Rarely Never

42. Media Habits - Daily Newspaper Almost one out of four households read the entire paper, while 21% read only the front page section

43. Media Habits - Radio 31% listen to the radio between the hours of 6:00 am to 10:00 am, and 25% listen between the hours of 10:00 am and 3:00 pm

44. Media Habits - Internet 37% of CHIP participants have access to the Internet at home Aggregate Eligibles Participants

45. Focus Group Methodology

46. Focus Group Methodology • Eight focus group sessions • Four venue regions of West Virginia • Charleston/Huntington • Twin Falls • Clarksburg • Princeton • 8 to 10 participants per group • Two hours per group

47. Focus Group Schedule Dec 15: Charleston State Caseworkers Dec 15: Charleston Outreach workers Jan 6: Twin Falls Americorps/Vista Volunteers Jan 11: Charleston Senior Service Workers Jan 13: Clarksburg Participants & Eligibles Feb 8: Princeton Participants & Eligibles

48. Focus Group Findings

49. Awareness • Informational efforts need to be stepped up, especially for CHIP • Enrolling in government insurance programs is perceived as “terribly complicated” • Direct correlation between awareness and lack of/prominence outreach throughout West Virginia • All agree there is a great marketing need

50. Administration & Structure • There is sentiment for a stand alone CHIP program • Even state workers cite inconsistencies in administration • RAPIDS automatic screening confuses • Hospitals and senior centers are assets to be used