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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 24 Section 5. Outreach (Section 2102(c))

Describe the procedures used by the state to accomplish:

Outreach to families of children likely to be eligible for child health assistance or other public or private health coverage to inform them of the availability of the programs, and to assist them in enrolling their children in such a program: (Section 2102(c)(1)) (42CFR 457.90)

Outreach in the first two years of TexCare, which is the state’s generic outreach campaign for Children’s Medicaid and SCHIP, focused on a statewide media/marketing campaign focused on a call-to-action to families to call the TexCare hotline or send in a written application; direct application assistance by TexCare’s contracted community-based organizations’ (CBO) outreach staff; and mass dissemination of information about the program. These strategies were appropriate for the "start-up" phase, as the challenge was to reach hundreds of thousands of unidentified families eligible for children's health insurance.

TexCare has always been designed to outreach on behalf of both Children’s Medicaid and SCHIP. However, because SCHIP was a new and separately financed program that offered the first-ever opportunity of coverage to hundreds of thousands of families, much of the focus of state and local stakeholders has been on assuring the achievement of the ambitious SCHIP "start-up" goal. Now that SCHIP has been successfully launched, Texas is entering a new outreach phase that is dominated by the need to promote renewal and appropriate utilization of services. The Medicaid focus of the outreach effort has been sharpened with the implementation of SB 43, 77th Legislature, Regular Session, 2001, which is state legislation simplifying Children’s Medicaid. This legislation benefits many families because it mandates an application and enrollment process for Children’s Medicaid- eligible families as seamless, simple and transparent as that enjoyed by SCHIP-eligible families.

Texas’ call-to-action outreach efforts that have been so effective in the first two years of the program have not stopped. But, these activities needed to be diversified and made more strategic as Texas’ focus shifted to include the permanent incorporation of TexCare information in systems (e.g., schools) in the community and the perpetuation and appropriate utilization of existing coverage.

In all aspects of implementing TexCare, Texas has learned from the experience of other states. A review of that experience suggests that a broadening of Texas’ strategy was appropriate. By diversifying beyond mass information dissemination and direct application assistance, the program will benefit from: • increasing the efficiency of efforts to identify and target under-served populations;