Cities Expanding Health Access for Children and Families Initiative: Lessons from the Planning Phase

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After a very short six months, we have come to the conclusion of the Cities Expanding Health Access for Children and Families (CEHACF) project’s planning phase. On May 30, 2014, NLC received business plans from all 12 cities for outreach campaigns to enroll children and families in Medicaid and the Children’s Health Insurance Program.

Business plans are currently under review and NLC will select approximately six cities to receive implementation grants in July 2014. These grants will support cities with up to $260,000 each and ongoing technical assistance over 18 months during the initiative’s final phase to implement outreach campaigns.

Medicaid and CHIP are the nation’s two most important public health insurance programs for families, and are available year-round. Unlike purchasing private insurance through the Marketplace, there is no open enrollment period for Medicaid or CHIP which will allow eligible families to enroll at any time.

Mayors and local elected officials have a vested interest in connecting children and families to Medicaid and CHIP, providing a powerful role for cities to play in making that connection. NLC has learned some important lessons through the CEHACF planning phase which are outlined below to help interested city leaders with campaign planning.

  1. City Leaders and Stakeholders are Motivated by Better Health Outcomes for Kids
    During the planning phase, we anonymously surveyed initiative participants consisting of local elected officials, senior city staff members, school administrators, representatives from hospitals and clinics, and other community partners to understand what motivated them to become involved in health benefit outreach. The number one response from 29 out of 33 respondents was to help create better health outcomes for kids. The number two response from only two respondents was to reduce city costs related to uninsured populations. The cynic in me found this discovery very surprising, since I thought the primary motivating factor would be financially-rooted, but it turns out community leaders just want kids to have a healthy start in life! With this information, we hope city leaders can better develop messaging strategies to enlist and motivate community partners to engage in health benefit outreach.
  1. Assess the Market
    In the private sector, the saying goes, “know your customer.” Similarly, to effectively reach families and connect them to Medicaid and CHIP, local leaders need to understand their target audience(s). As part of the planning phase, initiative participants were encouraged to conduct market analyses through community surveys, focus groups, and interviews to learn about the specific needs, attitudes, and preferences of target populations. Through this exercise, initiative participants not only gained an awareness of community outreach needs, but also an understanding of existing services and how to fill service gaps. With greater knowledge about community needs, cities can custom design outreach strategies tailored for their communities, which will hopefully lead to more effective outreach and enrollment strategies.
  1. Sustain Outreach and Enrollment Initiatives by Incorporating them into Existing Systems
    At the planning phase cross-site meeting in March, one participant shared that unless new outreach and enrollment initiatives can be sustained over time, they should not even be initiated. This statement really struck me, as it did—I think, for many other meeting participants. The statement led us into a discussion about how to sustain outreach and enrollment efforts, and through this dialogue, we concluded that efforts can be more readily sustained if they are incorporated into existing community programs and systems. This might be done through 2-1-1 information and referral systems, parks and recreation departments, libraries, school districts, or Head Start offices.  There are many other ways to incorporate outreach and enrollment efforts into existing city programs and systems and city leaders can be creative in considering existing community structures that can help sustain efforts.

As we move into the implementation phase of the CEHACF initiative, we will continue to share our lessons with the hope that more cities will be motivated to develop outreach and enrollment campaigns. After all, children and families in communities all over the U.S. are currently eligible for Medicaid and CHIP, but may not know it. All it might take is for a city leader to help make a connection!

For more information about the CEHACF initiative, contact Chuan Teng at to find out which cities will move into the implementation phase, please visit the Institute for Youth, Education and Families website on July 14!