North Carolina’s Strategies to Connect K-12 Students to Health Care Healthy and Ready to Learn Webinar Training December 11, 2012
Webinar Agenda Healthy and Ready to Learn Project: North Carolina’s Strategies to Connect K-12 Students to Health Care11:00 am – 11:10 am: Welcome and introduction to Healthy and Ready to Learn project in 2012 -2013 Steve Shore, Executive Director, NC Pediatric Society; Ania Boer, HRL Project Director11:10 am – 11:25 am: Health Check (Medicaid) and NC Health Choice (SCHIP) – children’s health insurance programs in North Carolina Norma Martí, Public Health Minority Outreach Coordinator, NC DPH11:25 am - 11:40 am: School outreach strategies for K-12 students, Guidelines and Ordering Materials for 2012 -13 Ania Boer, HLR Project Director Betty Macon, India Foy, Laura Brewer, HRL Local Community Coordinators11:40 am – 11:50 am: School nursing and public health supporting Healthy and Ready to Learn Ann Nichols , School Health Nurse Consultant, NC DPH Cheryl Herberg, President, School Nurse Association of NC11:50 am – 12:00 pm: Q&A
N.C. Healthy and Ready to Learn Project:• Funded by CHIPRA in 2009-2011 Children’s Health Insurance Program Reauthorization Act – 16 high-need pilot counties outreach in 2010 – 32 counties added in 2011 (845 schools)• Continuation funded by NC Office of Rural Health and Community Care from Oct. 2011 until August 2013 – Expansion from kindergarten to elementary schools (950 schools) – Expansion to middle and high schools (950 + 745 = 1,695 schools) – 60 LEAs in 46 counties
Healthy and Ready to Learn Initiative Child Health Insurance Outreach Schools Includes Elkin City & Mount Airy City Includes Lexington City & Thomasville City Includes Weldon City & Roanoke Rapids Includes Asheboro City Includes Mooresville City Alleghany Northampton Ashe Gates Camden Surry Stokes Rockingham Caswell Person 11 Vance Warren Currituck 17 Granville 10 Hertford Pasquotank Watauga Halifax Wilkes Perquimans Includes Yadkin 11 13 Asheville City Avery Forsyth Orange Chowan 42 Guilford Alamance Franklin 69 Bertie Mitchell 21 Durham Caldwell Nash Yancey Alexander Davie 29 17 Edgecombe Madison Iredell 5 Martin Washington 21 Davidson Wake Tyrrell McDowell Burke 5 Dare 22 Randolph Chatham Wilson Pitt 17 Catawba Rowan 23 20 Buncombe 25 20 Beaufort Haywood 26 Johnston Hyde Swain Lincoln Greene Rutherford Cabarrus Lee Harnett 22 Graham Henderson 1o 24 Montgomery 8 12 Wayne Jackson Polk Cleveland Gaston Stanly 5 15 18 29 Mecklenburg 16 Moore Lenoir Transylvania 8 Craven Macon Pamlico Cherokee Cumberland 15 7 Clay 48 Includes Hickory Union Anson Richmond Hoke Jones Duplin City & Newton 29 6 9 Sampson 8 9 Conover City Scotland Carteret 9 OnslowCONTACT: Includes Kannapolis City Robeson Bladen 19Ania Boer, Project Director, (email@example.com, 919-839-1156) 23 7 PenderLocal Community Coordinators: ColumbusLaura Brewer (firstname.lastname@example.org, 910-865-5507) 10 New Hanover 24Anson, Bladen, Brunswick, Buncombe, Cherokee, Cleveland, Columbus, Cumberl Brunswick Includes Clinton Cityand, Davidson, Gaston, Montgomery, New 9 Includes Whiteville CityHanover, Randolph, Robeson, Rutherford, Scotland, Richmond, Union.Betty Macon (email@example.com, 252-822-3340)Craven, Duplin, Durham, Edgecombe, Halifax, Harnett, Johnston, Lee, Lenoir, Ma Total of 46 countiesrtin, Nash, Onslow, Pitt, Sampson, Vance, Wayne. (60 LEAs)India Foy (firstname.lastname@example.org, 336-617-6628)Alamance, Burke, Cabarrus, Catawba, Forsyth, Guilford, Iredell, Rockingham, Ro 1,695 schools (950 elementary, 745wan, Stanly, Surry, Wilkes. middle and high)
N.C. Healthy and Ready to Learn project:• School-targeted outreach and enrollment effort to register all “eligible and uninsured” children in grades K-12 into child health insurance programs Health Check or NC Health Choice• Partnership of Local Education Agencies, School Nurses, SHACs, State Agencies (DPI, DPH, DMA), Physicians and community-based organizations, supported by the Office of Governor and State Superintendent• HRL Steering Committee has 49 members• Identifies uninsured students through school outreach, Kindergarten Health Assessment and other forms
Why is Healthy and Ready to Learn important?• All children need healthcare coverage and medical home to stay healthy• Because healthy children learn better!• Students need to be healthy to learn and graduate from high school• Students’ health status is linked to absenteeism and performance• It supports one of the State Board of Education goals: “Healthy and responsible students”• Children learn about healthcare system by experiencing it• More children need health insurance in economic recession
HRL Grant Agreement 2012-2013A. The XXX Schools will receive a $1,000 grant per county for LEA use at discretion to offset modest expenses and:1. Designate a school representative, such as school nurse or school office/administrative staff, to be a contact person to assist the NC Pediatric Society Foundation’s outreach efforts to find uninsured school students, and to participate in the training Webinar to be held at 11 am on December 11, 2012 (details will follow);2. Use the HRL grant for: staff time to assist with tasks like distributing Health Check/ NC Health Choice outreach materials, paying for school nurses to participate in professional development, organize SHAC meetings or to support activities that promote assistance to families who may be eligible for NC’s health insurance;3. Provide feedback, data and lessons learned and/or suggestions to improve the project, report quarterly an estimate of the number of families assisted, and invite HRL staff to at least one of your SHAC meetings.
HRL Grant Agreement 2012-2013 – Cont.B. The North Carolina Pediatric Society Foundation will:1. Provide a $1,000 grant per county for LEA(s) to use at your discretion as described above between Nov. 19, 2012 and August 31, 2013 to support HRL goals;2. Host the Healthy and Ready to Learn Steering Committee and provide regular updates to all agencies and organizations represented plus LEA partners, and present at the SHAC meeting;3. Inform principals in your LEA about the HRL participation after November 19, 2012, unless your system prefers to do so directly. NOTE: Please inform your principals by Nov. 19, 2012.
HRL Data Collection FormPlease enter the number of K-12 students/their families who wereprovided information through brochure, envelopestuffer, application, personal assistance or at school events about HealthCheck/NC Health Choice children’s insurance. Email completed forms toyour HRL Local Community Coordinator each quarter. October - December 2012 Total # of families/children assisted this quarter: Other/Notes: January - March 2013 April – June 2013 July - August 2013
Evaluation of Healthy and Ready to Learn in 2011-2012UNC-G, Center for Youth, Family and Community Partnership survey results (113 respondents):• Strong to moderate support of HRL’s effectiveness• Success of HRL implementation: – benefited families, – educated parents and enabled children access to regular health care, – children coming to school with fewer health issues, – gave options to those with chronic illnesses or need of mental health services – personal gratification to HRL school partners• Challenges to enroll children into HC/NCHC: – find new ways to identify uninsured and eligible students, – contact and encourage parents to enroll their children, – increase involvement of different school staff members, – expand HRL outreach beyond elementary school
Evaluation of Healthy and Ready to Learn – Cont.Distribution of outreach materials:Year 1 (Jan. 2010-Sept. 2010), 16 pilot counties: 61,983Year 2 (Oct. 2010 – Sept. 2011), 48 counties: 202,912Year 3 (Oct. 2011 – Sept. 2012), 46 counties: 270,000Total for all years: ~535,000Number of children/families assisted by school nurses or school staff:Year 1 – approximately 1,000 between July 2011-Sept. 2011 for 16 pilot counties (no data collected prior to)Year 2 – approximately 56,300Year 3 – 127,874Total – approximately 185,000+
NC’s Public Programs Providing Quality Health Care for Kids: Health Check / NC Health Choice Health Check/NC Health Choice & Medical Home Healthy & Ready to Learn Webinar, December 11, 2012Children and Youth Branch
School Outreach StrategiesHow to find uninsured children?• Review school forms with health insurance status – Kindergarten Health Assessment Form, – Health assessments, – School Registration, – Sports Physicals, – Field Trip, – School Health Contact, – Emergency Contact forms.• Add a question about insurance if forms don’t have it• Follow up with outreach materials or in-person information, as appropriate
Example: Onslow County Schools Health ServicesHEALTH CARE INFORMATIONStudent’s Name ______________________________________ Grade/Teacher ___________________Where your student gets regular health care: Student has: 1 Health Department 1 Medicaid 3 No Insurance 2 Hospital Clinic 2 Private Insurance/HMO 4 Other: _____________ 3 Community Health Center Doctor/ Practice Name: 4 Private Doctor/HMO _____________________________________ 5 Other __________________ Dentist Name: 6 No regular place _____________________________________ I would like information on free/low cost health insurance for my student.Forward to School Nurse
What can school staff and SHAC members do?• Review school forms to check if child has health insurance• Remind families to complete all “Parent complete” parts on the KHA, emergency contact, field trip forms, etc.• Always share those three pieces: promotional materials, an application form and address of the local DSS with families of uninsured children• Parents are more likely to apply if they see income guidelines based on family size so keep outreach materials on hand• Promote child health insurance at school events
What can school staff and SHAC members do - cont?• Put into operation ideas from bi-weekly HRL Outreach Hints emailed on Wednesdays• Check Healthy and Ready to Learn Facebook page for updates and strategies• Think of and share middle and high school outreach ideas with HRL staff and other LEAs• Implement at least three school-based outreach ideas provided by HRL at your LEA
Guidelines to Sustaining Healthy and Ready to Learn (HRL) Outreach in Elementary Schools1. Include HRL on SHAC agendas and identify a person responsible for updates on child health insurance outreach.2. Include child health insurance outreach materials at kindergarten orientations every year.3. Display child health insurance information during school’s open houses.4. Check Kindergarten Health Assessment forms to see if a child has health insurance. Share Health Check/NC Health Choice information with those who are uninsured.
Guidelines to Sustaining Healthy and Ready to Learn (HRL) Outreach in Elementary Schools5. Add health insurance status questions to current school forms such as emergency information cards collected at the beginning of school year, field trip forms, school health forms, etc. Share HC/NCHC information with those who indicate no insurance coverage.6. Check a child’s health insurance status based on parent reports and Parent Policy Booklets’ signature sections.7. Share HC/NCHC information during school registrations.8. Include a link to child health insurance information: http://www.nchealthystart.org/public/childhealth/index.htm on your school’s webpage.
Guidelines to Sustaining Healthy and Ready to Learn (HRL) Outreach in Elementary Schools9. Ask about child health insurance status during vision/dental screenings and 5th & 6th grade vaccination requirements.10. Include HRL and child health insurance information during staff meetings, support team meetings such as principal, social worker, teacher, school nurse meetings.11. Orient new school staff members about child health insurance and HRL.12. Present HRL at Parent Advisory Councils, PTAs, PTOs and other parent groups.13. Add HC/NCHC outreach information to health referrals.
Guidelines to Sustaining Healthy and Ready to Learn (HRL) Outreach in Elementary Schools14. Display HC/NCHC poster in prominent school locations where parents can see it.15. Send outreach materials with school report cards.16. Include HC/NCHC information with free or reduced school lunch applications and/or acceptance letters and summer lunch programs.17. Use your school’s voice system Alert Now/Connect Ed to share child health insurance information. For a ready-to-use script, go to Sept. 20, 2012 HRL Facebook post at: http://www.facebook.com/HealthyandReadytoLearn. Update the annual income guidelines every April 1.
Middle and high school outreach focus• Send HC/NCHC info with report cards• Opportunity to contact students directly, not only parents• Message to teens needs to be positive, informative and why they need it• Use social communication technologies: – Text messages to students (parental permission needed, come from school’s medical professional)• Peer-to-peer messages work best• Pick teen champion to share it with other students (video/TV club, school newspaper)• Include HRL in Health and Safety, Wellness, PE classes• School-based health centers to share information• Collaborations with school clubs and their Presidents and Advisors• Utilize school announcement system with direct message• Involve schools’ counselors, psychologist, PE teachers (beside social workers and school nurse)• Driver ED – add insurance status
Outreach in middle and high schools What are other LEAs doing? Central region:• Placing brochures in the office waiting room and the visitor “sign-in” area• Include brochures in the “new student” packets• Add HC/NCHC materials and applications to the mobile unit and inquire about coverage during intake• Review health/PE forms for status of insurance• Send info and applications to parents when the school nurse is providing referrals for vision or hearing screenings• Send HC/NCHC envelope stuffers home with report cards
Outreach in middle and high schools What are other LEAs doing? Southwestern region:• Partner with allies for teens such as: – TOP - Teen Outreach Programs, – Advocates for Teens, – Beta Clubs, – FHA clubs• Collaborate with Nutrition Director to obtain a list of every child, by school, in the LEA, who has an outstanding school cafeteria bill of over $100 and determine if these students are eligible for F/R Lunch and thus may also be eligible for Health Check or NC Health Choice
Middle and high schools What are other LEAs doing? Northeast region• Attach HC/NCH info to student athletic physical forms which are required for participation in middle and high school sports• Distribute NC health insurance information during sports physical examination clinics held at school sites• Provide NC health insurance materials to middle and high school students during 1-on-1 health office visits and/or to class groups during health presentations• Attach materials to nurse referrals• Review annual student health information forms and follow-up as needed• Place NC health insurance posters and materials in school nurse office, guidance offices and school office• Provide materials at sporting events, Open Houses/Orientation, "Parent Nights"• Send fact sheet home with report cards• Use televised announcements
School Nursing and Public HealthSupporting Healthy and Ready to Learn ProjectAnn Nichols, State School Nurse Consultant, NC Division of Public Health Cheryl Herberg, President, School Nurse Association of North Carolina “Working for a healthier and safer North Carolina”
Division of Public Health• Long-term sustainability is critical• Assuring access to care as a forethought, not afterthought.• Institutionalizing the project – Goal of State Division of Public Health – Goal of Children and Youth Branch of DPH – Goal of School Health Unit of DPH “Working for a healthier and safer North Carolina”
School Nurse Association of North CarolinaSNANC is committed to assisting the HRLInitiative with the following :• MOU understanding• Presentation of program at Executive Committee meetings• Support initiative at all regional meetings in Fall and Spring throughout the state
Factors Influencing Health Outcomes Public Policies Community & Environment Clinical Personal Care Behavior HealthSource: Robert Wood Johnson Foundation. “Overcoming Obstacles to Health: Report from the RobertWood Johnson Foudnation to the Commisssion to Build a Healthier America.” February 2008.
2020 Healthy People Increase the proportion of adolescents who have had a wellness check-up in the past 12 months. 68.7 percent of adolescents aged 10 toBaseline: 17 years had a wellness checkup in the past 12 months, as reported in 2008Target: 75.6 percentTarget-Setting Method: 10 percent improvement National Health Interview SurveyData Source: (NHIS), CDC, NCHS
HRL Project Strategies: Focus on Middle and High Schools Students through School Nurse and CommunitySchool Nurse Point of Service is a time to observeinsurance status.• Siblings of referred students• Teacher referrals• Student referral teamsAdolescents are also old enough to beaware of health insurance.• Speak directly with student• Include benefits of insurance in health promotion opportunities
School Nurse Opportunities for Insurance Referral6th grade Tdap requirementCollege immunizationsAcute illnessVision screening follow up One-on-one health counseling
YOU can make a difference! 10 HRL Actions Steps:1. Share information about the Healthy and Ready to 3. Review school forms to check Learn and child health insurance programs, Health insurance status . Check/NC Health Choice, with school staff and all your SHAC members (This PowerPoint will be posted at: 4. Hang a HC/NCHC poster so www.NCPedsFoundation.org ). that families can see it.2. Order free (English/Spanish) outreach materials, i.e. fact sheets (D4, D4BR), envelope stuffers (D3), applications (D6E, D6S) and poster (D5) from your HRL Local Community Coordinator or download materials in English, Spanish and other languages at: http://www.nchealthystart.org/outreach/index.html
YOU can make a difference! HRL Actions Steps:5. Give outreach materials to families 7. Create or implement the Guidelines and outreach with uninsured children and those ideas in your school system. For example, include who mark “no insurance” on KHA and HRL on SHAC agendas and identify a person other school forms. Be sure to share: a responsible for updates on child health insurance flier with income guidelines (fact sheet outreach. or envelope stuffer), an application, and the address of the local DSS. If your school has a Pre-K program, please reach out to families of 4-year old children.6. Consider following up with families to see if they need help enrolling and offer 8. Please help us keep track of the number of families them resources such as you assist. Every quarter we will ask for an www.NCHealthyStart.org and the approximate number of K-12 families you have local DSS. reached.
YOU can make a difference! HRL Actions Steps:9. Call us if you need help with ordering materials, scripting a message, need a cover letter to send to families, or want us to mail you fliers with DSS addresses by county. Local Community Coordinators for HRL are: Laura H. Brewer (south/west region, office in Robeson County), email@example.com, 910-865-5507, Betty Macon (north/east region, office in Halifax County), firstname.lastname@example.org, 252-822-3340, and India Foy (central/west region, office in Guilford County), email@example.com, 336-617-6628. Visit www.NCPedsFoundation.org and https://www.facebook.com/HealthyandReadytoLearn for outreach tools and resources! Like Us on Facebook and check our page often.
Healthy and Ready to Learn Project Local Community CoordinatorsProject DirectorAnia Boer, ME, MA C: Central Region1100 Wake Forest Road, Ste 200 NE: Northeast Region India Foy, MPHRaleigh, NC 27604 Greensboro, NC Betty Macon919 839-1156 336-617-6628 Roanoke Rapids, NCFAX: 919-839-1158 firstname.lastname@example.org email@example.com firstname.lastname@example.org Alleghany Vance Northampton Gates Currituck Ashe Surry Rockingham Stokes Caswell Granville Warren Person Hertford Watauga Wilkes Halifax Yadkin Alamance Mitchell Avery Forsyth Orange Franklin Bertie Caldwell Guilford Nash Yancey Alexander Davie Durham Madison Edgecombe Tyrrell Burke Iredell Davidson Wake Martin Washington Dare Randolph Chatham Wilson Buncombe McDowell Catawba Rowan Pitt Beaufort Swain Haywood Lincoln Johnston Greene Hyde Rutherford Cabarrus Montgomery Lee Graham Henderson Harnett Wayne Jackson Transylvania Polk ClevelandGaston Stanly Moore Lenoir Craven MecklenburgCherokee Macon Clay Cumberland Pamlico Anson Richmond Hoke Sampson Jones Union Duplin Scotland Onslow Carteret Robeson Bladen Pender S & SW: Southern & Southwestern Region Columbus New Laura H. Brewer Hanove St. Pauls/Lumberton Brunswick 910-865-5507 email@example.com December 2010
North Carolina Pediatric Society Foundation Healthy and Ready to Learn project team: Steve Shore, MSW, Executive Director, NCPS-F Ania Boer, ME, MA, Project Director, firstname.lastname@example.org Laura Brewer, Local Community Coordinator for south/western region (office in Robeson County), email@example.com, (910) 865-5507India Foy, MPH, Local Community Coordinator for central/western region (office in Guilford County), firstname.lastname@example.org, 336-617-6628 Betty Macon, Local Community Coordinator for northeastern region (office in Halifax County), email@example.com, (252) 822-3340 1100 Wake Forest Road, Suite 200 Raleigh, NC 27604 Phone: (919) 839-1156 Fax: (919) 839-1158 www.NCPedsFoundation.org
North Carolina Pediatric Society Foundation Healthy and Ready to Learn project team: Steve Shore, Executive Director Ania Boer, Project Director From Left: Betty Macon, Local Community Coordinator for northeastern region, Laura H. Brewer, Local Community Coordinator for south/western region, India Foy, Local Community Coordinator for central/western region
Thank you for your continued support of the Healthy and Ready to Learn Project! Q&A