It’s All Elementary: Strategies to Connect K-5 Students to Health Care Healthy and Ready to Learn Webinar Training November 29, 2011
Webinar Agenda Healthy and Ready to Learn Project It’s All Elementary: Strategies to Connect K-5 Students to Health Care1:30 pm – 1:40 pm: Welcome and introduction to Healthy and Ready to Learn project in 2012 Steve Shore, Executive Director, NC Pediatric Society; Ania Boer, HRL Project Director1:40 pm – 1:55 pm: Health Check (Medicaid) and NC Health Choice (SCHIP) – children’s health insurance programs in North Carolina Norma Martí, Public Health Minority Outreach Coordinator, NC DPH1:55 pm - 2:10 pm: School outreach strategies and HRL Action Steps for 2012 Betty Macon, India Foy, Laura Brewer2:10 pm – 2:20 pm: School nurses and School Health Advisory Councils Clementine Buford, Immediate Past President, School Nurse Association of NC Jessica Gerdes, State School Nurse Consultant, NC DPH2:20 pm – 2:30 pm: Q&A
N.C. Healthy and Ready to Learn Project:• Funded by CHIPRA in 2009 Children’s Health Insurance Program Reauthorization Act• 16 high-need pilot counties outreach in 2010• 32 counties added in 2011• Continuation funded by NC Office of Rural Health and Community Care from Oct. 2011 until Sept. 2012 – Expansion from kindergarten students to all elementary school students – 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, (firstname.lastname@example.org, 919-839-1156) 23 7 PenderLocal Community Coordinators: ColumbusLaura Brewer (email@example.com, 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 (firstname.lastname@example.org, 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 (email@example.com, 336-617-6628)Alamance, Burke, Cabarrus, Catawba, Forsyth, Guilford, Iredell, Rockingham, Rowan, Stanly, Surry, Wilkes.
N.C. Healthy and Ready to Learn project:• School-targeted outreach and enrollment effort to register all “eligible and uninsured” children in elementary school 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 44 members• Identifies uninsured students through school outreach and the Kindergarten Health Assessment form
Why is Healthy and Ready to Learn important?• It complements one of the State Board of Education goals: “Healthy and responsible students”• Students need to be healthy to learn and graduate from high school• Students’ health status is linked to absenteeism and performance• Children learn about healthcare system by experiencing it• All children need healthcare coverage and medical home to stay healthy• More children need health insurance in economic recession Healthy children learn better!
HRL Grant AgreementA. 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 elementary school students, and to participate in the training Webinar to be held at 1:30 pm on November 29, 2011 (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 a brief report on 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 – 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. 16, 2011 and September 30, 2012 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 the elementary school principals in your LEA about the HRL participation after November 16, 2011, unless your system prefers to do so directly. NOTE: Please inform your principals by Nov. 16, 2011.
HRL Data Collection FormPlease enter the number of children/families who were providedinformation through brochure, envelope stuffer, application, personalassistance or at school events about Health Check/NC Health Choicechildren’s insurance. Email completed forms to your HRL LocalCommunity Coordinator each quarter. October - December 2011 Total # of families/children assisted this quarter: Other/Notes: January - March 2012 April – June 2012 July - September 2012
Preliminary Evaluation of Healthy and Ready to Learn• HC/NCHC enrollment change in 16 pilot counties in 2009- 2010 through March of the current school year, 2010-2011, compared to 2008-2009• HRL counties continued to increase enrollment for kindergarten-aged children by over 3 percentage points more than non-HRL counties• These data provide preliminary descriptive evidence suggesting that the HRL initiative is effective• Focus group results suggest HRL “energized” the community to do the outreach• Final evaluation in Jan. 2012 (~9,000 KHA forms evaluated)
Preliminary Evaluation of Healthy and Ready to LearnDistribution of outreach materials:Year 1 (Jan. 2010-Sept. 2010), 16 pilot counties: 61,983Year 2 (Oct. 2010 – Sept. 2011), 48 counties: 202,912Total for both years: 264,895Number 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 56,300Total – approximately 57,300
How to find uninsured children?- Kindergarten Health Assessment Form(It includes a check box for the parent toindicate the child’s insurance status)- Other forms and health assessments used atyour schools such as School Registration, SportsPhysicals, Field Trip forms. Add a questionsabout insurance- Follow up with outreach materials or in-personinformation, as appropriate
Kindergarten Health Assessment Form• Form is often NOT filled out completely when it arrives at schools• Frequently, parents do not fill their part due to low literacy levels or not realizing it is their responsibility• Important to fill out form completely so the school staff has an entire record on childs health• Back side - under “Parent Complete”- identifies children who do not have health coverage
Why is a complete Kindergarten Assessment Form important? To track children’s health status and maintain a healthy lifestyle To save school staff’s time and make medical referrals easier To identify uninsured children and help them establish medical home To help enroll uninsured and eligible patients into NC’s children’s health insurance programs
Health Check / NC Health Choice: Keeping Students Healthy & Ready to Learn Norma Marti, NCDPH(as separate presentation placed at www.NCPedsFoundation.org, under Orientation/Outreach Tools: http://www.ncpedsfoundation.org/index.php?option=com_content&view=category&id=37&Itemid=63)
What can school staff and SHAC members do?• Review school forms, such as the KHA form and others, to check if child has health insurance• Remind families to complete all “Parent complete” parts on the KHA form• Share 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• Implement at least three school-based outreach ideas provided by HRL at your school
Examples of school-based child health insurance (CHI) outreach strategies to implement at your schoolUse existing health status assessments• Send HC/NCHC envelope stuffer home with every child, along with a response form to be returned to the child’s teacher (available from the “School Partnership” link above)• Ask parents to indicate the child’s current insurance status on school forms. Have them sign it, provide contact information, and ask if they want to receive a HC/NCHC application formExisting communication infrastructures• Use school voice mail systems to communicate a message to all parents or a targeted group of parents like those whose children qualify for F/RP School Meals, or who have newly enrolled kindergarteners• Home-schooled children may have a list serve that can be utilized to reach that population of students
Examples of school-based child health insurance (CHI) outreach strategies to implement at your schoolSchool-produced materials and forms• Use Parent/Student Handbooks as an opportunity to educate about CHI. (Information has been scripted for use in such a resource, see ‘School Partnership” link). If the parent has to sign a document that they reviewed in the Handbook, then a check box could be added to the form for parents to indicate if they would like further information or to be contacted about CHI• Ask about insurance status through School Registration, Sports Physicals, and other forms to promote CHI and follow up as appropriate. Include where to turn for more information: www.NCHealthyStart.org or go to local department of social services
Examples of school-based child health insurance (CHI) outreach strategies to implement at your schoolLocal PTAs/PTOs• The NC PTA is already involved in child health insurance outreach in some local areas. Articles have been published in their statewide “NC Parent- Teacher Bulletin” and the “Parent Resource Handbook” for PTA Presidents. There are links from the NC-PTA web site to CHI web pages.• Work with your local PTA to promote CHI• All examples of school-based outreach strategies are available at: www.ncpedsfoundation.org, under Healthy and Ready to Learn, go to “Action Plan.”
What are other LEAs doing? Central region:• Use existing communication channels and partnerships to promote children’s health insurance• Link Healthy and Ready to Learn to existing school/ community priorities (e. g., as SHAC goal)• Prepare direct mailings to parents with a letter about HC/NCHC• 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 You can make a difference!
What are other LEAs doing? Southwestern region:• KINDERGARTEN REGISTRATION - parent cover letter• Kindergarten preparation folders to parents (Cumberland)• Parent liaison for migrants (Robeson)• Parents interview with SHN and as they assist in child’s health care needs at Kindergarten Registration Most Successful Counties:• Robeson - All Principals of Elementary Schools participated in HRL Awareness Superintendant Luncheon• Cumberland - WEBINAR for all elementary school staff - PARENT NIGHT- HRL Local Community Coordinator and Carolina Community Care HCC invited to emphasize NCHC/HC and to assist parents with applications• Gaston - 30+ community professionals (dentist, local pediatrician, Fire Chief, Police Chief, etc) on SHAC for Community Awareness to promote HRL
What are other LEAs doing? Northeastern region:• Emergency cards include insurance question• Locally produced forms sent to all students grade 1-12 and given to all new students who enrollExample: 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
SNANC and Public Health: Supporting Healthy and Ready to Learn ProjectClementine Buford, Immediate Past President School Nurse Association of North CarolinaJessica Gerdes, State School Nurse Consultant, NC Division of Public Health “Working for a healthier and safer North Carolina”
#1 Coordinated School Health Approach School Health Education Physical Family & Education & Community Physical Involvement Activity Staff School Health Health Promotion Services Healthy Nutrition School Services Environment Counseling, Psychological & Social ServicesSchool Health Services +Family/Community Involvement
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 Nurses:• Provide services to students and families daily• Play a vital role in both educating and providing resources to families• Can make a difference
School Nurses:• Know the impact of being anuninsured student• Look forward toassisting in this project• Know that healthyChildren learn better
HRL Project Strategies• Focus on kindergarten – elementary school studentsthrough School Nurse and Community•Kindergarten Health Assessment •There are steps in the kindergarten health assessment process that would accomplish the HRL objective Physicians Local health department clinics School health centers•Siblings of kindergarten students•Teacher referral•Student referral teams•School Nurse Point of Service
YOU can make a difference! 10 HLR Actions Steps:1. Share information about the Healthy and Ready to 3. Make sure ALL information Learn and child health insurance programs, Health on the KHA form is complete Check/ NC Health Choice, with school staff and all your and follow up on families who SHAC members (This PowerPoint will be posted at: don’t fill out their part. www.NCPedsFoundation.org under Orientation). 4. Hang a HC/NCHC poster so2. Order free (English/Spanish) outreach materials, i.e. that families can see it. fact sheets (D4, D4BR), envelope stuffers (D3), applications (D6E, D6S) and poster (D5) from www.NCHealthyStart.org , click on Order. For other languages, check: http://www.nchealthystart.org/outreach/index.html. Add “HRL” under Department on order form from NCHSF.
YOU can make a difference! Actions Steps:5. Give outreach materials to families 7. Create or implement some outreach ideas in your with uninsured children and those school system from “School-based child health insurance who mark “no insurance” on the KHA outreach strategies.” For example, share materials during form. Be sure to share: a flier with kindergarten registration events or parent orientations, or income guidelines (fact sheet or place a simple message to parents on your school’s voice envelope stuffer), an application, and system. the address of local DSS. If your school has a Pre-K program, please reach out to6. Consider following up with families to families of 4-year old children. see if they need help enrolling and offer them resources such as 8. Please help us keep track of the number of families www.NCHealthyStart.org and local you assist. Every quarter we will ask for an approximate DSS. number of families you have reached.
YOU can make a difference! 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), firstname.lastname@example.org, 910-865-5507, Betty Macon (north/east region, office in Halifax County), email@example.com, 252-822-3340, and India Foy (central/western region, office in Guilford County), firstname.lastname@example.org, 336-617-6628. Visit www.NCPedsFoundation.org for outreach tools and resources!10. Share your success stories with us!
Healthy and Ready to Learn Initiative 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, NC.FAX: 919-839-1158 email@example.com firstname.lastname@example.org email@example.com 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 firstname.lastname@example.org December 2010
North Carolina Pediatric Society Foundation Healthy and Ready to Learn initiative team: Steve Shore, MSW, Executive Director, NCPS-F Ania Boer, ME, MA, Project Director, email@example.com Laura Brewer, Local Community Coordinator for south/western region (office in Robeson County), firstname.lastname@example.org, (910) 865-5507India Foy, MPH, Local Community Coordinator for central/western region (office in Guilford County), email@example.com, 336-617-6628 Betty Macon, Local Community Coordinator for northeastern region (office in Halifax County), firstname.lastname@example.org, (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 FoundationHealthy and Ready to Learn initiative 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 support of theHealthy and Ready to Learn Initiative! Q&A