This document discusses a collaboration between a university, public schools, and Extension to help uninsured families access Medicaid and SCHIP (BadgerCare Plus) in Wisconsin. The collaboration, called Covering Kids & Families, began as a statewide coalition in 1999 and now includes over 65 organizations. Through various projects, they work to increase awareness of and enrollment in BadgerCare Plus, focusing on reducing health disparities. One such project, called CHILD and now REACH BC+, partners with schools to help connect eligible families to health insurance. The document outlines evaluation results showing a need for outreach and ways the collaboration can help schools assist families with the enrollment process.

1. A university, public schools, and
Extension collaboration
to assist uninsured families with
access to Medicaid/SCHIP
Roberta Riportella, PhD
Health Policy Specialist UW Extension
Professor, Dept of Consumer Science, School
of Human Ecology
University of Wisconsin-Madison
covering kids & families

2. Purposes
• End goal: leave with tools so you can
replicate outreach project
• Who we are
• What we do
• How Extension has been involved
• Why we know it’s important…evaluation
base
covering kids & families

3. covering kids & families
● Began as RWJ statewide coalition
1999, currently 65 organizations
● Dedicated to reducing health
disparities and improving overall
health in Wisconsin
● Emphasis on enhancing local capacity
to maximize participation in
BadgerCare+
● Grant funded
covering kids & families

4. Covering Kids & Families
• Coalition of more than 65 statewide organizations
– Academic institutions – UW-Madison and UW Extension
– State agencies – WI Department of Health Services and
Department of Public Instruction
– Community Based Organizations – Family Resource Connection
and La Causa
• A statewide coalition with a university home allows us:
– Easy access to data to target problems and populations
– To be in the field and evaluate (research and outreach)
– Credibility within Wisconsin and beyond
covering kids & families

5. BadgerCare Plus
• Wisconsin’s SCHIP: State Children’s
Health Insurance Program
• Precursor, BadgerCare, began in 1999
• Eligible persons must apply & renew for
benefits
• Program expansions:
– Children at all income levels (some exceptions)
– Caretaker relatives up 200% of poverty
– Childless adults up to 200% of poverty
• Recent approvals for increased premiums
covering kids & families

6. Reaching the Uninsured
• Awareness among eligible families remains
incomplete
• There are newly eligible families all the time
• Information campaigns alone may not be
enough
– Many other barriers:
• Perceptions (income too high,
insurance unnecessary)
• Complicated family lives with
competing priorities
• Programmatic complexities (paperwork
requirements, difficult to navigate
alone)
• Language difficulties and cultural
beliefs
covering kids & families

7. The CHILD Project
Connecting Health Insurance with Lunch Data
The Goal: Sustainable, effective, efficient
processes that schools can use to reach
families in need of BadgerCare Plus (BC+)
The Method: Working closely with schools
across Wisconsin to improve and expand
outreach about BC+ while building local capacity
to assist with enrollment.
covering kids & families

8. CHILD to REACH BC+
• Began in 16 Wisconsin districts
– Pilot project – field test different methods
– Originally:
Connect free/reduced price lunch participants to
BC+
• CHILD (Connecting Health Insurance to Lunch Data)
• Currently in 3 CESAs (cooperative educational
service agencies) covering multiple districts
– Less direct assistance to individual schools, working
through community partnerships
– REACH BC+ (Retention and Enrollment to Achieve Children's
Health and Build Capacity)
covering kids & families

9. covering kids & families

10. Here’s What We’ve
Learned
• Build capacity among school staff
• Provide simple, accessible training tools on
BadgerCare Plus
• Provide county-specific outreach tools
• Tailor outreach strategies to district
capacity
• Strengthen community partnerships
• Integrate systems to collect and share
insurance information
covering kids & families

11. Before we were involved in the
project…we were fragmented
about how we were going to help
{uninsured} families. Now we
feel we have some strategies.
Health coordinator
CHILD district
covering kids & families

12. REACH BC+: School-based outreach in CESA 8
CESA 8 PAC Meeting presentation
Caroline B. Gomez
February 10,2012 covering kids & families

13. Overview
● Explain who we are:
● covering kids & families.
● REACH BC+.
● Discuss what we know about families and
health insurance:
● CESA 8 Parent Survey results (2011)
● What families in the Northwoods are thinking.
● Statewide School Pupil Services Staff Survey
(2009)
● Introduce ways CKF can help your school
district assist families through REACH BC+.
covering kids & families

14. Why This Project, Why Now
 In Wisconsin, 86,000 children (7 %) were
uninsured for all or part of 2009 (WI DHS)
 More families may be losing health
insurance, due to economy and rising
health care costs
 Information campaigns alone may not be
enough; families may need follow-up
contact, direct assistance or other
resources
covering kids & families

15. Parent Survey Results (cont’d)
• Percentage of uninsured
children hovered right at
the state average of 7%.
• This gives us an estimate
of how many uninsured
children may be in each
district:
Beecher: 17 Niagra:30
Bonduel: 57 Oconto: 77
Bowler: 26 Oconto Falls: 128
Clintonville: 101 Peshtigo: 85
Coleman: 52 Shawano-
Crandon: 63 Gresham: 178
Crivitz: 52 Suring: 33
Florence: 33 Tigerton: 19
Goodman- Wabeno: 35
Armstong: 10 Wausaukee: 35
Laona: 16 White Lake: 13
Lena: 27 Wittenberg-
Marinette: 151 Birnamwood: 86
covering kids & families

16. Cesa 8
Parent
Health
Insurance
Survey
Results What families in the
Northwoods are thinking.
covering kids & families

17. Parent Survey Results
CESA 8: Worried About Family Having
Health Insurance
N = 292
43%
34%
22%
1%
Not at all worried Somewhat worried Extremely worried missing
covering kids & families

18. covering kids & families

19. covering kids & families

20. Parent Survey Results (cont’d)
CESA 8: Specific Source of
BadgerCare+ Information Through Schools
N = 72
32%
17%
14% 14%
8%
7%
4%
3%
1%
covering kids & families

21. Statewide
School
Pupil
Services
Staff
Survey
(2009) School District Staff
Perspectives
covering kids & families

22. covering kids & families

23. Statewide School Pupil Services Staff Survey (cont’d)
● How would you rate your knowledge of
BadgerCare+?
Excellent
2%
Good Not very good
45% 53%
covering kids & families

24. covering kids & families

25. So, What is
BadgerCare+?
Eligibility and Covered
Services
covering kids & families

26. Video clip
http://dpimedia.wi.gov/main/Viewer/?peid=00653105c2764590abe97f3e6779cf98
covering kids & families

27. Schools Are a Natural Fit!
School staff are often a first resource for
families in need:
● Well respected, trusted
● Accessible for families
● Very likely already providing some
BadgerCare+ help
covering kids & families

28. What Can Schools Do?
● Increase awareness and understanding
of BadgerCare+ among key district staff
● Promote BadgerCare+ to students and
families
● Help students (and families) in need of
health insurance find the resources they
need to enroll in BadgerCare+
covering kids & families

29. REACH
BC+
This is where WE come in!
covering kids & families

30. http://www.ckfwi.org/toolbox.html
covering kids & families

31. What’s in the Toolbox?
• BadgerCare Plus Basics
• Outreach Materials
• County Tools
• Research and Data
Free, easy to download resources!
covering kids & families

32. BadgerCare Plus Toolbox
• Helping
families apply
• Express
enrollment
How To
covering kids & families

33. BadgerCare Plus Toolbox
• Downloadable
Materials
• Localizable
brochures
• Presentations
covering kids & families

34. Outreach Materials
• BadgerCare Plus
bookmarks, flyers
• Newsletter articles
• Presentations and
Trainings
• Outreach Plans
• Insurance Data
Collection Tools
covering kids & families

35. REACH BC+ Goals
● Increase knowledge among school and community
staff about eligibility and enrollment options such that
they are positioned to assist uninsured children
● Spur action among school and community staff to
proactively promote coverage options, identify
uninsured children and provide assistance
● Affect systems in schools and community
organizations so that this level of engagement is a
sustainable part of schools’ missions
covering kids & families

36. What Your Schools Get Out of
REACH BC+
• District access to CKF staff who can answer
your questions about access to health care
• Access to the CKF BadgerCare+ Toolbox
• BadgerCare+ trainings, tailored to
individual staff, groups, or districts
• Facilitation of partnerships among existing
agencies, schools and community
resources
covering kids & families

37. Give
Us the
Green
Light!
This is where YOU come in!
covering kids & families

38. Next Steps
1. Would you like Covering Kids & Families to
work with your school district so that your
staff are more prepared to assist families
with BadgerCare+.
2. Would you like us to follow up with you or
other school contact with more information
about the specifics of REACH BC+.
covering kids & families

39. Health & Education
“We’re firm believers that if we can
keep the kids healthy, they are going
to have a better chance at learning
and being successful here in school.”
• District Administrator,
a Wisconsin School District
covering kids & families

40. What we want from
Extension and others
• Help taking a well-tested, promising model
statewide
– CKF developed and tested the model in 15 diverse
districts over the past three years
– We now stand poised to put it to work, but need
local supports for schools to be most effective
– Statewide “replication light”
– More intensive replication in
Southwestern, Western and Central Wisconsin
covering kids & families

41. What we specifically want from
Cooperative Extension
• Level 1: What we call the “Basic ask.”
– Field a phone call from CKF staff to provide a
run down of what’s going on in the community:
organizations suited to potentially help, work in
the schools already in place, key contacts, etc.
– Provide space for gatherings of people to be
introduced to the toolbox
– Promoting the project to key, established
contacts and via existing communication
modalities (list serves, websites, newsletters)
covering kids & families

42. What we specifically want from
Cooperative Extension: cont’d.
• Level 2: A more involved ask – funding for
up to 5% FTE
– Promoting the project to less established contacts
– Attending gatherings of people getting introduced
to REACH BC+
• Level 3: Community collaborator – funding
for up to 10% FTE
– Help to develop the train the trainer package (a
refinement of our Toolbox)
– Get trained to deliver and delivering the BC+ 101
training
– Get trained to field and fielding initial technical
assistance requests in the wake of BC+ 101
covering kids & families

43. Why This Project, Why Now
• Virtually all kids, regardless of income, are
eligible
– Yet, 83,000 children (8%) were uninsured for all or
part of 2008
– Three-quarters of these children were eligible for
BadgerCare Plus
• Tough economy means there are newly
eligible families all the time, some brand
new to seeking public assistance
• Information campaigns alone may not be
enough
• Federal health reform causing additional
confusion
covering kids & families

44. Why This Project, Why You: Cont’d.
• Schools offer a semi-captive audience in a
trusted environment, are interested, doing
some work already, have systems, need help.
• At a time when county boards are asking
Extension to be more involved with helping
vulnerable families through these difficult
economic times, your engagement is not only
an asset for our work, but highly relevant to
your community needs.
covering kids & families

45. What We’ve Learned
• Provide localized outreach tools
• Tailor outreach strategies to district
capacity
• Build capacity among school staff
• Provide simple, accessible training tools on
BadgerCare Plus
• Strengthen community partnerships
• Integrate systems to collect and share
insurance information
covering kids & families

46. Helping Schools Help Families
Get Health Insurance
1. Assess local capacities and level of interest
a. What are you already doing that could
be adapted to include health insurance
outreach and/or enrollment assistance?
b. Who is there to help?
Challenges:
 Identifying and connecting with the
right people
 Navigating existing (and highly variable!)
school systems
covering kids & families

47. Helping Schools Help Families Get
Health Insurance
2. Enlist & Cultivate local partners
a. Make/re-affirm local connections
b. Provide training for MA/SCHIP
enrollment
Challenges:
 Fostering “buy-in”
 Keeping expectations realistic
 Need for on-going technical assistance
covering kids & families

48. Helping Schools Help Families Get
Health Insurance
3. Determine outreach strategies
a. Select and adapt materials for student
population
b. Strategies differ through targeting
specific populations, and by level of
intensity of personal contact
Challenges:
 Choosing strategies that complement
existing activities
 Data sharing agreements and data
sharing itself can be time intensive and
complex processes
covering kids & families

49. Helping Schools Help Families Get
Health Insurance
4. Implement outreach strategies
Challenges:
 Time & Energy
 Following through beyond providing information
5. Assess, evaluate, modify, assess, evaluate…
Challenges:
 Isolating the effects of outreach efforts on
changes in knowledge, attitudes, or coverage
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50. CHILD outreach strategies
covering kids & families

51. CHILD Project outcomes
and methods used for
measurement
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52. covering kids & families

53. Funding
2003-2007
Robert Wood Johnson, “Covering Kids & Families”
2007-2010
UW School of Medicine and Public Health’s Wisconsin Partnership Program (March 2007-
November 2010)
The Healthier Wisconsin Partnership Program, a component of the Advancing a Healthier
Wisconsin endowment at the Medical College of Wisconsin (July 2007-June 2010)
Federal funding has also been made available through the Wisconsin Department of Health
Services.
Beckner Funds; Evjue Foundation; Centene Foundation; UW Extension Cross-Divisional Award
Current
Helen Bader Foundation (July 2010-June 2012)
Ira and Ineva Reilly Baldwin Wisconsin Idea Endowment (July 2010-June 2013)
Wisconsin Department of Health (CHIPRA)
UW School of Medicine and Public Health’s Wisconsin Partnership Program (March 2010-
February 2013)
covering kids & families

54. Contact Us
covering kids & families
Caroline B. Gomez, Outreach Specialist
608-261-1455
cbgomez@wisc.edu
Michael Jacob, Project Coordinator
608-261-1455
mbjacob@wisc.edu
Covering Kids & Families Website
www.ckfwi.org
covering kids & families