Office of Minority Health

AltaMed Health Services Corporation

Los Angeles, CA, 90040

Project: Increasing Health Care Coverage for Underserved Communities in Los Angeles and Orange Counties

Amount: $249,898

Project Abstract

AltaMed’s primary service area of Los Angeles and Orange counties is in need of outreach, education, and enrollment services for predominately Latino communities who are eligible for Covered California, Children’s Health Insurance Program (CHIP), and expanded Medicaid (Med-Cal).   These underserved communities possess some unique characteristics, making them particularly difficult to serve. The communities that AltaMed serves are primarily Latino, low-income, and have significantly higher uninsured rates than the county and state averages. Latinos account for over two-thirds of the uninsured adults and Latino children account for over 80 percent of uninsured children in LA County. This project seeks to address the health disparities that affect low-income, primarily Latino constituents by helping to increase enrollment in health coverage. AltaMed also hopes to touch hard-to-reach young adults/adolescents, immigrants, people living with HIV, and non-English speakers.

AltaMed has developed a 3 Touch Protocol–a robust outreach, education, and enrollment process–that has been successful in recent years with the underserved communities, engaging consumers and connecting them to coverage. Touch 1: Outreach and Education includes leveraging AltaMed’s Youth programs and new media options to reach young persons, partner with family-serving organizations, and offer services, materials, and assistance in Spanish. It will use convenient community venues such as supermarkets, faith centers, and schools to address transportation barriers. The program will provide true cost saving figures of enrolling in health insurance to consumers to reduce anxiety and confusion about the cost of coverage, and will provide in-person assistance for the online application for individuals with limited internet familiarity. There will be community events held with and at partner organizations and a mobile outreach vehicle. The vehicle will bring outreach events to schools, supermarkets, and health fairs. The mobile unit will provide some primary care services, health screenings, and eligibility screenings. Outreach through social media will also be conducted to disseminate information about outreach activities through video production and monthly employee or patient spotlights.

Touch 2: Enrollment Assistance includes enrollment aid through small group workshops, one-on-one guidance in the field, and AltaMed’s health enrollment centers. AltaMed will provide educational and enrollment assistance at its community events, using internet capable tablets and printers/scanners in the field to assist consumers.
Touch 3: Follow up and Connection to Care consists of follow up and connection to care for clients reached by Touch 1 or Touch 2. Community Health Workers (CHWs) will follow up via telephone or mail after several weeks to assess if enrollment was successful. Once successful, staff will help link the consumer to a primary care provider. 
The expected outcomes of this project include providing outreach, education, and enrollment services to 38,795 individuals, focusing primarily on non-elderly Latino individuals and families; completing 2,000 applications through Covered California, CHIP, and Medi-Cal; and, supporting an additional 859 eligible individuals through retention and redetermination services to retain enrollment in private insurance, CHIP, and Med-Cal.

To evaluate the program, AltaMed will generate a daily dashboard from its monitoring and tracking systems, Customer Relations Management (CRM) and NextGen (AltaMed’s Electronic Medical Record), to assess progress toward reaching monthly goals for application completion and approval. CRM allows for longitudinal tracking of encounters through retention of accurate contact information, tracking of completed applications, access to verify enrollment, and access to set appointments for the consumer. NextGen will facilitate follow up with the consumers, and, if needed, conduct additional eligibility screenings for other programs. To track effectiveness of outreach activities, process and outcome measures will be reviewed on a bi-weekly and monthly basis. Process measures include:

• Total number of underserved and hard to reach populations (primarily Latinos) served through outreach, education, and enrollment activities for each budget year;
• Number of workshops for consumers on accessing and obtaining health information;
• Number of persons receiving Covered California informational materials during community outreach events;
• Number of CHWs trained and completing California Certified;
• Types of culturally and linguistically appropriate communication strategies used to effectively reach underserved Latino populations; and
• Number of presentations and types of displays and/or materials available to community-based organizations, faith-based organizations, and others for the purpose of outreach to culturally diverse and hard-to-reach Latino populations in English and Spanish.

Outcome measures include:

• Number of individuals from underserved and hard to reach minority populations to apply for health insurance coverage offered through the Health Insurance Marketplace;
• Number of persons enrolled in private insurance through Covered California, CHIP, and/or Medi-Cal; and
• Number of persons assisted with retention/redetermination applications to maintain coverage, and number of persons assisted with setting primary care appointments after enrollment.

NATIONAL PARTNERSHIP FOR ACTION TO END HEALTH DISPARITIES GOALS
Health System and Life Experience: Improve health and healthcare outcomes for racial, ethnic, and underserved populations.
Cultural and Linguistic Competency: Improve cultural and linguistic competency and the diversity of the health-related workforce.

RELATED HEALTHY PEOPLE 2020 OBJECTIVES & SUBOBJECTIVES

• AHS-1: Increase the proportion of persons with health insurance.
• AHS-3: Increase the proportion of persons with a usual primary care provider.
• AHS-5: Increase the proportion of persons who have a specific source of ongoing care.