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Jesse Trice Community Health Center, Inc. (JTCHC)

Miami, FL, 33142

Project: JTCHC, ACA Marketplace Enrollment Project

Amount: $250,000

Project Abstract
Jessie Trice Community Health Center, Inc. (JTCHC) recognizes that many of its community members do not fully understand the Affordable Care Act (ACA), the Health Insurance Marketplace (Marketplace), or the health center services that JTCHC provides.  Many in this under-served and hard to reach minority population, those primarily of African-American, Hispanic, Haitian, and Caribbean heritage, have not yet enrolled in the Marketplace. Additionally, significant disparities exist related to gender, age, race/ethnicity, geographic area, and socioeconomic status. The area is also a Health Provider Shortage Area and Medically Underserved Area.
To help the uninsured obtain health insurance, JTCHC proposes to conduct culturally and linguistically appropriate community-based outreach, education, and enrollment activities tailored to provide access for the communities of Hialeah, Opa-Locka, Miami Gardens and the surrounding areas. The target population includes the medically uninsured and underinsured residents of these communities, many of whom are the working poor (i.e., those below 200% of the Federal Poverty Level). The majority of the target areas have English as their first language; Spanish speakers (28.3%) and Haitian Creole speakers (2.8%) account for about a third of the target population. Chronic diseases such as HIV/AIDS, diabetes, heart disease along with behavioral health issues in the target areas are disproportionally higher than the county rate.

The project will use a multi-lingual/multi-cultural team to conduct ACA-related outreach, provide education on the Health Insurance Marketplace, utilize health information resources and brochures from Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) websites, and assist with enrollment, completion of the application to determine eligibility, and purchase of health insurance offered through the Marketplace. Outreach activities include identifying and assisting individuals to apply for health insurance coverage offered through the Health Insurance Marketplace and providing preventive health education regarding chronic disease management, access to quality health care, and appropriate utilization of health services. Staff will use culturally competent engagement techniques that include brief interventions, motivational interviewing, and non-judgmental strategies to interact with community members. One-on-one and group workshops for consumers will be conducted regarding accessing and obtaining Marketplace health insurance and related information. 

Outreach events will include workshops, tables and presentations at health fairs, and education sessions held at faith-based organizations. These activities will be held in conjunction with a Mobile unit, which allows staff to provide outreach and education directly in the community. In addition to the ACA-related education, staff will also educate community members about healthy behaviors; and, by using Motivational Interviewing (a goal-directed, client-centered counseling for eliciting behavioral change) and Trans-Theoretical Model-based Stress Management (TTM) (a process encouraging clients to use self-management techniques and to participate in their own health and wellness), the unit will focus on cardiovascular disease, hypertension, diabetes, nicotine addiction, HIV infection, and behavioral health disorders.

JTCHC has contracted with Behavioral Science Research Institute (BSRI) to carry out the evaluation, who will utilize the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework for evaluation.  BSRI will meet with Enroll America project leaders to obtain updated numbers on enrollment. This information will be combined with other process data from community partner outreach efforts and other supplemental qualitative data to strategically decide where to target additional outreach, educational, and enrollment efforts by zip code. Chi-Square tests will be used to determine if differences exist in the percentages of clients receiving services based on demographic variables. BSRI will also generate Performance Assessments to include qualitative and quantitative accomplishments, barriers and key issues to be reviewed by project staff to help improve program activities. In addition to the performance, process, and outcome measures, qualitative data will be collected through survey and brief interviews from clients at educational and outreach events, including information related to: barriers to securing or retaining coverage in the past, satisfaction with the ACA enrollment process, health coverage needs that are most pressing, and ideas about increasing individual coverage for their communities.

Progress on meeting performance measures will be assessed through data from radio spots to indicate listenership; the number of pamphlets and flyers printed and distributed; and, the number of “likes,” “views,” and “retweets” on social media. JTCHC staff will collect data on how the client learned about the project. Trainings for CHWs and for new hires will be monitored based on hours spent and learning webinars required. Data collected during education events will include race, age, and current insurance coverage. In addition, smaller events will collect information from participants about increases in education and/or awareness related to the ACA. Application and enrollment data will be tracked via an excel database based on zip code, gender, race/ethnicity, age, insurance coverage, preferred language, awareness, enrollment success, and event type.

Process measures include:

  • Number of community members reached via social media;
  • Number of community members reached via other forms of media;
  • Number of consumers engaged via individual outreach (by sociodemographic variables and awareness of Marketplace/ACA);
  • Number of staff receiving training (to become CHWs and/or Certified Application Counselors or receiving continuing education);
  • Number of consumers who receive education materials;
  • Number of consumers receiving individual or group education;
  • Number of clients filling out a Marketplace application; and
  • Number of clients receiving coverage via a successful application.

Anticipated project results include increased awareness of the benefits and requirements of the ACA, increased enrollment of minority populations in private insurance through the Marketplace or Medicaid/CHIP, and increased awareness of health disparities and available resources designed to address, develop, or improve health equity.

Awareness: Increase awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic, and underserved populations.
Cultural and Linguistic Competency: Improve cultural and linguistic competency and the diversity of the health-related workforce.


  • AHS-1: Increase the proportion of persons with health insurance.

11/12/2015 6:28:00 PM