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U.S. Department of Health and Human Services

Office of Minority Health

Office of Minority Health (OMH) Logo


Gateway to Care (GTC)

Houston, TX 77004-4407

Project: Together We RAISE Minority Enrollment (RAISE)

Amount: $250,000

Project Abstract

The Together We RAISE Minority Enrollment (RAISE) project is specifically designed to increase awareness and enrollment of the Health Insurance Marketplace and Medicaid/CHIP in three predominantly minority neighborhoods (Spring Branch, North Forest, and Briar Park) in Harris County, Texas. Within Harris County, 41 percent of the population is Hispanic, 33 percent Caucasian, 19 percent African American, and 6 percent Asian American – with 27 percent of the total population uninsured, the highest rate among the Nation’s top 10 metropolitan areas, and 34 percent of 18-64 year olds uninsured.

Through a Gateway to Care (GTC) Collaborative comprised of over 167 member and affiliated organizations, the target populations will receive culturally and linguistically appropriate materials, participate in outreach events, consumer workshops and other community-driven activities, and be provided with education and guidance on ACA-related enrollment and application processes. Outreach practices proposed include engagement of ethnic media (e.g., Univision) for broadcast of public service announcements (PSAs); use of a multi-platform media campaign involving television, radio, and online spots as well as newspapers and magazines; community-based events such as health fairs, enrollment fairs/’blitz’ campaigns; and, provision of regular assistance at various community locations (e.g., grocery stores, churches, and schools). These interventions will be provided by the partnering agencies who will then refer applicants to RAISE Community Health Workers (CHWs) to conduct intensive enrollment and retention efforts. RAISE CHWs live and work in the targeted communities, will be trained through GTC’s CHW Training Institute, and utilized as the principal ‘neighbor-to-neighbor’ conduit for recruitment, education, and enrollment assistance in the Health Insurance Marketplace and Medicaid/CHIP. Training materials developed by GTC and Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) will be used to train the CHWs. Through all of the project’s planned activities and materials, adoption and implementation of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care will be promoted.

Expected results include increased awareness of the benefits and requirements of the Affordable Care Act, increased enrollment into Marketplace insurance plans, Medicaid/CHIP, and increased utilization of health coverage. GTC will partner with the University of Texas School of Public Health Houston Health Services Research Collaborative to develop and implement an evaluation plan for the project with appropriate process and outcome measures.  A process evaluation will include activities and outputs of project staff and partners, comparing process information to the program’s initial expectations.

An impact evaluation will assess client perceptions of CHW services and continuity of client enrollment through a telephone survey of a random sample of clients after receipt of CHW services.  Clients will be asked questions regarding ACA and Medicaid/CHIP enrollment, utilization of health care services, and their perception of CHW services.  Data from this survey will also help determine the percentage of underserved minorities who received CHW services who plan on enrolling in the Health Insurance Marketplace, Medicaid or CHIP, and believe that CHW services assisted them in obtaining awareness of the health insurance marketplace, coverage, and care.

Process measures will be regularly collected and reported using a web-based, Structured Query Language (SQL) database (Web-Nav), utilized by GTC since 2004 to track CHW/Navigator services. It will be tailored to the reporting needs of the RAISE project and utilized by the GTC CHWs/Navigators to document client demographics and interactions during this project to report performance measures such as: 

  • Total number of underserved and hard-to-reach populations served through outreach and awareness campaigns;
  • Number of minorities per ethnicity enrolled in private insurance through the Marketplace or Medicaid/CHIP;
  • Number of workshops for consumers;
  • Number of individuals from underserved hard-to-reach minority populations to apply for health insurance;
  • Number of persons receiving appropriate and available informational materials from HHS, CMS, and others;
  • Number and type of culturally and linguistically appropriate communication strategies to reach underserved minority populations;
  • Number and type of Marketplace education and enrollment assistance promoted through partners’ websites, newsletters, etc.; and
  • Number of presentations, displays, and/or materials available to community-based organizations, faith-based organizations, and others.


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.
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.


  • AHS-1: Increase the proportion of persons with health insurance.
11/12/2015 6:33:00 PM