Turning Research Into Practice: Grassroots Strategies for Enrollment

1
Turning Research Into Practice Grassroots
Strategies for Enrollment

• Cheryl Meronk, MSG
• HICAP Program Manager
• Council on Aging Orange County

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Who We Are

• The local SHIP (State Health Insurance Assistance
  Program)
• Known in CA as HICAP Health Insurance
  Counseling and Advocacy Program, managed locally
  by the Council on Aging Orange County
• Provide unbiased information advocacy about
  Medicare and related insurance
• One-on-one counseling
• Community Education

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Coalition Building

• Social Security
• Social Services Agency
• County Office on Aging (AAA)
• Legal Aid Society
• Low Income Housing Service Coordinators
• Latino Health Access
• Asian American Senior Citizens Service Center

4
Coalition Building

• Linkages Case Management Program
• LTC Ombudsman Program
• 3 Elderly Nutrition Programs
• Public Health Nurses
• Community Action Partnership
• County Mental Health Older Adult Services
• Dayle McIntosh Center
• Alzheimers Association

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LIS Enrollment

• 330,000 Medicare beneficiaries in Orange County
• 55,000 dual eligibles
• Approx. 20,000 with income lt150 of poverty level
  and not on Medi-Cal (CA version of Medicaid)
• 637 enrollments
• Sept. 05 Feb. 06
• Kaiser Family Foundation Analysis, July 2003

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Outreach Strategies

• Community Education programs
• Sept. 05 Feb. 06
• 262 presentations
• 10,434 attendees
• Senior centers (congregate meal bingo programs)
• Senior groups
• Disability support groups
• Civic clubs
• Aging services professionals
• Medical groups (physicians)
• Partner with Social Security

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Outreach Strategies

• Train all coalition partners on LIS information
  and how to screen their clients for call center
  referrals or enrollment assistance
• SHIP volunteer staff counselors
• AAA Information Referral Specialists
• County mental health services
• Section 8 housing service coordinators
• Elderly Nutrition Program case managers
• Linkages Program case managers
• Community Action agency food bank
• LTC Ombudsmen
• 80 Skilled Nursing Facilities
• 400 Board Care/RCFEs

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Enrollment Strategies

• SHIP Counselors
• 14 staff (most part time)
• 35 volunteers
• 55 counseling sites throughout Orange County
• Call center toll free local numbers
• 5 days week, 8 hours/day
• 6 incoming phone lines
• 2-7 telephone counselors at any time
• High call volume
• 26,466 calls Sept. 05 Feb. 06
• Call center collaboration with AAA (call
  transfers)

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Enrollment Strategies

• Enrollment events
• Partnered with Social Security
• Walmart
• Special Events
• Senior centers
• Computer labs
• Leisure World
• 600 attendees
• On-site events difficult, as many people come
  unprepared to answer enrollment questions

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Obstacles

• Eligibility
• Already receiving Medi-Cal (Medicaid) benefits
• Assets too high
• Language barriers
• Limited language capabilities Spanish,
  Vietnamese, Chinese, Korean
• Populations of Persian, Russian, Samoan,
  Marshallese and other LEP seniors not being
  reached
• Mistrust of government entities
• Low attendance at Social Security sponsored
  enrollment events
• Misperceptions about program
• Not understanding benefits
• Misinformation
• Estate recovery
• eligibility

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Lessons Learned

• Better eligibility data needed
• Enlist trusted community partners
• List-driven strategies
• Cultural and language capabilities
• On-site enrollment important for establishing
  trust in community
• However, much less efficient than call center
• Call center strategy key

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Questions?