CHIP EDUCATION PROJECT Karin Dunn HCHD/Gateway to Care.

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Presentation transcript:

CHIP EDUCATION PROJECT Karin Dunn HCHD/Gateway to Care

Origins  Mandated by the 1999 Texas Legislature to determine efficacy in reducing costs when using peer-to- peer educators Community Health Workers Promotores de Salud Lay Health Workers About 70 other titles  Project Started in January 2006 and projected to continue to December 2008, serving 8,103 families

Project Overview  Educate Harris County CHIP families on how to appropriately use benefits PCP as “medical home” Ancillary Benefits (Dental & Vision) Case Management Identify barriers to use (language/culture, transportation, etc.)  Provide options to overcome Insure that parents have HMO’s member service line number and nurse triage lines

Referral Mechanisms  Provided by Health Plans based on self-defined criteria Emergency Room Usage (frequent/primary care related) Near end of term  Navigators identified from patients of clinics where they are co-located  Since June 2007, have received a sample of newly enrolled families on CHIP directly from HHSC

Served through Febuary 29, 2008  Educated 4,877 families  Another 1,213 were educated, but were off CHIP as time of service

Findings to Date  Parents are confused by Program due to multiple changes over past 5 years and multiple errors encountered  Parents do not understand how managed care fits into benefits package – do not understand that member service line is available for problems with providers or for other issues

Findings - continued  Parents do not understand that ancillary benefits available – dental & vision  Parents have no knowledge of plan- provided nurse triage line  Parents do not know who to notify of address change  Families with child(ren) moving from Medicaid are often moved to another health plan.

Additional Outcomes  Community Health Worker Training Institute 5 certification classes (160-hour each) Continuing Education classes to maintain certification CHW Regional Symposium Navigator Associates Training