1. CHIPRA MENTOR ORIENTATION
CHIPRA TEEN LEADER PROJECT

2. Post-It Notes What do you hope to get out of this project?
What do you hope teens would get out of it?

3. Presenters Dr. Kim Uyeda, MD, MPH Director Student Medical Services,
Community Partnerships & Medi-Cal Programs
Jeanne Aguinaldo
Student Engagement Program Director
The L.A. Trust for Children’s Health
Nina Lee Nguyen, M.P.H
Project Coordinator

4. Mentor Orientation Agenda
1. Overview of LAUSD’s CHIPRA Project
2. Health Insurance 101 (Covered CA & Medi-Cal)
3. LAUSD’s CHAMP
Break
4. Teen Leader Project
5. Recruit, Train, Support
6. Wrap Up

5. Overview of CHIPRA in LAUSD

6. What is CHIPRA?
The Children’s Health Insurance Program (CHIP) was signed into law in 1997 The program provides health coverage to eligible children through Medicaid
The program is administered by states, and funded jointly by state and federal government.
The U.S. Census Bureau showed that in 2008, 7.3 million children did not have health insurance coverage that year.
Overview of LAUSD’s CHIPRA Project

7. What is CHIPRA?
CHIPRA stands for Children’s Health Insurance Program Reauthorization Act
Signed by President Obama on February 4, 2009
The Act support states in developing efficient and effective strategies to identify, enroll, and retain health coverage for uninsured children who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP), but not enrolled.
Overview of LAUSD’s CHIPRA Project

8. Who is Involved? Overview of CHIPRA in LAUSD LAUSD
Parent Community Services Branch Outreach
The L.A. Trust
Teen Leader Project
CHAMP and Healthy Start enrollment
Overview of CHIPRA in LAUSD

9. History of the Teen Leader Project
LAUSD has a history of successfully using youth engagement to positively impact community health through outreach and education efforts.
Blood pressure screenings and education in Latino community
Changing attitudes and behavior through the Students for Nutrition and eXercise (SNaX) program
Covered CA Outreach & Education Teen Leader Project
Overview of CHIPRA in LAUSD

10. The L.A. Trust for Children’s Health
TEEN LEADER PROJECT subcontracted to
The Los Angeles Trust for Children’s Health
The L.A. Trust is a non-profit organization working to improve the health of children of LAUSD. Our mission is to increase student health and readiness to learn through access, advocacy and programs.
Overview of CHIPRA in LAUSD

11. Goal of CHIPRA Teen Leader Project
Through trained mentors and teen leaders, fourteen thousand four hundred (14,400) relatives, adult family friends or neighbors will receive educational information about:
The importance of health insurance to stay healthy
The requirements in U.S. to have health coverage
The basics of Medi-Cal and how to facilitate access enrollment and assistance through CHAMP
Overview of CHIPRA in LAUSD

12. Each Teacher or Certificated Staff
The Role of Teachers
Train the Trainer Model
15-20 Teen Leaders
Each Teacher or Certificated Staff
Up to
500 Students
3000
1000
2000 25
12 Trusted Adults
The impact of outreach and awareness!
Overview of CHIPRA in LAUSD

13. CHIPRA is also known as ___________________.
Check Your Knowledge!
CHIPRA is also known as ___________________.

14. Health Insurance 101

15.
Health Insurance 101

16. What is Health Insurance?
“A contract that requires health insurer to pay some or all of your health care costs in exchange for a premium.”
Healthcare.gov, U.S. Centers for Medicare & Medicaid Services
Health Insurance 101

17. How does health insurance work?
Members pay a monthly (or semi-annual or annual) premium to the insurance company
People can have “employer-based” health insurance through their jobs. Employer will pay a portion of premium, and you pay a portion out of your paycheck
The policy spells out what services the insurance company will cover and how much of the bill you have to pay out of pocket.
Health Insurance 101

18. How much does insurance cost?
Depending on what type of plan and coverage that you have, prices for co-pays, deductibles, and other out-of-pocket expenses can vary.
Co-pay: This is a way of sharing medical costs. You pay a flat fee every time you receive a services. (e.g. $20 for every visit to doctor)
Deductible: The amount you must pay each year to cover your medical expenses before insurance starts paying.
Health Insurance 101

19. What are the types of plans?
Health Maintenance Organization (HMO)
PREFERRED PROVIDER ORGANIZATION (PPO)
No deductible but there is copayment (correction: may be a low deductible)
Limited to seeking care from within the plan’s network of doctors
You can choose a primary-care physician, but you will need a referral from your primary-care physician to visit a specialist
Generally more affordable due to limitations
Deductible vary with the premium
Doctors, hospitals and providers are part of the PPO network, you can see doctors outside the network and receive partial coverage
A physician in the network requires co-payment
A physician outside network requires a coinsurance (you pay part of the bill)
Understanding how the system works
Health Insurance 101

20. What are the types of plans?
HEALTH SAVINGS ACCOUNTS (HSA)
Savings accounts that allow you to save money to pay for current and future medical expenses on tax-free basis
In order to be eligible, you must be covered by high- deductible health plan
Good option for individuals who want to protect themselves from high health care costs.
Health Insurance 101

22. Why America Needed the Affordable Care Act (ACA)
50 million Americans had no health insurance.
129 million Americans with pre-existing conditions could be turned away or taken advantage of, and often were.
Premiums were doubling every ten (10) years while corporate profits soared.
Health Insurance 101

23. Affordable Care Act
The Affordable Care Act (ACA) is also known as ObamaCare. It is a Federal law passed in 2010, that changes how some people get health care in the US
Under ACA, insurance companies can’t deny anyone care because they’re sick now or have been sick in the past (pre- existing conditions)
Covers children on parents’ health insurance policy until they turn 26 years old
The ACA creates health benefits exchanges. In California, it is called Covered California.
Health Insurance 101

24. Affordable Care Act ACA Accomplishments
Free preventive care; free annual check-ups
Standard forms in easily understandable language
Easy-to-use, online marketplace
Established 10 essential health benefits and minimum levels of coverage
Expanded Medi-Cal eligibility from 133% to 138% federal poverty level (FPL)
Health Insurance 101

25. Affordable Care Act 10 ESSENTIAL HEALTH BENEFITS (EHB):
Outpatient (Ambulatory) Services
Emergency Services
Hospitalization
Maternity and Newborn Care
Mental Health and Substance Use Disorder Services, including Behavioral Health
Prescription Drugs
Therapy (Physical and Occupational Therapy)
Laboratory Services
Preventive and Wellness Services & Chronic Disease Management
Children’s Pediatric Services, including Oral and Vision Care
Health Insurance 101

26. Covered California
Covered CA is the health insurance marketplace where you can compare and choose health plans
It can help people find out if they qualify for financial help to make insurance more affordable.
People can also find out if they’re eligible for low or no cost coverage through Medi-Cal.
Legal residents of CA who do not have health insurance from their employee or a government program can get coverage through Covered CA.
Health Insurance 101

27. Choose from silver, bronze, gold and platinum health plans
from 11 health insurance companies
Health Insurance 101

29. Covered California
Health Insurance 101

30. SIX (7) LA COUNTY’S APPROVED HEALTH PLANS
Covered California
SIX (7) LA COUNTY’S APPROVED HEALTH PLANS
Anthem Blue Cross of California
Blue Shield of California
Health Net
Kaiser Permanente
L.A. Care Health Plan
Molina Healthcare
Oscar Health Plan
Health Insurance 101

31. WHAT IF I AM ALREADY INSURED?
Covered California
WHAT IF I AM ALREADY INSURED?
Employer-provided: If your employer provides insurance, then you are probably okay. They are required by law to give you a letter stating the insurance provided by them meets Minimum Essential Coverage standards.
Medi-Cal Covered: Medi-Cal meets the Minimum Essential Coverage standards. You are covered!
Covered but It’s Expensive: If your employee share of the monthly premiums exceeds 9.5% of your household income, then you are able to opt out of employer-provided insurance and enroll into a Covered CA plan. Your employer is required to give you a voucher of equivalent value to use in the exchange.
Health Insurance 101

32. Covered California: Open Enrollment
OCTOBER 1
Covered CA Renewal Period Begins
NOVEMBER 1
Covered CA Open Enrollment Begins
JANUARY 1
Health Benefits Begin on this Date!
JANUARY 31
Open Enrollment Period Closes
YEAR-ROUND
Qualifying Life Changing Events = Special Enrollments
Medi-Cal Enrollments
*If the ACA continues to be a law by the end of the year.
If everything stays the same
Health Insurance 101

33. Covered California QUALIFYING LIFE EVENT
Exceptions exist for those who have qualifying life events. The law provides for individuals to enroll outside of open enrollment periods if they experience changes in their lives such as moving to a new state, changes to income, and changes to family status (including marriage, divorce, and the birth of a child).
Health Insurance 101

35. Medi-Cal
Medi-Cal is the State of California’s Medicaid health insurance program. Medi-Cal and the Children’s Health Insurance Program (CHIP) offer free or low cost health coverage for eligible children and other family members.
Health Insurance 101

37. Medi-Cal Health4AllKids
In 2015, Senate passed two bills (SB)75 and (SB)4, which changed Medi-Cal for children:
All income-eligible children (families earn <266% FPL) who are less than age 19 can enroll in full-scope Medi- Cal
Children with restricted-scope Medi-Cal will transfer to full-scope Medi-Cal without having to reapply
Children with Kaiser Permanente Child Health Program and Healthy Kids must apply for Medi-Cal
Health Insurance 101

38. Medi-Cal Health4AllKids
Medi-Cal does not share immigration information.
Children should apply for Medi-Cal now, even if they have other coverage or have family members with coverage.
Some families may have to pay a small premium for Medi-Cal.
Most families will need to select a health plan.
Health Insurance 101

39. Medi-Cal Health4AllKids
Medi-Cal Does Not Share Immigration Information
Children are no longer restricted based on immigration status. All children in California should qualify for Full Scope Medi-Cal, If they meet the income eligibility requirements.
Restricted Scope (“emergency” Medi-Cal): primarily undocumented adult immigrants.
Full Scope services not available under restricted-scope: dental, vision, ongoing primary, preventive, prescription, specialty care, mental health, & substance abuse.
Health Insurance 101

40. Medi-Cal Health4AllKids
Children should apply for Medi-Cal Now
Children in restricted scope should have been automatically moved to full scope on May 2016
Children should apply for Medi-Cal NOW even if they have other coverage such as:
Transitioning from Kaiser Child Health Program
Transitioning from local Healthy Kids
County health program (e.g. My Health LA)
Many of these programs do not track whether their kids have restricted scope Medi-Cal
Health Insurance 101

41. Medi-Cal Health4AllKids
Some Families May Have to Pay a Small Premium
Medi-Cal is free for kids with family income below 266% FPL ($2,794/month income for a family of 4)
Above that, Medi-Cal monthly premiums are $13/month/child ($39/month maximum per family)
No Medi-Cal co-pays* – treatment & medication without charge
Health Insurance 101

42. Check Your Knowledge!
California’s health benefits exchange is called ____________.
True or False? All income-eligible children can enroll in full-scope Medi-Cal regardless on immigration status.
True or False? Children who are currently enrolled in Kaiser Permanente Child Health Program or Healthy Kids, will automatically be enrolled/transferred into Medi-Cal.

43. CHAMP Children’s Health Access and Medi-Cal Program

45. Children’s Health Access and Medi-Cal Program (CHAMP)
CHAMP is part of the of Student Health and Human Services Division at Los Angeles Unified School District
CHAMP supports student academic achievement and promotes wellness by enrolling children and youth into health insurance programs.
CHAMP provides information to parents and district staff on free or low-cost health insurance options.
LAUSD’s CHAMP

46. CHAMP Services Covered CA (all ages)
CHAMP provides application assistance for the following programs:
Covered CA (all ages)
Medi-Cal (restricted/full-scope) (all ages)
CHAMP refers eligible clients to:
My Health L.A. (19 & up)
WIC, CHDP, CalWORKS and Other county/state/ federally funded programs
LAUSD’s CHAMP

47. CHAMP Services Over the phone enrollment assistance
In-Person assistance by appointment, with a HCA at one of the following Hub locations:
SEPA Center (Plasencia EL) 1379 Angelina St. Los Angeles 90026
Zelzah Clinic, 6505 Zelzah Ave. Reseda
Referral to any of 100 schools where Healthy Start staff offer enrollment assistance
Helping locate a certified application counselor in your area.
LAUSD’s CHAMP

48. Check Your Knowledge!
What is the name of the unit in LAUSD’s Student Health and Human Services Division that can assist families in enrolling in health insurance programs?

49. Repeal & Replace?
Health care advocates are advising people to continue applying for health insurance, either through Covered CA and Medi-Cal
CHAMP will continue to assist families with health insurance enrollment, information will not be shared with immigration authorities.
Any replacement to the ACA will not occur overnight
Covered CA and Medi-Cal 101

50. Teen Leader Project

51. Teen Leader Project
Step 1: Recruit active students to participate Step 2: Find a space and time to train the students with Teen Leader Training, CHAMP Video, and Resources Step 3:Ensuring personal safety Step 4: Provide on-going support and guidance Step 5: Ensure accountability for Contact Log Step 6: Collect Contact Log, Contact Sheet by April Step 7: Evaluate Teen Leader Project
Teen Leader Project

52. Recruit, Train, Support

53. Recruiting Teen Leaders
Who do I recruit?
10th - 12th graders in good academic standing
For Spring 2017, recruit minimum of students
Follow school policy on parent permission for participation
Check into school’s service learning requirements
Emphasize on the service-learning component
Recruit, Train, Support

54. Recruiting Teen Leaders
Spread the word with flyers, announcements, info meeting, etc.
Customize the Flyer with Your Name and Room Number
Recruit, Train, Support

55. Training Teen Leaders Secure a location for the training
Schedule two-hour training (one-time after school or separate in 2-3 sessions)
Teen Leaders are providing outreach and education. They are NOT Certified Enrollers
Personalize your training with anecdote to make the experience more meaningful for your leaders.
Recruit, Train, Support

56. Risk Your Pennies Game
Recruit, Train, Support

57. Support and Guidance Ensuring personal safety
Teen Leaders should only provide outreach and education to trusted adults (e.g. relative, neighbor, family friend)
Teen Leaders should not be outreaching to strangers, going door-to-door, or out in public spaces
Providing on-going support and guidance
Have weekly check-ins
Make yourself available for questions
Recruit, Train, Support

58. Support and Guidance Ensuring accountability for Contact Log
Teen Leaders need to make 12 contacts
At check-in meetings, get updates on Contact Log, ask Teen Leaders about their experience, review Questions
Recruit, Train, Support

60. L.A. Trust Staff Support
End of March, Staff will and contact everyone to check the progress of the project at your school
Staff will be available to provide support for your trainings (photo opportunities)
Staff will respond quickly to s or phone calls

61. Debrief Meeting Required de-briefing for Teacher Advisors
Monday, April 24th, between 5-7 p.m.
Or Monday, May 1st, between 5-7 p.m.
Location: Beaudry building TBA
Required documentation for stipend payment
Submit calendars, contact logs, meeting sign-in sheets, student evaluations, and extra materials

62. Check Your Knowledge! What grade levels can Teen Leaders come from?
Teen Leaders should only outreach and educate ____________adults.
How many contacts are students asked to reach?
When is the next Debrief meeting?

63. Best Practices from Previous Cohorts
“I found it helpful to have the seniors present to older peers”
“I encouraged students to use Thanksgiving break to talk to adults”
“Used an existing Government class period 6 and took from there”
“Announcements didn’t work, personal recruitment did”
“Students were assigned a reflection paper, got positive feedback”
Recruit, Train, Support

64. Teen Leader Project Successes
Some evaluation responses from past CHIPRA Teen Leaders:
“In the future I would like to go into public health, and an important component of health is that people have covered services.”
“I liked being able to educate people about something that could really benefit them.”
“I do want to continue because I want to help others and it helped me a lot with social skills.”

65. Teen Leader Project

66. Post-election Resources
LAUSD Student Health and Human Services
Extended Support Sites at 8 locations throughout the district
Open weekdays from 8:00 a.m. to 4:30 p.m.
Hotline number: (866)
For more resources on immigration, mental health, DACA policies, refer to:

67. Review Materials Teen Leader Toolkit
Inside Each Teen Leader Folder
1 packet of Training slides
1 Leader-Education and Outreach Guide
1 Medi-Cal Factsheet
1 Teen Leader Survey
12 Sheets of Contact Logs
12 CHAMP Flyers and Card (ENG/SPAN) per Leader
Swag: The L.A. Trust Pencils

68. The L.A. Trust Teen Project contact: Jeanne Aguinaldo
Nina Nguyen