1. CHIPRA MENTOR ORIENTATION
CHILDREN’s HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT

2. What would your 15 year old self want to know about health care?
Post-It Notes
What would your 15 year old self
want to know about health care?

3. Presenters Wiliam Celestine Director Wellness Programs
Student Health and Human Services
Jeanne Aguinaldo
Student Engagement Program Director
The L.A. Trust for Children’s Health
Nina Lee Nguyen, M.P.H, CHES
Project Coordinator

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

5. Overview of CHIPRA Teen Leader Project

6. What is CHIPRA?
CHIPRA stands for Children’s Health Insurance Program Reauthorization Act
Signed by President Obama on February 4, 2009
Support states with funding to develop 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)
Centers for Medicare and Medicaid Services announced $3.7 million in awards for outreach and enrollment efforts
Overview of LAUSD’s CHIPRA Project

7. 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
LAUSD was one of the recipients of that award, the district applied for a 2-prong approach
Educate Parents and Families-led by the Parent Community Services Branch
Educate Youth, which we are contracted to do
Overview of CHIPRA in LAUSD

8. 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

9. The L.A. 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

10. 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 basics of Medi-Cal and how to facilitate access enrollment and assistance through CHAMP
387 Teen Leaders
4619 trusted adults
Overview of CHIPRA in LAUSD

11. 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 30
12 Trusted Adults
The impact of outreach and awareness!
Overview of CHIPRA in LAUSD

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

13. Health Insurance 101

14.
What is Health Insurance?

15. Mentors explain…
What is health insurance? How does it work? What are the types of health insurances?
How do your students define health insurance? What is their understanding of how it works? Their families may have different kinds of coverage?
What is Health Insurance?

16. What is Insurance?
Insurance is a contract (called a policy) between you and the insurance company that says the insurance company will pay a portion of your expenses in case something happens (such as in the previous scenarios).
There is car insurance, medical insurance, life insurance, homeowner’s insurance, etc.
What is Health Insurance?

17. 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

18. 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

19. 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

20. Health Plans to Choose From
Health Maintenance Organization (HMO)
No deductible but there is copayment
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
What is Health Insurance?

21. Health Plans to Choose From
PREFERRED PROVIDER ORGANIZATION (PPO)
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)
What is Health Insurance?

22. Why is this all important?
Health care access is a human right
When you have access to primary prevention (vaccines, cancer, STD and diabetes screening) you avoid getting sicker and stay healthier longer
Having insurance can avoid a family falling into deeper poverty through a catastrophic incident
Students who are healthier do better in school
Discuss the Risk your Pennies Game
What is Health Insurance?

23. Covered CA, Medi-Cal, CHIP

25. Affordable Care Act
The Patient Protection and Affordable Care Act (ACA), also known as ObamaCare is a Federal law passed in March 2010, that changes how people get health care in the US.
Parts of the Law:
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
Free preventive care (for ex. vaccine or cancer screenings)
The ACA creates health benefits exchanges. In California, it is called Covered California.
Covered CA and Medi-Cal 101

26. 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

28. Covered California
Covered CA is the health insurance marketplace where you can compare and choose from 10 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.
Covered CA and Medi-Cal 101

30. Covered California
Health Insurance 101

31. Covered California
Health Insurance 101

32. 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

33. OPEN ENROLLMENT 2018 OCTOBER 11, 2017*-JANUARY 1,2018
Covered CA Renewal Period Begins
NOVEMBER 1, 2017
Covered CA Open Enrollment Begins
JANUARY 31, 2018
Open Enrollment Period Closes
JANUARY 1, 2018
Health Benefits Begin on this Date!
YEAR-ROUND
Qualifying Life Changing Events = Special Enrollments
Medi-Cal and CHIP Enrollments Anytime
Covered CA and Medi-Cal 101

34. 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.
1965 Passed Medicaid Law
Health Insurance 101

36. Medi-Cal
Always covers low-income children, pregnant women and families.
Citizens and lawful permanent adults must earn no more than 138% of federal poverty level
Los Angeles
Health Net Community Solutions, Inc
L.A. Care Health Plan
1965 Passed Medicaid Law
Health Insurance 101

37. Health Insurance 101

39. What is CHIP?
The Children’s Health Insurance Program (CHIP) was signed into law in The program provides health coverage to eligible children and pregnant women through Medicaid.
In California, 1.3 million children are covered by CHIP
Funding is currently in Jeopardy since reauthorization expired September 30, 2017
Overview of LAUSD’s CHIPRA Project

41. 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

42. 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

43. 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

44. 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

45. Medi-Cal 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.
Covered CA and Medi-Cal 101

46. 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.

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

49. 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

50. 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

51. 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

52. 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?

53. 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

54. Website: https://achieve.lausd.net/weareone

55. Teen Leader Project

56. 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

57. Recruit, Train, Support

58. Recruiting Teen Leaders
Who do I recruit?
10th - 12th graders in good academic standing
For Fall 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

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

60. Training Teen Leaders Secure a location for the training
Schedule one-hour trainings (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

61. Risk Your Pennies Game
Recruit, Train, Support

62. 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

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

65. L.A. Trust Staff Support
Second week of November, Nina 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

66. Debrief Meeting Required de-briefing for Teacher Advisors
Thursday December 7th, 5-7pm
Location: Beaudry building TBA
Required documentation for stipend payment
Submit calendars, contact logs, meeting sign-in sheets, student evaluations, and extra materials

67. 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?

68. 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

69. 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.”

70. Teen Leader Project

71. 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
CHAMP Flyers and Card (ENG/SPAN) per Leader

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