1. OUTREACH & ENROLLMENT Effective Strategies Leticia Cazares, MPH Director of Outreach San Ysidro Health Center

2. SYHC PATIENT DEMOGRAPHICS South (near U.S./Mexico border) and Southeast San Diego 85,731 patients (9 primary clinic sites) 76% Latino 90% below 200% Federal Poverty Level 82% better served in a language other than English 50% under age of 24 53% Uninsured (2013)

3. SYHC O/E PROGRAM Funded by Covered CA and HRSA 6 Certified Educators 18 Certified Enrollment Counselors (Eligibility Specialists)  13 clinic-based  4 community-based* 3 Retention Counselors * Will hire additional 4 counselors in October 2014 – stationed at storefronts and partner sites

4. KEY LESSONS LEARNED 1. Training and technical support must be customized to meet the needs and literacy levels of the O/E staff. State training and support is not enough! 2. O/E implementation requires everyone in the organization to be engaged, educated on basics, understand their role, updated on changes to be successful and sustainable. 3. O/E materials must be culturally-appropriate and tailored to address myths, priorities and literacy needs of the target population. 4. Health literacy is very low, requiring longer appointments. More educational opportunities are needed outside of the individual face-to-face enrollment appointment. 5. An efficient data collection process/system is critical

5. EFFECTIVE O/E STRATEGIES 1. Train/educate all possible “messengers” 2. Customize training for Enrollment Counselors 3. Tailor outreach materials and talking points for messengers (relevant, clear and simple!) 4. Find more ways to inform and educate instead of just flyers! 5. Develop a Pre-Screening & Enrollment Protocol to improve productivity, quality and customer service 6. Partner with just about anyone!

6. ACTIVITIES 1. Cross-train front-line staff and providers to do pre-screening and referral using simple method and key messages 2. Conduct effective 101 presentations to teachers, counselors, business associations, library staff etc. to serve as messengers 3. Modify existing or create new job aids and tools for counselors to ensure they are prepared (i.e., immigration or taxes) 4. Provide on-going training for staff using various learning methods including role-play, videos and best practice sharing

7. ACTIVITIES (continued) 5. Reduce burden on counselors to educate by doing more group education at career centers, community colleges; show videos to captive audiences (waiting rooms) 6. Distribute easy pre-screening forms that list key eligibility criteria, required info and documentation needed for application 7. Host “o ne-stop shop” enrollment events with partners

8. ENROLLMENT EVENTS

9. PRESS CONFERENCES

10. PREPARING FOR NEXT OPEN ENROLLMENT Focus groups/surveys with recently and remaining uninsured Focus on “retention” strategies (i.e. tickler system to remind patients with upcoming renewals) Prepare enrollment counselors with job aids in key areas such as immigration and taxes Offer more educational opportunities around Health Insurance 101 Develop stronger partnerships with media

11. RESOURCES California Endowment (Asegurate campaign) Insure the Uninsured Project National Immigration Law Center California Immigrant Policy Center ACLU Latino Coalition for a Health California Kaiser Family Foundation Enroll America National Council of La Raza

12. CONTACT acainfo@syhc.org