© 2016 Enroll America | StateOfEnrollment.org

Kristelle Jose, Fatima Morales and Betzy Estudillo | Lori Miller Nascimento, Moderator

05.12.16

Engaging Youth Populations: Strategies for Engaging Schools, Former Foster Youth & Youth Immigration Groups

California HighlightsPopulation: >39 million

>9 million children

Covered California ~ 1.6 million enrollees

Medi-Cal (Medicaid) expansion ~ 13 million enrolled~ 5 million children

Medi-Cal coverage for all children, regardless of immigration status startingMay 16, 2016!

Coveredtil26: Medi-Cal Coverage for

Former Foster Youth

School-Based Health ServicesHome Visiting

Developmental Screening& Early InterventionChildhood Trauma

Family Preservation & Reunification

Stability & PermanencyJuvenile Justice

CHILDREN’S HEALTH EDUCATION

Coverage & Access(ACA Implementation,Health Homes)

Former Foster Youth Health Coverage

Oral Health

Early Mental Health

Nutrition

Media & Health(Advertising & Obesity, Nutrition, Portrayal of Race)

Early Learning Access & Quality (Child Care, Preschool and TK)

Kindergarten Readiness Assessment

Common Core Implementation

STEM

Finance Reform

Accountability

Chronic Absence

School Discipline

Foster Youth Education Reform

Teaching Effectiveness

Expanded Learning

Education Technology

CROSS SECTOR ISSUES

CHILD WELFARE

Current Issue Coverage

Children Now – Who We Are

Non-partisan national, state, and local research, policy development, and advocacy organization dedicated to improving children's overall well-being

The Affordable Care Act & Former Foster Youth

Allows young adults to remain on their parent’s insurance up to age 26

Provides equity for Former Foster Youth through Medicaid up to age 26

Fills a critical need for a very vulnerable population

• FFY tend to have higher health care needs due to childhood abuse, neglect, and trauma

• Youth who age out of foster care often lack adequate supports to navigate the transition to adulthood

Former Foster Youth Eligibility• In foster care at age 18 or older

- In California, OR- In another state

• Living in California now

• Under the age of 26

No income or assets test. Former foster youth qualify regardless of income.

Former foster youth qualify regardless of placement type. Includes youth placed with relatives and youth in probation-supervised placements.

Peer-to-peer & youth friendly

outreach

Outreach & technical

assistance to direct service providers &

county agencies

Policymaker education &

advocacy

Media work

Coveredtil26 Outreach and Education Campaign

Key SuccessesPolicy Advocacy Wins“No wrong door” enrollment in Medi-Cal

• FFY fixes to Covered California enrollment system reprioritized

• Developed and issued guidance to counties on simplified enrollment and retention policies for FFY

• Revised the MC 250A and issued guidance to counties with instructions to accept it for any FFY up to age 26

• Issued instructions to counties to fix incorrect Covered California eligibility determinations received prior to programming fixes

• Streamlined FFY enrollment into Medi-Cal through the Hospital Presumptive Eligibility program

Automatic transition into the Medi-Cal program for FFY for youth exiting care at age 18 or older

• CDSS issued guidance to social workers and probation officers with best practices for ensuring coverage for youth transitioning out of care

• CDSS and DHCS executed a global data sharing agreement that includes FFY as a covered population. This allows CDSS and DHCS to track and reconcile data for all youth 18-26

Key SuccessesPolicy Advocacy WinsImmediate enrollment based on self attestation

• Clear instructions to counties on their responsibility to verify FFY status ex parte; FFY not required to provide documentation

• AB 592 (Stone): Developed a statewide process for youth to obtain information about their FFY status for various state education, health, and other services.

Former foster youth should receive timely and accurate information about eligibility for Medi-Cal coverage

• Created and instructed counties to use new notices of action specifically tailored to FFY

Youth-friendly retention policies

• FFY not required to fill out or return anything on a yearly basis to stay covered until age 26 and no loss of coverage due to a loss of contact.

Key Successes

DHCS significantly increased its outreach & education efforts related to Medi-Cal coverage for FFY

DHCS created a monthly FFY workgroup in response to our advocacy efforts

Lessons Learned

Local and state approaches are key

Partner with trusted messengers and local experts

“Ground” and “air” strategies are essential

• www.coveredtil26.org: youth-friendly website with FAQs and enrollment tips, free outreach materials, policy guidance, and more.

• The Children’s Movement: receive updates and information about key kids' issues and campaigns in CA

http://www.childrennow.org/take-action/

@ChildrenNow@Health_CN

Children Now is spearheading Coveredtil26. Funded by a grant from The California Wellness Foundation.

Resources

Kristelle Jose Senior Outreach Associate kjose@childrenspartnership.org

ALL IN For Health Campaign

ALL IN For Health brings new tools and information about health coverage and care opportunities directly into communities. Through high-impact

partnerships with local organizations in communities, we reach families and children where they live, learn, and play.

How to Connects With Schools What do Schools Need?

• Identify key school staff to lead• Develop materials specific for the school community• Make it easy for schools to participate with sample and tailored messages• Understand the way schools/school districts communicate with their staff, students, and parents• Follow the academic calendar and school themes i.e., Back-To-School

• Tailored materials• Health outreach and enrollment

education• Connections to enrollment

assisters • Assistance with outreach and

enrollment activities

Roles of Partners • Provide strong connection to

leaders with deep education and community networks

• Provide strategic advice• Disseminate materials • Spread information through

networks• Amplify messages through social

media• Create a culture of coverage

Best Practices 1. Understand schools’ priorities and capacities » Provide different points of entry for schools to engage with tailored materials

and messaging » Simplify the process and provide simple instructions 2. Materials increase engagement » Have pre-printed material readily available» Provided translated & customizable versions 3. Strategic communications- repeat messaging at every level» Schools, administrators, organizations, parents, etc. and on social media 4. Provide assistance with enrollment events » Connect schools with enrollment counselors » Help plan and coordinate events5. Enlist trusted partners» Highly credible statewide organizations

Materials • ALL IN Toolkit

Fact sheets Flyers Bookmarks Robocall scripts Pre-made social media messages Regular newsletter blurbs for

newsletters and eblasts All materials are available in Spanish

• ALL IN can provide technical assistance and support at hosting trainings, presentations, health fairs & enrollment events

Immigrant Health in California: Opportunities for DACA Recipients and the Fight for Health4All

BETZABEL ESTUDILLOCALIFORNIA IMMIGRANT POLICY

Founded in 1996, CIPC is a non-partisan, non-profit statewide organization that seeks to inform public debate and policy decisions on issues affecting the state’s immigrants and their families in order to improve the quality of life for all Californians. CIPC engages in policy advocacy, and also provides technical assistance, training and education on immigrant issues.

Undocumented Californians and Health

Access The Affordable Care Act (ACA) has expanded health coverage to millions of Californians Remaining Uninsured

• UC Berkeley Labor Center study- After the full implementation of the ACA, there will be 2.7-3.4 million Californians who will remain uninsured

• About 1.2 million will be undocumented CaliforniansAccess “Band Aid” Care - Patchwork of coverage for the undocumented.

• Some counties offer coverage, other counties don’t offer any coverage, and some offer limited scope/duration coverage.

• Emergency and charity care

What is DACA?• Deferred Action for Childhood Arrivals

• Program was announced by the Secretary of DHS in June 2012• Deferred Action is limited relief from immigration enforcement• not just limited to DACA recipients

• DACA Eligibility

• DACA recipients receive deferred action and employment authorization and is renewable for 2 year periods

• In some states DACA recipients also have access to a state-issued ID and Driver’s License and Medicaid

How did DACA come about?

Organizing and direct action by immigrant youth

• “Right to Dream” campaign established after the DREAM Act failed in 2011

• Legal analysis by policy experts, including NILC

Immigrant youth continue to lead in policy conversations/campaigns

• Health4All• stopping deportation/detention• immigrant inclusive policies

DACA Demographics UC Berkeley Labor Center/UCLA Center for Health Policy Research Report Study (February 2014)

• 154,000 Californians granted deferred action under DACA (December 2013)

• Estimated that up to 125,000 would be eligible for Medi-Cal

Many DACA recipients in CA will likely remain uninsured because they do not qualify for or will enroll in Medi-Cal or will lack access to affordable private coverageCurrent Data:

• DACA recipients nationwide: 1,198,605 approved cases (March 21, 2016)

• DACA Recipients in CA: 347, 878 approved cases (March 21, 2016)

Taking the ACA out of DACA

• President Obama’s announcement to exclude DACA individuals from the Affordable Care Act (ACA)

• U.S. Department of Health and Human Services (HHS) specifically excluded DACA recipients from eligibility for health insurance through federal Medicaid and the Marketplaces (with or without subsidies)

• Not subject to the individual mandate

Photo Credit: Pocho-One Photography

DACA & Medi-Cal • Medicaid (Medi-Cal in CA) Expansion— Starting January 1, 2014, all low-income childless adults including qualified immigrants and PRUCOL are eligible for full-scope Medi-Cal, if they meet the income requirement.

• DACA individuals are eligible for full-scope Medi-Cal, if they meet the income requirement.How is this true? • In California DACA status is considered Permanently Residing in the U.S. under the Color of Law (PRUCOL) and are eligible for state-funded full-scope Medi-Cal benefits

•  

Challenges & Opportunities

• DACA recipients unaware they may be eligible for full-scope Medi-Cal

• County eligibility workers unaware of DACA status and eligibility for Medi-Cal, or provided incorrect information

• DACA recipients concerns with applying due to fear of deportation (for extended undoc family members), public charge, and that it may hurt their chances of adjusting their status in the future

• Opportunity to work with immigrant youth, advocates, immigrant rights organizations, and the Department of Health Care Services (DHCS)

• Key step towards ensuring that all Californians have access to healthcare

Medi-Cal Eligibility Division Information Letter No.: I 14-45

DACA+ & DAPA• President Obama announcement on November 2014 to expand DACA to 3 years, eliminate the age cap, and change the date of entry to 2010• Extend deferred action to parents of US Citizens and lawful permanent resident children • DAPA: Deferred Action for Parents of Americans and lawful permanent residents

Texas v. U.STexas and 25 other states sued the Obama Administration to block the President’s November 2014 administrative action.They claimed that:

• they had ‘standing’ to bring the case because they would incur costs such as issuing drivers’ licenses to more people with deferred action

• the President was not authorized to take the actions without following administrative rulemaking procedures

Important: the original (2012) DACA program is not affected

HEALTH4ALL

Legislative History• Proposal by Senator Ricardo Lara to ensure that all Californians have access to quality and affordable healthcare, regardless of immigration status• Health4All bill first introduced in 2014 • Re-introduced in December 2014 • SB 4 was signed by Governor Brown on October 9, 2015!• SB 10 & SB 1418– 2016 proposal authored by Senator Lara

Health4All Kids- SB 4 & SB 75

• The 2015-2016 California budget included an initial $40 million and an ongoing commitment to expand access to full-scope Medi-Cal for all children, regardless of immigration status.

• Beginning May 16, 2016 undocumented children under the age of 19 will have access to full-scope Medi-Cal

• This expansion will guarantee comprehensive coverage to 170,000 – 250,000 undocumented children

• Implementation and outreach efforts underway asking families to enroll undocumented children in restricted-scope “emergency” Medi-Cal

• More information: www.health4allkids.org

SB 10 (Lara): Providing All Californians Access to

Covered California• On April 7, 2016 Covered California Board supported a 1332 waiver proposal to allow undocumented Californians and DACA recipients to purchase a health plan

• SB 10 allows undocumented people and DACA recipients to purchase coverage through Covered California with their own money by requiring the state to apply for a federal Section 1332 waiver (a formal request to the federal government).

• We are also in conversations with the federal administration on the process of the waiver

SB 1418 (Lara):Expanding Full-Scope Medi-Cal to Undocumented Adults

• SB 1418 expands access to health care coverage to Californians unjustly excluded from care because of their immigration status.

• The bill seeks to allow undocumented adults to receive full-scope comprehensive Medi-Cal upon availability of funding through the state budget.

• Undocumented adults at or below 138% of the FPL will be able to enroll in full-scope Medi-Cal and receive an array of services including doctor visits, tests, medications, emergency care.

Group Activity

• Write down three partners you wish to connect with in your community • Write down three strategies to connect to them and what that partnership looks like

Questions

Contact Information

Fatima Morales - fmorales@childrennow.org

Kristelle Jose - kjose@childrenspartnership.org

Betzabel Estudillo - bestudillo@caimmigrant.org