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Covering Kids & Families

Supporting Families

Child Care/Early Education

Southern Business Leadership Council

Carolina Nutrition Alliance

Eligibility Process Improvement Center



2004 Annual Report

2004 Chartbook of Major Indicators

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Knowledge — Leadership — Action

Covering Kids & Families

Forty-four million Americans lack health coverage and sadly, 8.4 million of them are children under the age of 18. Two-thirds of these uninsured children live in families with incomes below 200% of the federal poverty level ($38,700 for a family of four). Such severely limited resources can place attainment of private health coverage out of reach even if they are fortunate enough to work for an employer that offers health coverage. There is hope for families unable to afford health coverage on their own. The Southern Institute's groundbreaking research on improving access to Medicaid coverage for lower-income children and families in the early 1990s led the way to reform and the removal of public health coverage eligibility barriers. In 1997 The Robert Wood Johnson Foundation (RWJF) named the Southern Institute as the National Program Office for its Covering Kids national health coverage initiative.

The Covering Kids initiative (1998-2002) was established to reduce the number of eligible, uninsured children through enrollment in Medicaid or the State Children's Health Insurance Program (SCHIP). A review of the Covering Kids initiative indicated, "In all 50 states and the District of Columbia, people and organizations at the state level and in local communities were mobilized to reach out to families and encourage state governments to experiment with outreach, administrative simplification and coordination. Covering Kids empowered organizations and individuals to get deeply involved and effect change in formerly 'off-limits,' complex, and misunderstood publicly-financed health care programs." Encouraged by the gains made during the initiative, and armed with research suggesting that offering coverage to parents can help identify and enroll more eligible children, RWJF established the next phase in 2002. The Foundation named the initiative Covering Kids & Families (CKF), and once again requested that the Southern Institute lead the effort as the National Program Office.

Covering Kids & Families is the nation's largest single effort to find and enroll eligible children and adults in Medicaid and SCHIP. It is a four-year, $55 million national initiative of RWJF with a focus on reducing the number of eligible, uninsured children and adults through enrollment in Medicaid and SCHIP. Critical to the operation of CKF is a combination of three interrelated strategies that reduce eligibility barriers and effectively contribute to the reduction in the number of uninsured children and adults who are eligible but not enrolled in Medicaid and SCHIP. These three strategies are:

· Outreach to uninsured, eligible children and adults;

· Simplification of burdensome policies and practices that act as barriers to eligible children and adults who wish to enroll in public health coverage programs; and

· Coordination of policies and procedures that promotes a seamless system and places children and adults in the appropriate program at all times.

Covering Kids & Families is a national network involving grantees in all 50 states and the District of Columbia. Forty-six states focus on enrolling eligible children (known as CKF Part 1) and 17 states also perform activities to enroll eligible adults (known as CKF Part 2). The remaining five states operate through CKF Liaison grants that address CKF outreach, simplification and coordination strategies on a smaller scale. Overall, CKF encompasses statewide projects in all 50 states and the District of Columbia and approximately 146 local projects, with CKF coalitions totaling approximately 7,350 members representing 5,675 organizations nationwide.

The Southern Institute utilizes a regional technical assistance approach to help grantees implement the CKF strategies. In 2004 our CKF staff led a calendar filled with activities to advance the goals and strategies. One of the major tactics used by the Southern Institute in direction of this national program is to convene CKF grantees with federal, regional and state Medicaid and SCHIP officials, regional and national organizations and policy experts to build knowledge and capacity to accomplish the goals of CKF. Four regional meetings were held in Miami, San Francisco, Boston and Chicago between May and July of 2004. The regional meetings gave CKF grantees the opportunity to work one-on-one with state and federal Medicaid and SCHIP officials from their respective regions of the United States. In addition to sharing knowledge and building partnerships, regional meeting attendees participated in three days of intensive collaboration, which resulted in the development of action plans designed to address state-specific challenges. Since grantees returned home, they have been encouraged by what they have accomplished in terms of implementing their action plans and have commented positively on results that have been achieved.

The CKF program also sponsored additional meetings in 2004 to engage grantees, health coverage policy experts and public and private organizations in discussions about CKF-related issues. Two meetings of the CKF Eligibility Policy Group, which is composed of state and national health coverage policy experts and promotes dialogue and information sharing among experts, were held in January and September of 2004 in Washington, DC. Two CKF Regional Partnership Meetings also were held in 2004 to encourage information sharing and relationship building among groups whose work is closely related to that of CKF. The Southern Regional Partnership Meeting was held in February in Atlanta and convened southern-based advocacy and provider groups. The Western Regional Partnership Meeting was held in November in Denver and convened policy staff designated by governors in the western region.

The CKF Process Improvement Collaborative, which began in 2003 with the first of three learning sessions, continued in 2004. The CKF collaborative takes advantage of the experience gained by the Southern Institute through directing RWJF's Supporting Families After Welfare Reform project (2000-2004). The second and third learning sessions were held in 2004. The learning sessions help teams of grantees and state and local officials learn to test, adapt and implement strategies that can maximize the efficiency and effectiveness of the enrollment and renewal processes in Medicaid and SCHIP. A second CKF Process Improvement Collaborative to be conducted by the Southern Institute's Eligibility Process Improvement Center was approved to take place in 2005.

Covering Kids & Families staff provided continuous support to facilitate the day-to-day operations of CKF statewide and local projects in addition to the major activities described earlier. Staff completed 18 CKF state technical assistance site visits and an additional 14 state site visits in conjunction with the CKF Process Improvement Collaborative. Support also was provided through the CKF Web site, CKF Announcement listserv, interactive CKF Talk listerv, e-mails, conference calls, publications and one-on-one technical assistance.

Everyday the Southern Institute works to increase the number of children and adults with health coverage. It is something no one should have to live without. We will continue to direct national CKF activities in 2005 and help make certain that every eligible child and adult has access to public health coverage.

To learn more about improving access to health coverage and the CKF Initiative please visit or