Covering kids: A community coalition approach to sustained child health insurance coverage

Background: The Consortium for Infant and Child Health (CINCH), a leading child health coalition in Hampton Roads, Virginia, identified over 32,000 uninsured children who were eligible, but not enrolled in Medicaid/SCHIP in 2001. A collaborative, systems approach was utilized to remedy the problem. Methods: Coalition partners identified barriers in state and local systems for Medicaid/SCHIP, were engaged in a problem solving collaborative and asked to help fund and deliver interventions. Results: Enrollment barriers such as mandatory waiting times, costs and complex application forms were significantly decreased and sustainable systems of outreach were implemented within community organizations and businesses. Health care competitors worked together to fund and implement solutions: Over $1 million in program funding was raised and 19,000 children were enrolled in the region between 2002 and 2007. Conclusions: A community coalition approach to identifying, enrolling, and sustaining enrollment in children's Medicaid/SCHIP can change systems and increase and sustain enrollment. Identifying direct benefits to participating in outreach was a key finding of the project. Competing community organizations can be both engaged to work collaboratively, as well as provide significant funding for programs benefiting the greater community.