Oregon Children's Health Equity Outreach Project: Using Community Health Workers to Reach Vulnerable Families

Background The Oregon Children's Health Equity Outreach Project is a federally funded grant to enroll eligible children from mixed status immigrant families into Medicaid. Low income children from undocumented families are twice as likely as children from citizen families to be uninsured. Undocumented families face many barriers to obtaining coverage for their eligible children including deportation fears, language and cultural issues, misinformation, and challenges verifying income.

Methods Five health care safety net providers with 13 sites in 9 counties received funding to assist children from mixed status families with enrollment in Medicaid. Grantee-reported applications were tracked through the state enrollment, eligibility and Medicaid data systems to determine eligibility and outcomes. Semi-structured focus group interviews were conducted with grantees to learn more about how community health workers successfully reach and enroll eligible children from these families.

Results Focus group participants painted a rich picture of the many skills and abilities necessary to reach and enroll children from undocumented families into Medicaid. Success is not formulaic, but rather is a fluid process inherently based on community and trusting relationships. To date, grantees reached more than 10,000 families, assisted with 5,000 Medicaid applications, and enrolled 8,000 eligible children from undocumented families into Medicaid. The average cost per child enrolled was $56.

Conclusion The results support continuation of funding for culturally appropriate and focused outreach efforts for children from undocumented families and for sustained research investigating access to care, immunization, and health outcomes for this population.