Developing resources and tools to assist outreach and enrollment of minority PLWH into ACA coverage options

Background: Racial/ethnic minorities living with HIV are more likely to be uninsured than whites living with HIV and are disproportionately served by the Ryan White HIV/AIDS Program (RWHAP). The Affordable Care Enrollment (ACE) Technical Assistance (TA) Center used results of a national needs assessment (NA) to guide development of responsive, tailored job aids for case managers assisting minority PLWH with ACA enrollment.

Methods: A structured NA was conducted during the first Marketplace open enrollment period (December 2013) to explore RWHAP grantees’ and providers’ enrollment capacity and cultural competency. Based on responses, the project developed culturally and linguistically competent activities including eight webinars, 12 tools and three web resource pages. Success was measured through qualitative feedback, process metrics, participant ratings of tool usefulness and intention to use and share tools (1=low; 5=high).

Results: NA findings showed limited of knowledge about ACA coverage options, client concerns about getting insurance, and the need for guidance on policies and best practices. Between July 2014 and January 2015 there were 1712 unique downloads of ACE tools, and 638 de-duplicated individuals participated in webinars. Average post-training evaluation scores included “usefulness of information for your work” (n=386; average score = 4.3), “likelihood of using one or more tools presented” (n=288; average score = 4.1), and “likelihood of sharing one or more tools presented” (n=288, average score = 4.2).

Conclusions: Culturally and linguistically appropriate education, materials and training, designed to build capacity for enrolling minority PLWH, were successful in responding to the needs articulated by RWHAP grantees and providers.