Building a Culture of Health in California
With nearly 38 million residents, 44 percent of whom speak a language other than English at home, California is the most populous and diverse state in the country. In 2012, California also had the greatest number of uninsured residents, many of whom were low-income families.
And while the state made history by enrolling an estimated 3.4 million Californians in health insurance last year, there are still 3.2 million more who are eligible for health insurance who have not yet enrolled, according to Covered California’s executive director, Peter V. Lee.
How do you reach such a diverse and often underserved population to inform them about the opportunities through Covered California and expanded Medi-Cal?
One way is to leverage the existing infrastructure of family resource centers (FRCs), community-based organizations that provide comprehensive and culturally appropriate services. Across California, FRCs represent more than 20 linguistic and ethnic groups and are trusted in the communities they serve.
“Family resource centers are connected to dozens of other community services, such as school districts or community housing,” said Fiona Lavelle, program manager at the California Family Resource Association (CFRA), a statewide membership association of approximately 300 organizations. CFRA advocates for the programs and policies that help FRCs and their communities thrive.
In September 2013, California Family Resource Association received a one-year, $600,000 grant from The California Wellness Foundation to provide outreach, education and enrollment services for those eligible for health care coverage through Covered California and newly expanded Medi-Cal under the Affordable Care Act (ACA).
Sandra Martínez, Cal Wellness’ director of public policy, notes that FRCs are great settings for community members to conveniently receive health care coverage and enrollment information.
“We know that family resource centers already see clients for an array of services,” Martinez said. “So, this is an opportunity for the centers to use their expertise and reach to help foster awareness about coverage options and increase enrollment.”
In 2013, the first year of open enrollment under the ACA, CFRA’s partners completed outreach to 97,000 Californians and enrolled 10,400 people in Medi-Cal or private health plans offered through the Covered California marketplace.
“Through their networks, they are reaching a lot of people who have never been insured before and may not know how to utilize the health care system,” said Padmini Parthasarathy, a program director at Cal Wellness.
Using outreach and education, FRCs meet families and individuals at places of worship, local stores, school and community events, and job fairs to let them know about the new options for health care coverage.
In Southern California, CFRA’s partners often use a promotoras approach, which emphasizes using community members to convey important health and wellness information.
“They train local Spanish-speaking residents to serve as liaisons between their communities and the integrated health and family support services offered through family resource centers,” Lavelle said. “It takes time and the face-to-face caring attention of someone who is really acting as a navigator of this whole new system.”
The promotoras program at the Chula Vista Community Collaborative in Southern California recently helped a family of three enroll in a Covered California plan. When a staff member followed up by phone to see how the family was doing, the father thanked the team for helping his family get health insurance for the first time.
On the phone, he laughed and said: “I’m in the doctor’s office at this moment.”
Lavelle explained that this is how a culture of coverage in California is built. But, it’s just the beginning.
“We work with all of our communities, all of our families, and really invest the time to build the understanding of insurance and how to use it,” she said. “The ultimate goal isn’t just that people are covered, it’s that people’s health outcomes improve.”