With the federal government's welfare reform act well under way, the welfare caseload has dropped from 12.9 million recipients in 1996 to 5.8 million in 2000. America has its
lowest percentage of the population on welfare in 35 years, but what happens to families once they leave?
Some families assume that when they go off welfare, they lose all welfare benefits, such as health insurance for children. But children can qualify for free health coverage
through Medicaid or low-cost insurance through the State Children's Health Insurance Program if a family's income is 200% to 250% above the federal poverty level, $17,650 for a
family of four.
Seven hospitals in King County, Wash., decided they wanted to find an issue they could work together on. Initially, they wanted to tackle universal healthcare access, but it
was too big of a project, says Randy Revelle, VP for Washington State Hospital Association. Insuring kids in Washington State seemed much more feasible.
Not only would the hospitals be helping children, but insurance could help prevent minor ailments from escalating into more serious conditions that require ER visits.
Instead of creating a new nonprofit agency, the hospitals turned to the Washington Health Foundation, a nonprofit that works closely with the Washington Hospital Association,
to administer Kids.Health.2001. The three-year campaign for getting children insured picked up more than a dozen additional partners over the years.
Pacific Rim Resources of Seattle was tapped to handle PR and communications. One of the biggest challenges: Stretching a communications budget of about $1.2 million budget
over three years. The project is slated to come in on budget - thanks to special advertising rates, help from vendors and community involvement.
"When it's a truly social issue, don't be afraid to ask for something at a special rate," says Julie Colehour, PRR director of marketing. "The thing that has been most
successful is the friend-to-friend, face-to-face outreach in the communities."
More than a Band-Aid
In Seattle and the rest of King County, the number of uninsured children and teens in 1998 hovered at about 34,000 - leaving 60%, or 20,000, of those kids under 19 eligible for
free health insurance. Washington actually has one of the lowest rates of uninsured kids in the country. But team members felt the state's success made their task even more
difficult.
"The kids that were left were the harder-to-reach group," says Laurel Yamaguchi, PRR program manager.
The Kid.Health.2001 team wanted to pinpoint why parents weren't taking advantage of existing programs. Language/cultural barriers, lack of awareness and a perception that
Medicaid is a form of welfare were among some of the key obstacles that came out of focus groups in early 1998.
Spreading the Word
To break down the language barrier, the team enlisted the help of the Seattle Public School System. Working closely with the teachers who cater to non-English speakers, PRR
was able to determine how many kids spoke which languages. Letters and flyers describing the campaign, in 12 languages -- including Vietnamese and Somali -- were sent home to
47,500 students. Posters, brochures and other materials were translated.
Advertisements and Op/Ed pieces appeared in non-English and English newspapers that reached low-income neighborhoods.
The campaign turned to community members to help spread the word. School support workers, school nurses and emergency room nurses were trained to enroll kids for insurance
benefits.
Yamaguchi says it was key to run the campaign for more than one year. "We established trust in the community," she says. "We showed we are around. We're not going to promise
this and leave."
The bulk of these advocates were paid for their work, but a small number were volunteers. Some didn't have the training to actually enlist kids, but could provide contact
information to families.
The media also played an important role. Revelle estimates that about 50 percent of enrollments came from the communications aspect of the campaign. The other half was through
working in schools. Campaign workers held a media kickoff with children, professional athletes and politicians. Throughout the campaign, PRR pitched stories and updated the media
on its progress.
The Results
Kids.Health.2001 is set to conclude in July. So far 6,735 kids have been enrolled. Ten other Medicaid outreach programs also have benefited during the campaign, enrolling
more than 4,200 additional kids.
The Seattle Times, Seattle Post-Intelligencer and Tacoma News Tribune are just a few of the area news outlets who have profiled the campaign. Revelle
says the hospitals and partners are looking to extend the program another year. By the end of 2002, he thinks Kids.Health. and 10 other area Medicaid programs could possibly
reach all 20,000.
(Pacific Rim Resources: Julie Colehour, Laurel Yamaguchi, 206/623-0232; Washington Hospital Association: Randy Revelle, 206/216-2515.)
Speaking the
Language
Creating a campaign with such a multicultural theme was no easy feat, says Laurel Yamaguchi, Kid.Health.2001 manager at Pacific Rim Resources. Translating materials explaining
the insurance program and eligibility requirements had to be just right.
The firm wrote the material but had a company translate it into 12 languages. Campaign outreach workers were concerned the wording was too advanced or not sensitive enough.
Now when PRR employees get material translated, they include about 15 pre-translated phrases they want integrated.
Talking to Teens
When the campaign first launched in July 1998, uninsured emancipated teens were also part of the target audience. But by 1999, the team learned to readjust its focus. Teen-
agers, often drifting from place to place, were difficult to reach and not as receptive to the message. The resources to reach teens weren't there, Yamaguchi says."We wanted to
put our efforts into someone who will be insured" and benefit longer, she says.
Key Players: Laurel Yamaguchi, PRR program manager; Nancy Welts Schulte, PRR account director; Mike Rosen, PRR group account director; Randy Revelle,
Washington Hospital Association
Campaign Stats
Timeframe: July 1998 to July 2001
Budget: $4.7 million for the entire campaign/ $1.2 million for PR/communications