The Affordable Care Act provided millions more people access to health insurance coverage through an expansion of public programs like Medi-Cal, and the establishment of Covered California, the state’s health insurance exchange, which provides subsidies to low- and moderate-income Californians to help them purchase private health insurance coverage.

In addition, all children in California, regardless of immigration status, now qualify for full-scope Medi-Cal coverage. The expansion of Medi-Cal includes undocumented youth under the age of 19. You can find out more and download resources at www.health4allkids.org.

How SBHCs Can Help

School-based health centers (SBHCs) should – and do – provide students and families with information about the health care coverage that is available to them. They play an important role in ensuring that students and families are enrolled in health insurance since they are a trusted source of information and care. Below are some key outreach and enrollment strategies that have worked for SBHCs around the state.

Outreach Strategies

• Be sure to screen all patients for health insurance status.
• Participate in Back to School nights. Engage parents and families by providing information, forms and giveaways. 
• Include health insurance flyers in enrollment packets and other back-to-school paperwork.
• Work with school nurses, academic counselors, and other school staff to identify uninsured students.
• Address parental concerns around insurance enrollment by ensuring that outreach staff speak students’ home languages and can explain coverage options and paperwork requirements, including relationship to fears about public charge.
• Share information at health fairs and other school wide events. 

Enrollment Strategies

• Train your staff to support enrollment efforts. They can become Certified Application Assistants (CAAs), or you can establish an agreement between your SBHC and community-based organizations that have them. CAAs can view school records to check insurance status, which is NOT a violation of education privacy (also known as FERPA) rules. 
• Connect with Medi-Cal enrollment staff through your County Social Services Agency. 

SBHC Outreach and Enrollment Stories

• United for Success Middle School is a small school in Oakland. SBHC staff there found that most students seen at the SBHC had Medi-Cal or other health insurance, but that their parents, grandparents and guardians often did not. Many adults were fearful of reaching out for medical care because of their immigration status and/or a mistrust of the “system.” To help reach as many members of their community as possible, SBHC  staff developed this flowchart to guide outreach and enrollment activities.
• In collaboration with the USC School of Dentistry, St. John’s Well Child and Family Center in Los Angeles embarked on an innovative program to provide preventive dental health and other services outside of the traditional health center setting. The Sonrisas Pediatric Dental Access Program, which is funded by L.A. Care and First 5 Los Angeles, utilizes a USC-owned mobile dental unit to deliver dental care at various elementary schools throughout South Los Angeles. Services provided on the “Charlie Van” during monthly outreach include oral health education, dental screenings, as well as insurance enrollment assistance. Patients needing additional services are linked to one of St. John’s SBHCs or community-based health centers. 

For more information, visit the ALL IN for Health website, which has resources schools and SBHCs can use to connect students and families to health coverage.