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Understanding the Health Benefits Exchange Outreach and Enrollment Grant

On September 27 the California Health Benefit Exchange (the Exchange) held a stakeholder Webinar soliciting input on the Outreach and Enrollment Grant as a component of efforts to enroll uninsured individuals into the Exchange. Program sponsors (California Health Benefits Exchange, the Department of Health Care Services, and Managed Risk Medical Insurance Board) provided a presentation outlining the proposed Outreach and Enrollment Grant, followed by an open session for questions.

The Exchange anticipates a total of $40 million dollars in federal funding for the Outreach and Enrollment Grant Program over a two-year period, with awards made in two phases: Phase I, majority of the funding will be granted ($15-$25 million); Phase II, grants made to address gaps coverage not awarded in Phase I ($5-$10 million). Funding will be provided to selected agencies for the following three objectives through December 2014 when the grant period ends: 1) awareness; 2) education; and 3) retention.

Applicants can look to a UC Berkley report using CalSIM Model 1.7 to provide the framework of the perspective target market, with goals to:

  • Promote awareness of the benefits of the ACA
  • Provide consumers with information and tools to enroll
  • Complement the broader marketing strategy in areas that may not be reach
  • Remove barriers from enrollment
  • Drive consumers to Assistors Program resources

The Assistors Program and Outreach and Enrollment Grant Program serve the same population, but have different goals and separate funding streams:

  • Assistors Program provides some education but focuses on helping people enroll into programs by filling out applications, where assistors will be compensated $58 to successfully enroll patients into the Exchange. Due to limited funding Assistors will not be compensated for enrolling patients into Medi-Cal but are expected to educate clients on all coverage options
  • Outreach and Enrollment Grant Program focuses on promoting awareness and education about coverage options and then providing clients a link to assistors’ enrollment services

Under the guiding principles to target resources based on areas with the highest number of uninsured and subsidy eligible individuals; to ensure outreach to all regions and markets in the State including hard-to-move, rural, and limited English proficient populations and to complement the Assistors Program; two potential funding strategies were proposed:

Proposed Funding Strategy

Funding Allocation

Grant Size

Geographic
  • Allocate higher amount of funding to geographic areas with the greatest opportunity:

-Priority 1 Counties: 20 counties with most uninsured receive more grant dollars

-Priority 2 Counties: remaining counties with less uninsured receive less grant dollars

  • Ensure that all geographic areas get a minimum amount of grant dollars
A range of grant sizes:

Small: up to $25,000

Medium: up to $100,000

Large: up to $250,000

Up to $500,000 reserved for special priorities pool focused on multi-county/regional, statewide

Special Priorities Fund Multi-county/regional funding pool – collaborative of agencies, or single agency with large scope
Targeted populations – not geographic in nature i.e. targeting specific occupational sectors, specific cultural and/or linguistic groups, market segments that typically do not see the value of insurance
Re-granting program –regional or community foundations to disseminate funds to organizations (sub-grantees) within the target geographic areas

Any organization (public or private) without a conflict of interest is able to apply for the grant. Applicants may apply with other organizations as a collaborative but each agency is allowed to submit only one application. If an agency applies for a Phase I grant but is not awarded, they may reapply for a Phase II grant. However, Program Sponsors encourage all agencies to apply in Phase I as the majority of funding will be awarded then. Comments on the grant proposal were due to the Exchange Board by October 5; with Phase I grant application to be released on November 16.

Complete Outreach and Enrollment Grant Application Timeline

Date

Task

September 27, 2012

Stakeholder Webinar

October 5, 2012

Final Written Comments from Stakeholders Due

October 16,2012

Board Review 1st Draft of Comprehensive Grant Application

November 16, 2012

Phase I Grant Application Release

TBD

Bidders/Grantees Conference

January 4, 2013

Phase I Grant Application Response Due

February 15, 2013

Announcement of Phase 1 Awards

April 1, 2013

Phase II Grant Application Release

TBD

Bidders/Grantees Conference

April 29, 2013

Phase II Grant Application Response Due

May 22, 2013

Announcement of Phase II Award

December 2013

End of Grant Funding

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