    [Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
    [June 22, 1998]
    [Pages 1017-1018]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Memorandum on Actions To Improve Children's Health Insurance Outreach
    June 22, 1998

    Memorandum for the Secretary of the Treasury, the Secretary of
    Agriculture, the Secretary of the Interior, the Secretary of Labor, the
    Secretary of Health and Human Services, the Secretary of Housing and
    Urban Development, the Secretary of Education, the Commissioner of
    Social Security

    Subject: Federal Actions to Improve Children's Health Insurance Outreach

        Last year, with bipartisan support from the Congress, I was pleased
    to sign into law the Children's Health Insurance Program (CHIP). This
    new program will help millions of children of working families obtain
    affordable and much-needed health insurance. As of today, 20 States have
    had their CHIP plans approved and most States have applied for approval.
        Yet, as recent studies show, rapidly implementing CHIP and ensuring
    that all eligible children are enrolled in this new program or Medicaid
    has never been more important. This month, a major report from the
    Institute of Medicine confirmed that children without health insurance
    are more likely to be sick, less likely to be immunized, and less likely
    to receive medical treatment for illnesses, such as recurrent ear
    infections and asthma. Without treatment, these diseases can have
    lifelong consequences. Another study by the Agency for Health Care
    Policy and Research concluded that there are 4.7 million uninsured
    children who are eligible but not enrolled in Medicaid. Several million
    more will become eligible for CHIP as States implement their programs.
        Only an intense, sustained campaign in both the public and private
    sectors can address the significant challenge of uninsured children. On
    February 18, 1998, I requested children's health outreach proposals from
    eight Federal agencies on how the executive branch of the United States
    Government can assist in children's health insurance outreach.
        In response, I received the Report to the President: The Interagency
    Task Force on Children's Health Insurance Outreach, which contains
    proposals on how to engage the executive branch in children's health
    outreach. I have reviewed this report and found these proposals sound,
    innovative, and worth undertaking.
        Therefore, I hereby direct you to take the following actions to
    promote children's health insurance outreach, consistent with the
    missions of your agencies and the content and timelines of each
    potential initiative described in the Report.
        The Secretary of Health and Human Services shall ensure that the:
        Health Care Financing Administration, among other proposed
                actions, creates an on-line clearing house for outreach
                information and facilitates relationships between State
                Medicaid and CHIP agencies and community-based and private
                organizations to identify, educate, and enroll uninsured
                children in State health insurance programs;
        Health Resources and Services Administration, among other
                proposed actions, trains health care providers to help
                identify and enroll children in health insurance through its
                National Health Service Corps and Area Health Education
                Centers, which trains students and health providers and
                distributes information to families that use the community
                clinics that it funds;
        Administration for Children and Families, among other
                proposed actions, distributes

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                promotional material and applications for Medicaid and CHIP
                to the families they serve through Temporary Assistance to
                Needy Families (TANF), Head Start sites, and subsidized
                child care sites;
        Agency for Health Care Policy and Research, among other
                proposed actions, supports investigator-initiated
                evaluations of outreach activities to better understand
                which outreach and enrollment strategies work best and to
                disseminate results to improve outreach performance;
        Centers for Disease Control and Prevention, among other
                proposed actions, puts outreach referral information in its
                public health publications and pamphlets;
        Indian Health Service, among other proposed actions,
                integrates ``train the trainer'' techniques to educate
                select community members who can then provide information on
                health insurance to the rest of the community;
        Substance Abuse and Mental Health Services Administration,
                among other proposed actions, develops and implements an
                educational campaign for uninsured children with special
                needs.
        The Secretary of Agriculture shall, among other proposed actions:
        Educate Regional and State directors of the Women, Infants,
                and Children (WIC) program and other Food and Nutrition
                Service programs on health care programs that are available
                to families with uninsured children and determine what
                information to give to these families; how to coordinate the
                application process to facilitate enrollment in CHIP and
                Medicaid; and how families applying for school lunch
                programs can receive information on health insurance;
        Provide information to the Cooperative State Research,
                Education, and Extension Service regional and State program
                staff and grantees and encourage dissemination of
                information to families regarding the CHIP and Medicaid
                programs.
        The Secretary of Education shall, among other proposed actions:
        Educate and assist families through its Partnership for
                Family Involvement program, which promotes family
                involvement in education, and includes employers, schools,
                education organizations, and community and religious groups.
        The Secretary of Housing and Urban Development shall, among other
    proposed actions:
        Provide information on children's health outreach to
                applicants for competitive grants, and ask its directors of
                Public Housing Authorities and Empowerment Zones/Enterprise
                Communities to post or distribute this information.
        The Secretary of Interior shall, among other proposed actions:
        Develop and distribute culturally relevant referral
                information to Native American families through the Bureau
                of Indian Affairs, especially focusing on tribal schools,
                colleges, and social services agencies.
        The Secretary of Labor shall, among other proposed actions:
        Distribute Medicaid and CHIP outreach information through
                its Job Corps Centers, One-Stop Career Centers, welfare-to-
                work grant programs, and small businesses contacts.
        The Secretary of the Treasury shall, among other proposed actions:
        Post children's health outreach information for families at
                IRS walk-in centers and provide this information to
                Voluntary Income Tax Assistance sites.
        The Commissioner of Social Security shall, among other proposed
    actions:
        Distribute information and/or applications for children's
                health insurance in its SSA field office reception areas and
                provide to States names of families of children denied SSI
                so that States can send these families educational
                information and applications for children's health insurance
                programs.
        I also direct the Secretary of Health and Human Services to continue
    to work with the above mentioned agencies to assist them in fulfilling
    these commitments, to engage new agencies and develop other commitments,
    and report back to me in 1 year on agency accomplishments.

                                                          William J. Clinton