[Weekly Compilation of Presidential Documents Volume 34, Number 26 (Monday, June 29, 1998)]
[Pages 1188-1190]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
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

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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:
<bullet>    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;
<bullet>    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;
<bullet>    Administration for Children and Families, among other 
            proposed actions, distributes 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;
<bullet>    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;
<bullet>    Centers for Disease Control and Prevention, among other 
            proposed actions, puts outreach referral information in its 
            public health publications and pamphlets;
<bullet>    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;
<bullet>    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:
<bullet>    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;

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<bullet>    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:
<bullet>    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:
<bullet>    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:
<bullet>    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:
<bullet>    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:
<bullet>    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:
<bullet>    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