[Weekly Compilation of Presidential Documents Volume 35, Number 41 (Monday, October 18, 1999)]
[Pages 2013-2015]
[Online from the Government Publishing Office, www.gpo.gov]
<R04>
Memorandum on School-Based Health Insurance Outreach for Children
October 12, 1999
Memorandum for the Secretary of Health and Human Services, the Secretary
of Education, the Secretary of Agriculture
Subject: School-Based Health Insurance Outreach for Children
The lack of health insurance for millions of Americans remains one
of the great challenges facing this Nation. To help address this issue,
I worked with the bipartisan Congress to create the Children's Health
Insurance Program (CHIP), the single largest expansion of children's
health insurance in 30 years. The 1997 Balanced Budget Act allocated $24
billion over 5 years to extend health care coverage to millions of
uninsured children in working families. CHIP builds on the Medicaid
program, which currently provides health coverage to most poor children,
and together, these programs could cover most uninsured children.
Yet too few uninsured children eligible for CHIP or Medicaid
participate. Barriers to enrollment include parents' lack of knowledge
about the options; cultural and language
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barriers; complicated application and enrollment processes; and the
``stigma'' associated with so-called welfare programs. The Vice
President and I have made removing these barriers to enrollment a high
priority. In 1997, I launched a major public-private outreach campaign
called ``Insure Kids Now.'' Foundations, corporations, health care
providers, consumer advocates, and others have participated through
activities such as setting up enrollment booths at supermarkets and
promoting the national toll-free number
(1-877-KIDS NOW) on grocery bags, TV and radio ads, and posters. In
addition, we created a Federal Interagency Task Force on Children's
Health Insurance Outreach in February 1998, which has implemented over
150 new activities to educate and train Federal workers and families
nationwide about the availability of Medicaid and CHIP.
Today I am directing the Secretaries of Health and Human Services,
Education, and Agriculture to focus children's health insurance outreach
on a place where we know we can find uninsured children: schools. State
experience indicates that school systems are an ideal place to identify
and enroll uninsured children in Medicaid or CHIP because schools are
accepted by parents as a conduit for important information. In addition,
health insurance promotes access to needed health care, which experts
confirm contributes to academic success. We have learned that children
without health insurance suffer more from asthma, ear infections, and
vision problems--treatable conditions that frequently interfere with
classroom participation; and children without health insurance are
absent more frequently than their peers. As we strive for high standards
in every school and classroom, it is essential that we help families
ensure their children come to school ready to learn.
Therefore, I hereby direct you, in consultation with State and local
agencies, to report to me a set of recommendations on specific actions
to encourage and integrate health insurance enrollment and outreach for
children into schools, consistent with the mission of your agency. This
report shall include:
<bullet> Specific short- and long-term recommendations on
administrative and legislative actions for making school-
based outreach to enroll children in Medicaid and CHIP an
integral part of school business. These may include:
<bullet> Technical assistance and other support to school districts
and schools engaged in outreach;
<bullet> Suggestions on how to effectively use the school lunch
program application process to promote enrollment in health
insurance programs;
<bullet> Lists of practices that have proven effective, such as
integration of outreach and enrollment activities into
school events such as registration, sports physicals, and
vision and hearing testing; and
<bullet> Model State CHIP and Medicaid policies and plans for school-
based outreach.
<bullet> A summary of key findings from the national and regional
conferences scheduled for this fall on the topic of school-
based outreach. These conferences will bring together
national and State education officials, Medicaid and CHIP
directors, public policy experts, and community-based
organizations to examine the use of schools to facilitate
the enrollment of children in Medicaid and CHIP; evaluation
tools to monitor the effectiveness of current school-based
outreach efforts; and best practices in school-based
outreach and enrollment for children's health insurance.
<bullet> Recommendations on methods to evaluate CHIP and Medicaid
outreach strategies in schools. Performance measures should
be an integral part of school-based CHIP and Medicaid
outreach strategies, as they can inform policy-makers on the
effectiveness of these strategies, as well as help to
identify areas of improvement.
I direct the Department of Health and Human Services to serve as the
coordinating agency to assist in the development and integration of
recommendations and to report back to me in 6 months. The recommended
actions should be consistent with Medicaid and CHIP rules for coverage
of appropriate health- and outreach-related activities. They should be
developed in collaboration with
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State and local officials as well as community leaders and should
include recommendations on fostering effective partnerships between
education and health agencies. These recommended activities should be
complementary, aggressive, and consistent with my Administration's
overall initiative to cover uninsured children.
William J. Clinton