This guest post was written by Anna Kanter, Stephanie Altman, and Stephani Becker from the Sargent Shriver National Center on Poverty Law and originally published in full on The Shriver Brief. The Shriver Center’s health team trains extensively on Affordable Care Act (ACA) implementation in Illinois and runs HelpHub, an online technical assistance center for enrollment specialists in Illinois.
As the third open enrollment period quickly approaches, we can look to experienced assisters to figure out how to best plan for a successful year. Our state, Illinois, had a large cadre of in-person assisters — hundreds of federally funded Navigators, state-funded In-Person Counselors (IPCs), and Certified Application Counselors (CACs). Spread out across the state from Moline to Chicago and Waukegan to East St. Louis, they served diverse groups from Polish, Latino, and Chinese immigrant enclaves to college towns and farming communities.
We know from their reports, data, and experiential anecdotes that over the past two years they reached populations that may never have gotten coverage without in-person enrollment help.
Even with their different backgrounds and experiences, the enrollment assisters we interviewed this summer all had similar best practices to share, and they zeroed in on three strategies that were key to successful outreach plans: partnerships, meeting people where they are, and building trust.
1) Partnerships drive success. Partnerships of all kinds — with the state, with other community-based organizations, and with other enrollment entities — made all the difference so Illinois enrollment assisters could increase their impact.
Martin Logo of the Project of the Quad Cities said that their collaboration with Get Covered Illinois was a huge resource for staff trainings and logistical support. In addition they worked with local job training sites through Partners in Job Training and Placement in Rock Island County. The partnership included daily tabling, weekly presentations, and one-on-one enrollment sessions. The Project of the Quad Cities was invited to speak during various job information classes and reached a large number of uninsured, unemployed residents who previously had minimal information about the ACA.
2) Meet people where they are. In order to be effective, assisters must go to the people. As Bill Green of the United Way of Metropolitan Chicago stated, “You have to go inside the community itself.” According to Green, the most effective enrollment events by far were ones that “piggybacked on existing community events. Creating our own events didn’t work very well.”
Every interviewee mentioned the ongoing necessity of expanding enrollment assistance and health literacy by providing language access in multiple languages. In Chicago, a large portion of the uninsured do not speak English, so it is important to be able to educate them about their health insurance options in languages that they can understand.
3) Build trust. The most pervasive best practice among our interviewees was a simple concept but one that takes time to develop. Janice Parker, a Navigator at Navicore Solutions summed it up well: “It’s not just as easy as ‘You want health care? Enroll!’ It’s also a matter of trust.” This takes time to invest in the relationship building; however, one way to build trust more quickly is for the state, medical centers or contracted organizations to make a concerted effort to hire from the communities they serve so that they have culturally competent, linguistically expert, trusted partners from the beginning.
The interviewees spoke about the deep ties they developed with clients; the emotional impact of the job is huge, and their effect on the lives of their clients is tangible. Megan Davy, of Peer Services in Evanston, explained: “Every day, somebody hugged me and said thank you. People share their [specific individual] information. To help somebody feel safe — what’s more important than their health?”