Wednesday, 15 May 2002 Evaluation Present: Ruth Ota, Bill Wood, Beth Giesting, Supin Wongbuskaram, Stephany Vaioleti, Robert Hashimoto, Richina Spell, Christi Keliipio, Charlene Gaspar, Piilani Pang, Wanda Kakugawa, Marcia Hartsock, and Barbara Luksch Next meeting: 6 August 2002 at 11:00 AM at HPCA Conference Room 1. Market Trends Pacific's Qualitative Assessment The Evaluation Task Force initiated a qualitative assessment of health and health insurance attitudes and issues among families with uninsured and insured children and youth. The purpose of the study was to: a. Identify major concerns that parents and guardians have about their children's health. b. Understand the relative importance of children having health insurance among this group. c. Identify reasons that children and youth may be without health insurance. d. Elicit ideas from these families about improving the process of obtaining health insurance. e. Measure the success of Hawaii Covering Kids' outreach strategies. It was part of the Hawaii Covering Kids Data Project funded by HMSA Foundation. Bids were sent to five companies and Market Trends Pacific, Inc. was selected to conduct the research. Barbara distributed copies of the focus group discussion guides and Wanda Kakugawa, president of Market Trends Pacific, Inc. and Dr. D. William Wood, University of Hawaii at Manoa researcher, presented their findings. We discussed how participants were referred to Market Trends Pacific, Inc. by outreach workers and next steps for presenting and publishing the study. Task force members felt there is vital information that should be shared first with Med-QUEST and then with the Process Simplification Task Force and key legislators. Barbara will write a letter to Aileen Hiramatsu and Susan Chandler with a copy of the report and request a meeting with Med-QUEST senior staff. She will also schedule a presentation for the Process Simplification Task Force and legislators. A second study will be organized and the focus groups will involve pregnant women. Barbara will meet with Wanda and Sue Uyehara (WIC) to discuss inviting participants. 2. Quantitative Data We reviewed tables and charts from Susan Forbes at Hawaii Health Information Corps on hospital emergency room visits in 1999. This data is an indicator we are tracking for the Hawaii Covering Kids project. Barbara also distributed Med-QUEST enrollment data and pilot project applications data that is available in PDF format on the web site. 3. New Grant We discussed our new grant activities that begin 1 June 2002. We added two responsibilities to the task force's list: advise on follow-up of qualitative assessment studies and monitor outcomes and indicators. 4. Hawaii Covering Kids Data Project: Quantitative Data Bill Wood and Supin Wongbusarakum updated the group on completion of Year 3 (June 2001 to May 2002). The report for Year 2 will be published after the independent school information is completed and the Year 3 report needs profiling information extracted from the public schools emergency cards. Ruth mentioned DOH and DOE will pilot-test scanning software for Form 14 and emergency cards in August, which will eventually make data collection simpler. Friday, 24 May 2002 Process Simplification Task Force Present: Susan Chung, Adrienne Dillard, Aileen Hiramatsu, James Lum, Piilani Pang, Peter Kay, Barbara Luksch, Lynn Fallin, Havinne Anderson, and Ruth Ota Next meeting: 20 August 2002 at 3:00 PM at the State Capitol Room 423 1. Technology Presentation Peter Kay from CyberCom, Inc. presented information on connecting new technology with a mainframe system. Public internet software (such as web site, internal Med-QUEST processing, Microsoft Office) would connect to an XML Gateway (that uses secure and controlled industry standards, open architecture, and is highly integratable) that connects to an internal network (Med-QUEST's HAWI system). The objective is to make the eligibility workers more efficient and productive using modern technology as well as help Med-QUEST's business partners' jobs easier. Following the presentation and extensive discussion, the group decided to recommend small step implementation: a. Med-QUEST develop an informal qualifier computer software. An eligibility worker would input basic information from the application and the software would determine what programs the applicants qualify for. b. Med-QUEST develop an electronic version of the interactive voice response system. This would allow Med-QUEST's business partners to check if the applications they submitted for customers are pending, approved, or denied and the reason for denial. c. Hawaii Covering Kids implement Phase 2 of its electronic application. 2. Ask Aloha United Way Havinne announced that Ask AUW will soon be three digits. Effective July 15 a caller can press 211 from any island and be connected to their service. Also, they will be live 24 hours 7 days a week. 3. Updates a. Simplified Application: Barbara distributed copies of Draft #16 that Med-QUEST is field-testing through its Kaua'i office. b. Simplified Renewal Form: Barbara distributed copies of Draft #7 that Med-QUEST is field-testing through its Kona office. Currently over 400 cases per month with children and youth are closed due to failure to provide information. The task force will continue to monitor this data. c. Children and Pregnant Women Application: Barbara distributed a sample of the five questions required. This will first be implemented through Phase 2 of the electronic application. It was noted that Med-QUEST created simplified applications specifically for 9-11 Net and COBRA Premium Reimbursement and this could be a next step. Friday, 14 June 2002 Media and Public Information/Identification and Outreach Present: Lisa Taniguchi, Cynthia Henry, Liz Ahana, Ruth Ota, Sue Uyehara, Stephany Vaioleti, Lin Lenahan, Kathy Sthay, Lynn Fallin, and Barbara Luksch 1. Updates a. New Grant We reviewed our activities for the new grant that started 1 June 2002. We discussed continuing our immigrant outreach campaign with part two, focusing on enrolling adolescents, working with pharmacies to distribute information (a holdover activity from the first grant), and research partnering with the Boys and Girls Clubs (they are linked at the nation level with the Covering Kids & Families program). Barbara updated the group on other financial support that is required by The Robert Wood Johnson Foundation for the new grant. Proposals were submitted to Hawaii Community Foundation, HMSA Foundation, Verizon Foundation, Med-QUEST, and Castle Foundation to contribute money for various outreach, enrollment, and simplification objectives. b. Immigrant Outreach Campaign Phase 1 The first three target groups are Filipinos, Chinese, and Samoans. Barbara distributed a June advertisement schedule for radio, print, and television. KNDI radio station will air recorded interviews (featuring the DOH Bilingual Health Services staff) and advertisements about free health insurance. Print ads will be in The Fil-Am Courier, Hawai'i Filipino Chronicle, Mabuhay! Hawaii-Filipino Directory, The World Journal, and Samoan International News. There will be television advertisements on KIKU and a Samoan interview on Olelo. 2. News a. Ask Aloha United Way: 211 Trudie explained the FCC designated 211 nationally as an information and referral telephone number and AUW is working with local telephone companies to apply it in Hawaii. Ask AUW's official launch date for the new number is July 15 and the hotline service will operate 24/7/365. Ask Aloha United Way wants their information to be accurate and organizations send updates to them online. b. Kaiser and CBS A yearlong public education partnership was formed between The Henry J. Kaiser Family Foundation and CBS Television Network to design and air PSAs spotlighting children's health care needs and raising awareness that free health insurance is now available. The PSAs start in June 2002 and will promote the toll-free 1-877-KIDS-NOW telephone number for viewers to call for more information. c. 1-877-KIDS-NOW This telephone number has been relinked in Hawaii directly to Ask Aloha United Way. d. Keiki Fair 2002 This two-day event is 10-11 August at Blaisdell Center. Hawai'i Covering Kids and American Academy of Pediatrics-Hawaii Chapter will have a booth promoting kids health insurance and immunizations. 3. Presentation on Covering Kids Communications Camp Five Hawaii participants who attended this 3-day event in Baltimore, Maryland discussed information they learned that could assist our Hawaii Covering Kids project. Goal and Content To help our statewide and local coalitions with their communications and outreach work and prepare for Back-to-School 2002. In-depth media training plus workshops on media skills, forming media partnerships, market research, building business relationships, and promising outreach strategies. a. Barbara Luksch (Hawaii Covering Kids) * Julie Rovner, health correspondent for National Public Radio, gave a history of federal CHIP legislation and explained that kids are not only a sympathetic cause but also cheap to cover. * We must simplify the application and renewal processes because we don't want to "turn parents on with outreach and turn them off by the process." b. Lisa Taniguchi (Hawaii Covering Kids Kauai Local Project) * Use parents/guardians as spokespersons to tell the message. Get media attention from an emotionally charged and dramatic human-interest angle. * Work with media in local communities-newspapers and radio that are specific to that neighborhood or island. c. Liz Ahana (DHS Med-QUEST) * Help parents/guardians understand that QUEST and Medicaid are separate from welfare and that kids of working parents/guardians can qualify. * Caretakers do not need legal guardianship. d. Stephany Vaioleti (Hawaii Covering Kids Kahuku Local Project) * Simplify information presented and use consistent messages. We updated the list below that was first written by the Identification and Outreach Task Force in June 2000: Words We Want Words/Thoughts We Don't Want Yes: health insurance or health care No: coverage, health coverage, health care coverage, medical assistance (unless referring to the Med-QUEST application) Yes: can get qualify No: eligible Yes: call 275-2000 (starting 07/15/02: call 211) free phone call (starting 07/15/02: Free Phone Call from All Islands) call ASK-2000 No: toll free Yes: QUEST and Medicaid No: Hawaii Covering Kids alone or no mention of Medicaid and QUEST (Hawaii Covering Kids perceived as a separate health insurance program), CHIP, SCHIP, HB 540, Immigrant Children's Program (confusion with application and enrollment) Yes: diacritical marks for Hawaiian words Yes: Do you know a child? (indirect approach) No: Does your child need? (on gatorcell signs) Does your child have.? (too direct and leads to feelings of guilt) Yes: Printed on gatorcell signs, T-shirts, etc.: Talk to Me (promotes verbal interaction) No: See Me (implies looking at the person) Yes: customer (promotes a positive business approach including customer service) No: client, participant, patient e. Ruth Ota (DOH Public Health Nursing) * Use research-based messages to motivate parents/guardians through understanding. Worthlin Worldwide did extensive research to better understand motivating factors for parents/guardians enrolling their children in Medicaid programs. Key discoveries include: parents/guardians want to protect their children, access to a physician means children will be healthy, health insurance is predominantly a financial consideration and not necessarily connected to children being healthy, parents want to reduce worry and stress and feel like they are good parents, and free or low-cost health insurance bridges concerns and the money gap. * Use values-based messages in marketing strategies. Findings showed the primary challenge is helping parents/guardians of eligible uninsured children believe these programs are designed for them; therefore messages must tap into the desire to be a good parent and make choices that reduce stress and bring peace of mind. Persuade by reason and motivate through emotion and emphasize benefits to the person, not just talk about the product. Emotional connections could be: "I'm a good parent," less worry, less stress, made the right decision, peace of mind, personal security, personal happiness, and accomplishment. 4. Back-to-School 2002 We watched the "Covering Kids 2002 Back-to-School" video and discussed our plans for August. Hawaii Community Foundation donated money to Hawaii Covering Kids to target parents/guardians of adolescents and the DOE is interested in a partnership to enroll teenagers. In addition to a news conference at a high school in Honolulu with the superintendent, we could make information available and/or have events at the 42 statewide public high schools. It was suggested the news conference include a parent, health care professional, HSTA representative, teen representative, and school administrator. Also, since one of our new local projects is in Kahuku, the Kahuku High School football team might be interested in helping our effort. Informational flyers and Med-QUEST applications should be available through administrators' offices, school health aides, counselors, registrars, coordinated school health facilitators, and athletic directors in each high school during this campaign and throughout the school year. 5. Announcement Cynthia explained that Waikiki Health Center is conducting its annual fundraiser to help pay administrative costs for students' physical examinations and immunizations. They have canisters at local businesses for donations and task force members mentioned several additional partners who may be interested in helping.