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Local Project – Targeting Rural Children
New Hampshire’s rural project will target Strafford County where children are at least
30% more likely to be uninsured than in other parts of the state. These children live in families who are
challenged by issues of isolation, low-literacy, poverty, lack of housing and transportation, and those
with a demonstrated inability to follow-through on the application process. This project will conduct
outreach efforts countywide but will focus on the most rural communities of Strafford, Milton, Middleton,
Farmington, and northern Rochester. These areas are remote, without public transportation and all are rated
by KIDS COUNT 2001 as "poor" or "poorest".
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The HUB Family Resource Center in collaboration with the Strafford County Prevention Board, a long standing
broad-based community coalition, will lead the rural project. The HUB is headquartered in Dover and has
satellite programs in four towns and at schools throughout the county. The HUB is uniquely poised for
outreach through its home-visiting programs which reach families in the most remote locations. The
Prevention Board has been supporting prevention and wellness initiatives for the past 15 years. Its
membership includes leaders from the medical, educational, social service, child care, and business
communities. The board meets monthly providing an opportunity for networking and information sharing. In
addition, a number of key leaders in school administration, regional housing authorities, and health care
delivery have pledged their support for this project.
The overall goal of the rural project is to reach out, identify and enroll every eligible child in the
target population. The second goal is to test several strategies which simplify the process and enhance
the seamlessness of the system so that no eligible child is left uninsured. The third goal is to implement
strategies which support retention and coordination of coverage as family eligibility circumstances
change.
Outreach will be focused on identifying uninsured children through three strategies. First, the HUB will
partner with the School Lunch Program to identify uninsured, eligible children. This initiative will build
on the work pioneered by the previous Covering Kids grant with the intent of intensifying follow-up and
personalized application assistance to ensure success. Second, the HUB will partner with local housing
authorities. Lack of affordable housing is the most pressing economic factor affecting the county. This
strategy will target eligible children in the 2,000 families who reside in low-income housing units
throughout the county. Working with housing authority directors in the region, outreach workers will
identify uninsured children during the initial housing eligibility and re-certification processes. Third,
the HUB and its partners will integrate outreach in their home visiting programs, serving 300 families per
year, and in their parenting support groups and classes each week, reaching 500 families. Screening for
insurance status and educating families about Healthy Kids eligibility will become a standard part of the
home visiting protocol. A five-minute presentation on Healthy Kids and the enrollment process will be
incorporated in the parenting class curriculum.
A primary technique for simplifying the application process is to offer personalized, one-on-one assistance
through the project’s outreach coordinator, as well as home visitors and parent educators. The school lunch
initiative also offers a significant opportunity to simplify the process by using eligibility for free or
reduced school lunch as evidence of residence, age and income eligibility for Healthy Kids. Likewise, the
housing initiative offers an opportunity to use Section 8 housing eligibility as evidence of residence and
income in order to simplify the process.
Each HUB center receives 8 to 12 calls a day from parents seeking referral services. A very simplistic
strategy the HUB proposes will be to add to the welcome telephone message at The HUB and the Rochester
Parent Child Center the phrase, "Call us for information on applying for or renewing your Healthy Kids
Insurance". Just as with outreach, re-certifying Healthy Kids enrollment and assisting families in
transitioning between programs will become a standard part of the home visiting program, parent classes
and the housing initiative. This work will be supported by a tickler system integrated into a database
that is used to track families enrolled through the project. The HUB will also develop a process to
identify and make a connection with families about the Healthy Kids program during the annual mandatory
Section 8 re-certification process in order to coordinate continuing coverage. We will also seek DHHS
approval for the school lunch initiative to be coordinated with Healthy Kids renewal efforts in subsequent
years of the grant. A key component of the coordination strategy in this project is to educate parents
about renewal requirements and how to stay enrolled.
The HUB has the commitment of the home visiting teams, schools, housing authorities, hospitals and the
Prevention Board to continue the strategies after the four-year grant funding is complete. Sustainability
is better assured after having identified the successful ways of reaching families and keeping them
enrolled. As a local project site, the HUB will use successful models as the selling points to keep
the community involved in identifying and enrolling eligible children.
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