February 2004

Grant Results

SUMMARY

The Children's Defense Fund developed a Web-based clearinghouse on children's health insurance coverage and the states' implementation of the 1997 federal/state Children's Health Insurance Program (CHIP). It is no longer available on the Web.

CHIP is a federal block grant program designed to encourage the states to develop insurance programs for children in families earning too much to qualify for Medicaid but not enough to afford private health insurance.

Key Results
The Children's Defense Fund accomplished the following:

  • Developed a comprehensive database on implementation of CHIP in each state.
  • Enhanced the fund's Web site with sub-sites on various aspects of CHIP.
  • Developed a Child Health e-mail listserv that delivered two to four updates monthly to more than 6,600 subscribers.
  • Published six reports and analyses and created two media and outreach tool kits, which it disseminated to more than 3,000 researchers, children's advocates, community organizations and policy-makers.

Funding
The Robert Wood Johnson Foundation (RWJF) awarded two grants for the project between 1998 and 2002, totaling $645,911.

 See Grant Detail & Contact Information
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THE PROBLEM

In 1997, approximately 10.6 million children in the United States were uninsured. That year, Congress established the state Children's Health Insurance Program (CHIP), a block grant program designed to encourage the states to develop health insurance programs for uninsured children in families earning too much to qualify for Medicaid but not enough to afford private health insurance.

The voluntary program allowed each state to design its own CHIP to meet its specific needs. The goal was to increase enrollment of eligible but uninsured children in both CHIP and Medicaid through outreach, simplified enrollment procedures, and coordination between the two programs.

The individual states varied widely in their readiness — politically, financially and technically — to implement CHIP. To enroll the maximum number of eligible children, states needed to learn from one another and follow the evolving federal guidelines on implementation of CHIP.

The Children's Defense Fund proposed creating a Web-based clearinghouse as one way to educate the states. Created in 1973, the fund is a private child advocacy organization based in Washington, D.C.

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RWJF STRATEGY

In 1997, RWJF authorized Covering Kids®: A National Health Access Initiative for Low-income, Uninsured Children, to help states and local communities increase the number of children taking advantage of public and private health insurance programs. When CHIP also passed in 1997, RWJF enlarged Covering Kids to all 50 states, with the goal of reducing the states' procedural obstacles to enrollment in CHIP, Medicaid and other programs, and promoting active enrollment of all eligible children.

The fund's CHIP clearinghouse complemented the educational goals of the Covering Kids program. RWJF expanded Covering Kids in 2001 and renamed it Covering Kids and Families. The two programs together represent one of the largest investments ever made by RWJF, with combined authorizations of at least $150 million from 1998 to 2006.

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THE PROJECT

The Children's Defense Fund developed and implemented a Web-based clearinghouse providing extensive information on children's health coverage and implementation of CHIP in all 50 states.

The clearinghouse was designed to help states and others monitor CHIP activities in the states; inform policy-makers, advocates, researchers, practitioners and the public; and help build the evidence base for effective outreach, enrollment and implementation. It is no longer available on the Web.

In addition, the fund developed a subscriber e-mail listserv on CHIP; conducted CHIP-related teleconferences; and offered technical assistance to state agencies and advocates.

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RESULTS

The project director reported these key accomplishments:

  • Project staff developed a comprehensive database on implementation of CHIP in each state. Data included information such as types of programs, enrollment procedures and numbers of uninsured children.
  • CDF enhanced its Web site with sub-sites on various aspects of CHIP. Sub-sites included online application forms to facilitate enrollment and a student service link to engage young people in the program. The Web site recorded an average of 3,000 visits a month.
  • The fund developed the Child Health Listserv, an e-mail service and sent two to four updates monthly on CHIP policy, reports and data to a subscriber list that grew to more than 6,600 recipients. Subscribers to the service were state officials, children's advocates, national professional organizations, academic researchers and others. The Listserv is no longer available.
  • Project staff conducted national toll-free telephone conferences on various aspects of CHIP. The teleconferences were held one to four times a month, with approximately 100 participants in each call. They were arranged in collaboration with Families USA and other national organizations, and they covered topics such as CHIP regulations and eligibility issues. Participants included government officials, health professionals, policy researchers, children's advocates and members of the public.
  • The fund published six reports and analyses, and two media and outreach tool kits. Key publications included CHIP Check-Up, describing state plan designs, and All Over the Map, a 2000 progress report on CHIP. The media kits included model op-ed pieces and letters to the editor. More than 3,000 researchers, advocates and policy-makers receive the fund's publications, which are also available at the Children's Defense Fund Web site.
  • The fund sponsored or co-sponsored four national conferences on CHIP. The May 1999 Children's Defense Fund National Conference, in Houston, Texas, had 1,500 attendees and featured a one-day training on implementation strategies. The March 2000 National Conference in New York City had 5,000 attendees and included training on CHIP/Medicaid outreach in New York and 12 workshops on such topics as best practices in outreach and federal policies affecting CHIP.

Communications

Project staff made numerous presentations to professional organizations, such as the Academy of Pediatric Dentistry, and government agencies, such as the federal Health Care Financing Administration.

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LESSONS LEARNED

  1. Development of a comprehensive source of information on state implementation of a large, flexible federal program such as the state Child Health Insurance Program (CHIP) requires a budget adequate for extensive information gathering. The original budget for staff time for the project proved to be unrealistic, given the research demands. (Project Director)
  2. Information projects related to an evolving program such as CHIP must adapt over time as the program matures and fewer policy changes and developments occur. Project activities shifted over time from program design and implementation to assessment of outreach and enrollment activities. (Project Director)

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AFTER THE GRANT

In 2002, RWJF completed its participation in the project. The Children's Defense Fund continues the CHIP educational tools and activities developed under the grants with ongoing funding from the Kellogg, Packard and MacArthur Foundations, and the California Endowment.

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GRANT DETAILS & CONTACT INFORMATION

Project

Children's Health Insurance Coverage Project

Grantee

Children's Defense Fund (Washington,  DC)

  • Children's Coverage Education Project
    Amount: $ 147,031
    Dates: December 2000 to November 2002
    ID#:  039241

  • Promoting Implementation of State Children's Health Insurance Programs (CHIP)
    Amount: $ 498,880
    Dates: May 1998 to April 2000
    ID#:  033579

Contact

Greg Haifley
(202) 662-3541
ghaifley@childrensdefense.org

http://www.childrensdefense.org

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Note: Children's Defense Fund publications are available at the CDF Web site.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Dorn S, O'Connor J and Haifley G. CHIP Check-up: A Mid-Term Report on the State Children's Health Insurance Program. Washington: Children's Defense Fund, 1998.

CHIP Check-up: A Mid-Term Report on the State Children's Health Insurance Program. Washington: Children's Defense Fund, 1999.

Children's Defense Fund. Insuring Children's Health: A Community Guide to Enrolling Children in Free and Low-Cost Health Insurance Programs. Washington: Children's Defense Fund, 1999.

Dorn S, Teitelbaum M and Cortez C. An Advocate's Toolkit for the State Children's Health Insurance Program. Washington: Children's Defense Fund, 1999.

Children's Defense Fund. Congressional Workbook: Basic Process and Issue Primer. Washington: Children's Defense Fund, 2000.

Edmunds M, Teitelbaum M and Gleason C. All Over the Map: A Mid-Course Review of the Children's Health Insurance Program (CHIP). Washington: Children's Defense Fund, 2000.

Sponsored Conferences

"Delivering on the Promise: What's Next in Children's Health," co-sponsored with Families USA and the National Association of Child Advocates, November 5–6, 1998, Washington. Attended by 140 participants representing every state implementing CHIP, and members of several national organizations, including the American Academy of Pediatrics, National Association of Child Advocates and March of Dimes. Two plenary sessions and six workshop/discussion sessions.

"Children's Defense Fund's National Conference 1999," April 29–May 2, 1999, Houston. Attended by 1,500 participants representing several hundred national organizations, policy researchers, clinicians and the media, including: Families USA, California Healthy Families and Texas Association of Community Health Centers. Four workshops.

"Delivering on the Promise: What's Next in Children's Health, Part 2," co-sponsored with Families USA, November 8–9, 1999, Washington. Attended by 128 participants representing 120 state and national organizations, including National Immigration Law Center, Center on Budget and Policy Priorities, and National Council of La Raza. Four plenary panels and 12 workshop/discussion sessions.

"Children's Defense Fund's National Conference 2000," March 25–28, 2000, New York. Attended by 5,000 participants representing hundreds of national organizations, policy researchers, clinicians and the media. Twelve workshops and two panel discussions.

World Wide Web Sites

www.childrensdefense.org. "Children's Health Insurance Program" on the Children's Defense Fund Web site includes data, charts and graphs, reports, and analyses related to the federal Children's Health Insurance Program (CHIP). Washington: Children's Defense Fund.

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Report prepared by: Jan Hempel
Reviewed by: Richard Camer
Reviewed by: Marian Bass
Program Officer: Pamela Dickson

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