Elizabeth Wood
(Editor’s Note: In honor of the upcoming Children’s Health Insurance Program Reauthorization Act anniversary on Feb. 4, Say Ahhh! is highlighting how CHIPRA has helped connect children with coverage since President Obama signed it into law two years ago. This week, Elizabeth Wood, formerly with the New Jersey Office of the Child Advocate, shares an innovative strategy she initiated to reach out to eligible children and families.)
According to figures cited by the National Education Association, “English Language Learners are the fastest growing segment of the public school population….[B]y 2025, nearly one out of every four public school students will be an English Language Learner.” Estimates indicate that the majority of children living with non-citizen parents were born on U.S. soil and meet the strict residency requirements for Medicaid and other Federal Health Benefits as defined by Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
One of the Children’s Health Insurance Program Reauthorization Act’s (CHIPRA) principal objectives is to find and enroll all eligible children in need of health insurance coverage and to remedy barriers to that objective due to ethnic and cultural differences. CHIPRA offers states a generous set of incentives to attempt this feat; it also provides new options for sharing beneficiary data across government agencies (“the Express Lane Agencies”).
Back in 2009, when passage of national health care reform still seemed like a remote possibility, the NJ Office of the Child Advocate (OCA)* took an unconventional approach to tackling the need for a large-scale and cost-effective bilingual outreach strategy using several CHIPRA provisions as both inspiration and a kind of permission. The premise motivating our outreach project was that children in limited English proficient (LEP) or English as a Second Language (ESL) classrooms likely had parents that needed information about NJ FamilyCare coverage presented in their native language. In New Jersey, where 25.5 % of all residents speak a language other than English at home, a comprehensive outreach project includes an estimated 144,000 non-citizen children and many more U.S.-born children of non-citizen parents.
We posited that the need for translations went far beyond English-Spanish, but we had to find data to understand the real state of need. To that end, in late 2009, we mapped the state by linguistic need using data kept by the Department of Education. We used as the outreach tool a standard fact sheet on NJ Family Care (the state’s CHIP program); it provides among other things a basic program description, a list of covered services, cost per family size, eligibility restrictions for immigrants, and a multilingual information hotline number.
Here’s how it worked:
The Department of Education compiles data on all limited English proficient children enrolled in public schools for the purpose of calculating state school aid funding and compliance with Title III of the No Child Left Behind Act of 2001 (NCLB). Under NCLB, all public school districts must report the number of children with a non-English native language, the number of those who are limited English proficient, as well as the district identification number, district name, and county name.
The headcount of LEP students is tabulated by native language and by grade across the full range of public school grade levels from three-year-olds in preschool through high school students in twelfth grade. According to the State Profile of LEP Students 2007-2008, there were 279,366 language minority students served in 475 school districts, encompassing 168 foreign languages. Of those, 61,904 limited English proficient students were served. The data served as a proxy for how many parents of school-age children might need translation and interpretation services to successfully enroll their children in NJ FamilyCare.
The data were then aggregated according to native language and school district. When we took a close look at our numbers, we found tremendous variation in the languages spoken at the district level. For example, one district might need 1,500 Spanish, 350 Gujarati, 200 Polish, and 50 Vietnamese fact sheet translations. A district nearby might need 100 Spanish, 250 Arabic, 200 Mandarin Chinese, and 35 Urdu. Even the composition of our diversity is diverse!
What made this project so unique was that we used the aggregated data to create customized mailing packets in the top fifteen languages spoken in the state: Arabic, Mandarin Chinese, Haitian Creole, French, Korean, Gujarati, Hindi, Polish, Portuguese, Russian, Spanish, Tagalog, Urdu and Vietnamese. We tailored the mailing such that each school district received fact sheet translations that matched native language enrollment for the most recent school year.
Once aggregated, the district-level child counts and the customized translation packets were shared with each school district’s superintendent and ESL Coordinator for distribution to parents. As a result, limited English proficient parents with school-age children received language-accessible and official information about NJ FamilyCare and a tool for confidently approaching community health partners.
* The NJ Office of the Child Advocate was dissolved in July 2010 as a result of the budget crisis.
(Editor’s Note: If you have an outreach story to share in honor of the CHIPRA anniversary, please contact Say Ahhh! blog editor Cathy Hope.)
