Just because children and adults are eligible for benefits like health coverage
through Medicaid or the State Children's Health Insurance Program (SCHIP)
doesn't guarantee they will ever receive these services. The process of
applying for benefits can be frustrating for families because of requirements
like face-to-face interviews that can pull them away from work and long
applications that are difficult to understand and complete. These barriers are
further amplified by county and state eligibility systems that employ
unnecessary policies and procedures and rely on antiquated and sometimes
erroneous computer systems to decide whether or not someone will be approved or
denied. The outcome is too often discouraged families and a stressful,
unproductive environment for eligibility agencies.
In 2000 The Robert Wood Johnson Foundation (RWJF) decided to fund a project
that would help states and large counties solve problems in their eligibility
systems and processes that make it difficult for lower-income families to
access or retain Medicaid, SCHIP or Food Stamps, particularly families moving
from welfare to work. The Southern Institute on Children and Families was
selected to lead this effort as the National Program Office (NPO) for
Supporting Families After Welfare Reform: Access to Medicaid, SCHIP and Food
Stamps. Led by Southern Institute Vice President, Vicki C. Grant, PhD, MSW, and
including a project staff with experience in government eligibility systems,
Supporting Families grantees tackled challenges in states and counties that
resulted in positive changes in terms of the way children and adults access
benefits for which they are eligible.
Initially Supporting Families grantees were selected to receive technical
assistance either to identify key improvement measures for their eligibility
systems (Alabama, Connecticut, Delaware, Maine, Minnesota, South Carolina and
Cuyahoga County in Ohio), or to implement improvement plans in their
eligibility systems (Georgia, New Jersey, Los Angeles County and San Bernardino
County in California and Nassau County in New York). In 2002 RWJF and the
Southern Institute evaluated the existing model for technical assistance and a
decision was made for project staff to study and adapt an innovative method
developed by the Institute for Healthcare Improvement known as the Breakthrough
Series Collaborative. Following a period of training, Southern Institute
Supporting Families staff adapted the model to their needs and the result was
the Supporting Families Breakthrough Series Collaborative.
The Supporting Families Breakthrough Series Collaborative consisted of a group
of teams that worked towards a common goal of process improvements, and used
each other as a resource for learning by sharing ideas and experiences. Teams
tested specific improvement strategies that have proven to be successful in
addressing their areas of concern and implemented changes based on results from
their small scale testing (testing strategies in small increments or brief time
periods). Teams had access to each other, faculty members who are experts in
the topic field and the collaborative leadership comprised of Supporting
Families staff. Grantees participated in three learning sessions, independent
action periods, monthly conference calls and technical assistance site visits
during the collaborative.
The final Supporting Families Annual Meeting took place in San Antonio, Texas, in February 2004. Project staff led participants in general sessions and facilitated discussion groups where they heard and shared promising practices from their experiences with the Supporting Families project. A comprehensive report also was developed, which chronicles the Supporting Families experience. The Supporting Families Story: A Movement Toward Quality Improvement is a record of challenges and successes in the quest to improve the way families apply for and access public benefits.
In 2003 RWJF announced a special opportunity for Covering Kids & Families (CKF) grantees to participate in a process improvement collaborative. Covering Kids & Families was a project directed by the Southern Institute between 2001 and 2007. The CKF Process Improvement Collaborative was designed to capitalize on lessons learned from the Supporting Families Breakthrough Series Collaborative while focusing on improvements related to the goals and strategies of the CKF project. The CKF Process Improvement Collaborative took place between September 2003 and November 2004. Positive feedback from participants and interest generated by non-participating CKF grantees were factors in approval of a second CKF collaborative by RWJF, which took place in 2005.
The Supporting Families project officially ended on December 31, 2004. Supporting Families established a legacy that continues in the form of the Southern Institute Process Improvement Center. Developed from the knowledge and experience gained during Supporting Families, the Process Improvement Center will focus on quality and process improvements in the health coverage eligibility processes under Medicaid and SCHIP. The Process Improvement Center will assist public programs and related business leaders and administrators in cultivating a practical skill set and knowledge level to effectively implement process improvements in their respective programs.
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