Outreach and Enabling Services

Community Health Centers around the country conduct vitally needed outreach and enabling services (O&E) activities, including enrollment assistance. Enrollment assisters have traditionally engaged in activities to help consumers understand their coverage options, how to enroll into coverage, and how to use their insurance coverage. Their role has now evolved to include a range of “enabling services,” non-clinical services that allow individuals to access health care and improve health outcomes. These services can include eligibility assistance, health education, health literacy, outreach, transportation, and translation.

With support from the Robert Wood Johnson Foundation (RWJF) and from HRSA, NACHC generated a series of webinars, case studies, issue briefs, podcasts, and convened meetings of primary care association O&E staff and health center staff.

Contact Ted Henson, Director, Health Center Growth and Innovation, at (301) 347-0474 for more information.


The 2019 open enrollment period (OE6) for Affordable Care Act health plans was Nov. 1 – Dec. 15, 2018. Health centers continue to provide outreach and enrollment assistance to consumers looking for health insurance coverage. Funds for navigators and other consumer assistance have been cut so it’s important to share information broadly with your networks so people who need health coverage have the information they need to sign up. Here are a few resources to help you get started.

NACHC Case Studies on the Impact of O&E Activities on Health Centers

  • Borinquen Medical Centers of Miami-Dade, Miami, FL (2017) – This case study highlights the impact of conducting outreach and enrollment activities on the operations and finances of a large urban health center in Miami.
  • Partnership Community Health Center, Appleton, WI (2016) – This case study highlights how a health center serving both rural and urban populations trained and hired the first Certified Application Counselors (CACs) in its state and re-branded itself to serve all patients in its service area.
  • Mountain Comprehensive Health Center, Whitesburg, KY  (2015) – This case study highlights best practices and innovations implemented by a health center in rural Kentucky and how these O&E-activities impacted the health center’s finances and operations.

NACHC Issue Briefs on O&E

NACHC Podcasts on Outreach & Enrollment

General Information & Resources on O&E

Examples of Job Descriptions for Outreach and Enrollment

Following are examples of job descriptions for staff positions related to outreach and enrollment efforts. All will need to be modified based on the specific needs of the Community Health Center.

  • The first example from the Michigan PCA is specific to a health center staff position which will focus on doing the outreach and enrollment. View the job description.
  • The second example from the Arizona PCA is for a health center staff position in a more oversight/coordinating role. View the job description.

Outreach and Enrollment Webinars

In 2018, through the support of Community Catalyst and the Robert Wood Johnson Foundation, NACHC hosted a series of webinars and developed resources on outreach and enrollment, as well as customizable materials to support community health centers in their health literacy and outreach efforts.

Outreach and Enrollment Funding Strategies and Partnerships
This webinar explored innovative strategies and partnerships to ensure sustainable funding for outreach and enrollment activities.

Access the recording

Outreach and Enrollment in State Based Marketplaces
This webinar highlighted outreach and enrollment successes, challenges and best practices in State-based Marketplace states.

Access the recording

Medicaid and CHIP Outreach & Enrollment
This webinar provided an overview of successes, challenges and best practices for Medicaid and CHIP outreach and enrollment under the Affordable Care Act.

Access the recording.

O&E For Puerto Rico and US Virgin Islands Hurricane Evacuees
This webinar discussed coverage issues for evacuees in the wake of severe weather events in Puerto Rico and the U.S. Virgin Islands.  This webinar is intended for health center focused outreach, enrollment, and enabling services staff or volunteers. PowerPoint presentations and a recording of the webinar are now available. NACHC presented this webinar in partnership with UnidosUS.

Access the recording.

Outreach and Enrollment Policy Updates

2017 Changes to O&E Reporting for Health Centers: In 2016, health centers submitted quarterly progress reports to HRSA on their O&E-activities. On January 1, 2017, the process for reporting O&E-activities changed. This data will be captured in future years via the annual Uniform Data System (UDS) submission. See HRSA Program Assistance Letter (PAL) 2017-01 and FAQ #7 in the HRSA FAQs for O&E assistance.

2017 Navigator Grant Award Recipients: In September 2017, the Centers for Medicare and Medicaid Services announced nearly $37 million in Navigator grant awards to organizations nationwide to support local in-person assistance to consumers enrolling into Marketplace coverage. This is the third year of a three-year funding cycle. The 2017-18 funding levels represent a 41% reduction in overall funding for all grantees. These cuts were disproportionately allocated across the nation. For example, grantees in Indiana, Nebraska, Louisiana, Michigan, and Ohio received a 70% reduction in funding overall whereas grantees in Kansas, West Virginia, and Delaware received the same amount of funding overall.