Outreach and Enabling Services
Health centers provide critically important non-clinical, enabling services that help reduce barriers to care and increase access to health care and social services for the patients they serve. Theses enabling services including transportation, interpretation, health education, referrals, case management, environmental health risk reduction, and outreach and enrollment (O&E) assistance.
Health Center Outreach and Enrollment
Health centers continue to provide outreach and enrollment assistance to consumers looking for health insurance coverage. According to 2019 UDS data, health centers employed over 4,000 enrollment assisters — also known as Navigators, certified application counselors (CACs), in-person assisters, etc — to help consumers understand their insurance coverage options and enroll into public and private health plans. These assisters provided nearly 5 million assists to individuals seeking coverage.
Open Enrollment Key Dates
- In March 2021, the Biden Administration announced a Special Enrollment Period (SEP) for obtaining health care coverage through Healthcare.gov. The SEP currently extends through August 15, 2021.
- If you lost your health insurance due to a job loss, you may qualify for Special Enrollment Period through Healthcare.gov.
- Healthcare.gov has a “Coronavirus” page that explains changes in Marketplace coverage and eligibility resulting from the COVID-19 pandemic.
- On June 22, 2021, NACHC and Young Invincibles co-hosted a national event to promote the HHS Special Enrollment Period’s “Community Health Center Week of Action (June 21-25).” Click here to view the slides.
Resources on Enabling Services
In addition to enrollment assistance, health center staff also provide other enabling services such as health education, improving the health literacy of the newly insured, translation services, and peer counseling. Research shows that enabling services provided by health centers improve access to care, access to preventive services, and increase satisfaction among health center patients.
In 2019, with funding from HRSA, NACHC published four case studies on health centers and primary care associations that took innovative approaches to providing enabling services in their communities. Each case study focuses on a different issue — i.e. behavioral health integration, addressing food insecurity, etc. — and highlights how each organization invested in and expanded the role of their enabling services staff to address critical needs.
- A Focus on Apprenticeships: Alaska Primary Care Association Apprenticeship Program
- A Focus on Behavioral Health: WellSpace Health, Sacramento, CA
- A Focus on Field-Based Enabling Services: North Carolina Farmworker Health Program
- A Focus on Food Insecurity: Native Health, Phoenix, AZ
Publication on Community Health Worker Reporting in UDS:
MHP Salud released a publication titled “Reporting of Community Health Workers in the Uniform Data Sytems: Important Factor to Consider.” This tool provides resources that help health center identify staff that perform duties aligned with the Community Health Worker (CHW) profession and that how that should be reported in UDS.
Enabling Services Accountability Project
NACHC works closely with the Association of Asian Pacific Community Health Organizations (AAPCHO) on a range of efforts related to enabling services. AAPCHO’s Enabling Services Accountability Project was designed to increase EMR data collection on enabling services in order to demonstrate the role of enabling services in increasing access and quality of care for medically underserved communities.
Previous 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
- Outreach and Enrollment Issue Brief: Expanding the Role of the Enrollment Assister at Community Health Centers (April 2017)
- Improving Outreach and Enrollment Efforts in Health Centers Through Medical-Legal Partnership (February 2017)
- “Navigating the Health Insurance Marketplace: Community Health Centers and Consumer Assistance Programs,” (January 2015): This paper is a supplement to NACHC’s August 2013 Issue Brief “Navigating the Health Insurance Marketplace“
- Privacy and Security Standards for Personally Identifiable Information (November 2013)
- Conflicts of Interest During Application Assistance (November 2013)
- August 2013 Issue Brief “Navigating the Health Insurance Marketplace” (August 2013)
NACHC Podcasts on Outreach & Enrollment
- Creating a Culture of Enrollment: A Tale of Two Health Centers (Oct 2016): This podcast highlights how federal funding for O&E-activities impacted health centers in both Medicaid-expansion and non-Expansion states.
- Reports from the Field: Outreach and Enrollment in Milwaukee: This podcast focuses on successful, collaborative O&E-efforts spearheaded by Progressive Community Health Centers in Milwaukee, WI.
- Reports from the Field: Outreach and Enrollment at Health Centers (Feb 26, 2016): This podcast focuses on how health centers and primary care associations help enroll individuals into Marketplace and Medicaid coverage.
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.
Outreach and Enrollment in State Based Marketplaces
This webinar highlighted outreach and enrollment successes, challenges and best practices in State-based Marketplace states.
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.
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.
Contact Ted Henson, Director, Health Center Growth and Innovation, at (301) 347-0474 for more information.