HUSKY Focus Groups - What Parents Are Saying

EXECUTIVE SUMMARY

Uninsured children live with serious health risks because they are less likely to receive preventive and other medical care, and their families are at risk of financial ruin for even moderate illnesses or injuries. In July 1998, Connecticut took an historic step to improve the lives of thousands of children and teenagers by opening the HUSKY Plan (Healthcare for UninSured Kids and Youth). HUSKY offers free or affordable, comprehensive health care coverage to Connecticut children under age 19 who do not have health insurance, regardless of family income level. The HUSKY Plan combines the pre-existing Medicaid program with the new federal Children's Health Insurance Program.

Unfortunately, HUSKY enrollment numbers have not reached expectations. To expand enrollment and encourage more parents to take advantage of the opportunities HUSKY offers, the legislative Medicaid Managed Care Council's Consumer Access Subcommittee and the Department of Social Services (DSS) have joined to fund and sponsor several focus groups with parents of uninsured children. The focus group project asked parents of uninsured children for their attitudes about HUSKY and for their suggestions to improve outreach. While parents of uninsured children were recruited for the groups, a few of the focus group participants were current HUSKY customers. While focus groups are, by their nature, rich sources of intensive information, they also represent the attitudes of a narrow sample of the population. The focus groups proved to be very valuable in identifying problems and solutions for HUSKY enrollment.

The success of the project was due in no small part to the cooperation and commitment of administrators, advocates, legislators, community members, providers, and the parents who participated.

The findings were not surprising. Enrolling children in health coverage is not as simple as sending out brochures and waiting for clients to apply. In many cases, enrollment is a complex process involving information, advocacy, application assistance, follow-up and sometimes persuasion. While Connecticut has initiated a multi-level outreach program, including $500,000 in grass-roots outreach contracting and a significant media campaign, the focus group results indicate that many parents still need to know a lot more about HUSKY.

Many participants knew little or nothing about the program. Others had heard something about HUSKY but did not understand it well enough to see how it could help their family. Once parents learned about the program, they were universally enthusiastic about participating, and several offered to talk to people in their communities about the program. Despite steps to market it as a commercial product rather than a government program, HUSKY suffers from a general stigma and suspicion of public programs. Some parents are baffled by the health care landscape in general, and may confuse HUSKY with news and advertising 'noise' about commercial products. Some may need to hear about it from a trusted member of the community, and some may need to hear from several sources before they take action.

Since HUSKY includes an expansion of eligibility to thousands of new children, outreach must include new mechanisms to reach a new audience with little contact with DSS in the past. This is a significant challenge and requires the concerted efforts of new sectors of the state. These new 'HUSKY cheerleaders' must include many that are not now involved in children's health or outreach and do not consider that their role. Motivating these segments is only one of the challenges facing HUSKY.

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