First published on July 13, 2015 in observance of the COPH’s 30^th anniversary celebration.

Jodi Ray is a bundle of energy when she talks about the project that has become her life’s work, Florida Covering Kids and Families, which is a part of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies.

The founding program director was Mary Figg, a state representative for Hillsborough County.  After a year or two of preliminary maneuvers, the initiative began formally in 1999.  Figg had enlisted Ray, who has a master’s degree in mass communications, the year before to be program coordinator and handle all things media, including assisting her with crafting the successful request for that all-important initial grant.

“My job was to manage a multimedia campaign.  I’ve done a lot of mass communications on this job,” she said.  “In fact, I’d say I do more of that than anything else.”

The project was funded its first seven years by the Robert Wood Johnson Foundation to do outreach enrollment of children eligible for the Children’s Health Insurance Program and Medicaid.  During that time, a staff of two more than doubled to five by 2006, then, when that funding ended, was cut all too literally in half, reduced to a project director, a coordinator and a half-time assistant: essentially, a staff of 2-1/2.  Fortunately, they had a dedicated network behind them.

Jodi Ray

“We have a state coalition,” Ray said, “a large collaboration of partners from around the state and local coalitions in almost every community in the state.  We came together and said, ‘Our mission is to get uninsured into coverage.’”

The coalition was initially mandated by the RWJF grant, Ray said.  It remains active today and includes some of its original members.  No question, it answered a critical need in 2006, when half the staff was asked to keep up with an exponential work-load increase created three years earlier.

Crying on the phone

“In 2003,” she explained, “the state ended all outreach efforts for CHIP.  So they literally boxed everything up and sent it to me.  They gave me their contact lists and all of their partnerships and said, ‘Could you please take this on?’  Now granted, there were no financial resources with that at the time.”

“The state also closed enrollment for CHIP in Florida for 18 months.  As a result of that, we lost over 300,000 kids in the Florida KidCare program.  In one month alone, we lost 40,000 kids.

“There was no statewide outreach initiative except us,” she said, “me and my other 1-1/2 people.  The number of calls I got was unbelievable.  People were calling and crying.  It was terrible.”

That situation started Ray on an 18-month crusade, talking to newspaper editorial boards, legislators, community leaders, almost anyone who would listen.

Committed to moving forward, she and the coalition began implementing a plan that was as innovative as it was aggressive:  Sign up as many kids as possible to a waiting list.  When the list reached 120,000, the New York Times took notice and gave the state a boatload of blistering press.  Not long after, the governor issued an executive order to enroll all the kids on the list, and open enrollment returned permanently four months later.

In 2007, a new governor, Charlie Crist, declared the uninsured rate among children appalling.  He brought the state agencies together, Ray said, and told them to figure out how to make it better, and fast.

“One of the things they did was decide to give us some resources,” Ray said.

A state contract and marketing materials soon followed, along with help from state agency staffs on routine but time-consuming matters like mailing.  Growth was back, and with it, ramped-up after-school activities and more engagement with local businesses.

The results since have ranged from impressive to remarkable.  Since the first open enrollment period began on Oct. 1, 2013, the project has gained national media coverage for enrolling about 2.5 million previously uninsured Floridians, twice the expectation.

“We expanded to focus on all the newly eligible uninsured to help them get into whatever coverage options are available,” Ray said, “whether under the Affordable Care Act in the marketplace or Medicaid or CHIP.  One way or another, we were going to help people who didn’t have coverage get health insurance so they could get access to health care services.

“Health care services are important, and having preventive care, all those things.  We talk about all those things being necessary, but you’re not getting in the door unless you have health insurance.  So that’s what we focus on: the first step, getting people in the door.”

That may be the focus, but there’s plenty more to do.

“We also do one-on-one application,” she said.  “We have consumers that actually sit down with us and do enrollment.  We do everything that involves connecting people to health coverage.

“We even do some health literacy.  How do you use health insurance?  How do you make an appointment to see a doctor?  For many of the uninsured, these are not obvious.”

“We work with all the agencies on both the state and federal levels that are involved in implementing health coverage, and we get out there and shake the bushes.”

Media and more

As much effort as is spent on finding the uninsured, many do find FCKF first, Ray said.

“We get cold calls for everything,” she said.  “I used to wonder sometimes how people find us, but I don’t wonder that anymore.  All you have to do is help somebody.  Then that person gives your number to somebody else.  We get a lot of calls by word of mouth.  We helped someone at some point, and even years later, we get a call from that person’s family member or friend who needs help.”

“The things that consumers come in here and tell you are unbelievable, sometimes heartbreaking.  That’s the other thing that’s really tough,” she said.  “I’ve gotten calls that have made me literally get up and walk around the building a few times because the stories are terrible: the family living in a car; the kid who’s got some kind of horrible heart condition; the mother who had CHIP coverage, but something went wrong with her renewal, it got dropped, it’s Christmastime and she has no money because the asthma medication she had to pick up for her son cost $400.”

While grants provide the funding, the University of South Florida and College of Public Health make it work, Ray said.

“Our work has been very well supported by both the College of Public Health and the University.  I say this out loud every day:  I don’t think anybody doing this work could be in a better place.  I don’t think there’s any way Dr. Petersen could support our work any more than she does.  We get so much support from one end of this university to the other, and we worked with everybody through open enrollment.”

Student Health Services, the libraries, the Morsani College of Medicine and the Marshall Center were regular haunts, as were the St. Petersburg and Sarasota-Manatee campuses.

From the beginning, Ray, who became director upon Figg’s retirement in 2003, has been the media go-to person from the beginning, and that responsibility has grown as exponentially as the project itself.

“We do four press conferences a year.  I spend a ridiculous amount of time talking to reporters.  Just in the first open enrollment period alone, I probably did 80 or 90 interviews with reporters from one end of the country to the other.”

The result was major articles in The New Yorker, the New York Times and the Los Angeles Times, to name a few, as well as pieces widely disseminated by the Associated Press and Reuters, as well as personal visits from two national health secretaries.

Ray on Capitol Hill in a nationally televised discussion.

“During the first open enrollment period, we had the second-largest grant in the country,” Ray said.  “That, in itself, drew attention, and [U.S. Health and Human Services Secretary Kathleen Sebelius] came here, herself, and awarded the grant.  She came to the college, and that’s how I found out we’d gotten the grant.”

It’s little wonder, then, that what began with two people 17 years ago keeps a dozen in the USF office busy with training, policy work, education, outreach, grant-writing, communications, etc.  It’s an office full of multi-taskers, Ray said.

“We all do all of it,” she said.

Given the complexities of health insurance laws and regulations, not to mention a new set of rules for navigators, just keeping up is a task unto itself.

“We do have to make it a point to stay informed.  We’re constantly on webinars and trainings, reading policies and reading new rules.  We have our hands in a lot of different elements of public health, just because we have to.”

The toughest part of the job, she said, is not being able to help everyone.

“We still have a gap of folks who are not going to qualify for coverage they can afford because the state has not expanded Medicaid coverage,” she said.  “I’d like to see us be able to enroll everyone who has no access to health coverage.  I’d like to see that in less than five years, quite frankly.  I would hate for that to be a five-year goal.”

Ray makes it obvious that what she and her colleagues do at Florida Covering Kids and Families is what keeps her pumped with energy.

“It’s all very exciting,” she said.  “We’re right there at the front end of this, and that, in and of itself, is exhilarating.  I feel good about what we’ve been able to accomplish, so it’s all been worth the time and effort – and the stress and the exhaustion – because it’s paid off.  We’re actually having an impact, and people see it.”

Every flight needs a navigator

The federal navigator initiative aimed at getting people into the new health insurance marketplace has been a major focus of their work the past two years, as well as a major hallmark of their success.

“The navigators are tied specifically to the federal marketplace.” Ray explained, “Some states are not participating in the federal marketplace, but Florida happens to be one of those states that is.”

The federal program provides outreach enrollment funds.  The first funding opportunities began in 2013, Ray said, and her office applied for USF to get an award that would cover the state.  She and her team did all the grant writing.

“We had already been doing this work on the ground across the state to enroll kids in CHIP and Medicaid,” Ray said, “and many of the partners around the state had come to a consensus that it made perfect sense for us to be the applicant for this grant and take the lead.  So, what we did was look at the model that was already working and find a way to expand on that.”

The result was a $4.2-million award in 2013 to cover 64 of the state’s 67 counties, the exceptions being Broward, Miami-Dade and Monroe, which submitted their own applications separately.

“The second year,” Ray said, “we went back to those partners again and asked them if they would like to join us for the 2014 application.  They said yes the second time around, so the second time around, we covered all 67 counties in Florida.”

The second award was worth $5.3-million.  Ray’s group had secured million-dollar grants for their Children’s Health Insurance Program enrollments, but those, which  had been their largest to date, are easily dwarfed by the Navigator grants.

Most of the funds are vested in the people who get the job done, Ray said.

“A lot of people.  I’m a big believer that priority number one should be the human resource.  The folks on the ground.  The folks who are out there doing the education, the communication, the one-on-one application assistants, the people who know the processes.  We know from our history of doing this and tons of research that these are the folks who keep people from getting lost along the way through the process.”

In one regard, Ray said, the Navigator’s work has only begun with the enrollment stage.

“They help people navigate the enrollment process and get to the point where they can be enrolled and covered, and they’re also key to helping people appropriately use health insurance,” she said.  “We want folks not just to get in, but we want them to keep their coverage and to use their coverage properly.

“When you’re connecting people to health care coverage for the first time, these are not innately understood concepts.  Insurance is actually a pretty complicated idea, and if you’ve never used it, you really can get overwhelmed.  If you have it and you’re not using it, then the tendency to understand its value can be diminished.  The Navigators and the Florida KidCare application assisters on the ground are essential for that piece of it.  It’s not just about filling out the forms.”

The numbers tell just how busy those people on the ground have been.

“The first year, the projected enrollment for the federal health insurance marketplaces in Florida was around 450,000, give or take,” Ray said.  “We ended up enrolling – with all partners across the state, not just the USF partners – almost a million.  We doubled the projections, basically.

“The second year, the last number I saw was about 1.6 million, but that didn’t include the last month, the limited special enrollment period for people who got hit with the tax penalties.”

As impressive as those figures are, their national rank may be more so, especially given California’s stand as by far the most populous state of the union.

“The first year, every month, we came in second in the country to California,” Ray said.  “This year, our enrollment here in Florida was higher than enrollment in any other state in the country.  It’s a pretty successful initiative in Florida.”

That seems understated, especially considering that it was the work of about 90 Navigators the first enrollment period and around 150 the second round.  Ray was quick to note, however, that Navigators weren’t the only people involved.

“There are more resources that go into managing this than just the enrollment folks,” she said.  “We have IT people involved, we have human resource people involved, we have grant administrators involved.  It’s an undertaking, for sure.  It’s all a team effort.”

A niche in the state’s public health

The stakes, along with the numbers, will be higher for the third round, since the funding will be for three years.  Ray is undaunted by the change and, in fact, favors it.  For one thing, it will provide greater continuity in enrollment services, she said.

“We won’t have the start-up delays that come with a grant ending,” she explained, “and then waiting for another grant to come in.”

Given the early success but also knowing the nature of the funding world, Ray is cautiously optimistic about future Navigator grants.

“We’re keeping our fingers crossed,” she said.  “I feel like we’ve done a good job.  I think our outcomes have been really high.  Our partners at the federal level seem very pleased with the work that we’re doing.

“Florida certainly has been a shining star all the way through this.  Not because I was optimistic, but because I believed we were doing the right thing and that we knew what we were doing, I’m not surprised.  Because we didn’t go into this making up a plan of action.  We went into it with a sense of how it can be done, what the best practices were.  We had learned our lessons along the way.  We didn’t have to reinvent the wheel to do this.  All our collaborative partners made a big difference, too.

“I feel pretty good going into years three through five.  It’s going to be harder going into these years, because we’ve enrolled so many of the low-hanging fruit, so we really have to hone in on who we’re missing and whatever we need to do to make sure we’re not leaving people behind.

“This is our niche for the state of Florida in public health.  Whether it’s obesity or diabetes or getting cancer screenings, it’s very difficult for people to do anything about those things we talk about in public health if they don’t have health insurance.  So, I think we’re doing something valuable in contributing that first step to addressing some of these important public health issues that are so important.”

Story by David Brothers, College of Public Health.  Graphics courtesy of Florida Covering Kids and Families, CSPAN and Jodi Ray.

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With nearly one million Floridians set to lose Medicaid coverage now that the COVID-19 public health emergency is ending, leadership responsibilities of the Florida Covering Kids and Families (FL-CKF) program—housed within the USF College of Public Health (COPH)—is being divided into two roles.

The mission of FL-CKF is to foster and facilitate innovative methods for enrolling and retaining eligible children in Florida’s publicly funded insurance programs (Florida KidCare & Medicaid). It also works to enroll and retain eligible adults in the Federal Health Insurance Marketplace. It does this largely with the help of “Navigators,” or specially trained individuals who provide information on health insurance plans and assistance with signing up.

Jodi Ray, former program director of FL-CKF, is now a senior consultant for the program, working on policy, advocacy and Medicaid “unwinding.” (Now that the public health emergency is ending, the federal government is no longer paying states to get residents, regardless of income, enrolled in health insurance and Medicaid programs; the Department of Children and Families has identified 900,000 people who, based on their 2022 income, will become ineligible for Medicaid.)

Dr. Ellen Daley, a COPH professor and senior associate dean for research and practice, is principal investigator of the multi-year, multi-million-dollar program, which is grant-funded through the federal government.

Both role changes took effect earlier this year.

“This is a very tumultuous time when it comes to health care access and coverage, and being a good advocate is absolutely essential right now,” Ray said. “I’ll be investing a lot of my time on issues that affect the project but are outside of it—things like Medicaid unwinding and working with community, state and federal partners to determine how a lack of health care might affect social determinants of health and lead to problems such as financial or housing instability. Giving up the operational and administrative aspects of the program will allow me to devote more time to these things and to build a strong feedback loop, so details about what’s happening on the ground can be conveyed to state and federal partners, giving us some semblance of accountability.”

“The role Jodi is taking on is so critical to the State of Florida,” Daley added. “It really elevates the program. Jodi has so many connections and so much insight into the implications of the guidelines happening now with funding and eligibility. I see some of the program funders learning from her and taking notes. It’s amazing to have someone with Jodi’s background and expertise address what will be a continual need for the state—policy and advocacy.”

Daley said her role will be working with the COPH leadership team to help guide the program’s operations and support the essential work of the statewide partners who actually hire the Navigators and provide outreach and education to consumers.

“With a grant this size, operations—things like finances and research compliance—is a big job,” Daley said. “The role needed to be split up. With the team approach we’re taking, I’ll have input from human resources, finance and business operations and administrations. This will free Jodi up to do her critically important advocacy work and to communicate with our partners in the Covering Florida Consortium and also give her time to resume her DrPH studies.”

Story by Donna Campisano, USF College of Public Health

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In 2023, the Florida Covering Kids & Families (FL-CKF) Navigator Program, housed within the USF College of Public Health (COPH), will turn 10 years old.

This year the program employs some 200 Navigators, up from a low of 60 when funding was cut during the Trump Administration. Navigators not only help consumers—many of them in vulnerable, under-served populations—“navigate” health insurance enrollment using the Health Care Marketplace, but, according to FL-CKF Program Director Jodi Ray, they also help them navigate the entire health care system.

“Navigators are connecting enrollees to providers, helping them understand medical billing and giving them some health literacy,” Ray said. “Some people don’t know what to do once they get insurance. We tell them about things such as preventive care. Our job is so much bigger than enrollment work.”

And big jobs often come with big price tags.

This year FL-CKF was awarded $12.9 million by the U.S. Health and Human Service (HHS) Centers for Medicare and Medicaid Services, part of a record-breaking grant awarding FL-CKF roughly $36 million over three years. The funds will be used to hire more Navigators, as well as for advertising and outreach, Ray said.

“We’re doing digital campaigns, broadcast TV, radio ads and ads on streaming services,” Ray said. “But we’re also going to focus on rural areas where many of our vulnerable populations live and where mass communication ads may not be successful. This year, we’ll be putting people on the ground in those hard-to-reach places. Navigators will be visiting laundromats, barber shops, beauty salons, bodegas and other places in the community to try and reach people. We also have a partnership with Walgreens, and we’ll be setting up tables in some stores. We’ll be utilizing some new things this year that we haven’t in the past because we have the resources to do so.”

Ray notes that in 10 years, the Navigator Program has tripled in size. What would she like to see in the future? More integration with other public health services, she says.

“The Navigator Program can be replicated to so many other health and social services,” Ray commented. “For example, housing insecurity and health care disparities and food insecurity all go hand in hand. People may be living in places where there’s a food desert or transportation is a barrier. The Navigator Program can be a model for navigating these other systems and services as well.”

Open health care enrollment runs from Nov. 1, 2022, to Jan. 15, 2023. For more information, click here.

Story by Donna Campisano, USF College of Public Health

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Sophany Nuth’s 30-hour-a-week job baking doughnuts doesn’t come with health insurance.

His weekly take-home pay is about $318. With rent, food and other bills, the 35-year-old Seffner fathercouldn’t afford the $400 a month quotes he got from private health insurers to cover him, his wife and two young children.

He was so worried, Nuth considered moving his family to Canada or Australia, which have universal health care.

“It’s a big stress in the family,” he said.

But Nuth is staying in Florida after enrolling his family in a health care plan through the Affordable Care Act marketplace that he found with the help of navigators from the Family Healthcare Foundation. It will cost just $18 a month.

He is one of a record 2.7 million Floridians who have signed up for health insurance through the Affordable Care Act for 2022, a 600,000 increase from last year.

The federal program, which was signed into law by President Barack Obama in 2010, is more popular than ever nationwide, too. A record 14.5 million people signed up for this year, surpassing the previous high by almost 2 million. That’s despite Republican attempts to challenge it in court and abolish it during President Donald Trump’s term.

That’s due to President Joe Biden’s administration, which spent more on marketing and increased investment in the availability of subsidies through last year’s $1.9 trillionAmerican Rescue Plan, said Jodi Ray, the executive director of Florida Covering Kids & Families.It’s a navigator program based at the University of South Florida in Tampa that coordinates outreach efforts across the state.

The Department of Health and Human Services restored $80 million to fund outreach efforts cut by the previous administration with the goal of quadrupling the number of navigators, who help people pick and enroll in insurance plans. Also, more insurance companies offered plans in the federal marketplace this year and the cost of premiums remained flat or, in some cases, dropped slightly.

Read the full story from Tampa Bay Times here.

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On Oct. 21, Dr. Donna Petersen, dean of the USF College of Public Health (COPH), gave her 16th State of the College Address virtually to faculty, staff and administration through Microsoft Teams due to the COVID-19 pandemic.

“I am delighted to welcome you virtually to our State of the College Address,” Petersen said. “As always, we use this opportunity to highlight our college and people and to recognize those who have had particular achievements, welcome new faces and wrap up with a look-ahead.”

Year in Review

While the year was disrupted many times due to COVID-19, the COPH was able to prevail and still celebrate many successes. Some of these included:

• Holding the Inaugural Run Family Violence Out of Tampa 5k, sponsored by the Harrell Center
• Naming the first recipient of the Alena Frey scholarship
• Celebrating the Chiles Center 25th anniversary
• Offering USF OSHA Training Institute Education Center training in Spanish
• Launching Salud Latina USF to combat health misinformation in Spanish
• Welcoming students to the Bulls in Health Living Learning Community

Preparing Anti-Racist Public Health Professionals

“Last year I had mentioned that we had taken very seriously the events surrounding the murder of George Floyd and the response afterward,” Petersen said. “When you think about the social/moral determinants of health, you think about the historic racism that created the structure of many of our systems. This needs to be acknowledged, spoken about and acted upon.”

The COPH is “beginning at the beginning” with these new changes to combat racism and will continue to make the necessary changes. Some of these changes include:

• Eliminating the GRE requirement for admission
• Assigning summer reading and a reflection paper
  • 433 students learned something, were saddened, shocked, embarrassed, disgusted but also motivated, inspired and called to act
  • 1st assignment: identify a racist policy
  • 2nd assignment: identify a racist element in health care
  • Final exam: identify something “unacceptable” that must be changed

Our People

Emphasizing that people are at the center of public health, Petersen led her presentation with the introduction of new faculty and staff. She also recognized those who have received awards or been acknowledged for achievements. In the last year the college:

• Welcomed 27 new faculty and staff and saw nine faculty promotions
• Had two COPH staffers recognized with the USF Health Student Award Outstanding Shared Student Services Member and Provost’s Award for Outstanding Undergraduate Advising
• Applauded 12 faculty members who received awards and recognitions, both within the college and outside of it
• Saw Dr. Anna Armstrong, associate professor, and Laura Rusnak, instructor II, awarded the Cliff Blair Award for Excellence in Teaching
• Honored Dr. Joe Bohn, assistant professor, director of community engagement and deputy director of the DrPH program, with the 2021 Excellence in Teaching Award.
• Celebrated Florida Covering Kids & Families (FCKF) and Jodi Ray, instructor II and program director of FCKF, for receiving the largest federal grant ever awarded to this program.

Looking Ahead

“The world will never be as it once was. We will continue to work remotely, teach in different ways and engage differently. But culture is very important, and we will continue to cultivate a culture of mutual respect, honesty, transparency and commitment to our vision, mission and goals,” Petersen said. Coming up, the college will:

• Celebrate the COPH’s new normal with the Day of Renewal and Length of Service celebrations on Dec. 14
• Address loose ends with the structure at an all-college meeting
• Have an all-college retreat on the Academic Master Plan with partners, alumni, employees and students
• Launch an abbreviated strategic planning exercise

Link to view the full USF College of Public Health State of the College Address coming soon.

Story by Caitlin Keough, USF College of Public Health

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Florida Covering Kids & Families (FL-CKF), a community and consumer-focused nonprofit initiative based at the USF College of Public Health, has received a record-breaking $11.9 million from the U.S. Health and Human Service (HHS) Centers for Medicare and Medicaid Services. 

The grant will be used for the ninth year of the Affordable Care Act (ACA) Health Insurance Marketplace enrollment and outreach programs. 

According to its website, “FL-CKF works collaboratively with Florida agencies and stakeholders to advocate and conduct outreach to ensure all Floridians have access to affordable health care coverage. The initiative aims to foster and facilitate innovative methods for enrolling and retaining eligible children in Florida’s publicly funded insurance programs (Florida KidCare & Medicaid) and enrolling and retaining eligible adults in the Federal Health Insurance Marketplace.”

Jodi Ray, director of FL-CKF, says the group will receive $11.9 million per year for the next three years, for a total of nearly $36,000,000. 

That’s the highest any state has been awarded (North Carolina came in a distant second this year, with $4.9 million awarded) and a huge increase over last year’s $1.6 million that was awarded under the Trump administration. 

“Previously, we had to scale way back, because we lost resources,” Ray commented. “And now we’re expanding, because we’ve been awarded back those resources and more.”

Ray says she thinks FL-CKF received such a hefty grant award because the federal government looked at the group’s history and knows that it performs. 

“We’ve always exceeded our goals,” Ray said. “In fact, Florida has ranked the highest in enrollments for the marketplace every year. And we have nationally recognized programs. We’ve had at least six different states come to us asking for help with grant writing. And a lot of other grantees come to us looking for technical support. We do a really good job of doing what we are supposed to be doing—getting people enrolled in the ACA.”

Ray says much of the money will go to hire more Navigators (specially trained individuals who help consumers “navigate” the healthcare marketplace) to meet the increasing demand for affordable healthcare. According to Ray, their numbers will grow from about 60 who are staffed during the open enrollment period to 200 across the state who will work year-round. The money will also be spent on outreach and health education programs, including those centered around COVID-19 testing, vaccines and other protections. 

While Ray says she’s thrilled to receive such a significant grant, she also acknowledges that it’s overwhelming.

“I’m not gonna lie—it’s a bit stressful,” Ray said. “I feel very anxious about it because it’s a big undertaking, and we really do need more people and more equipment on board. What’s more, the HHS is going to be doing a lot of intense marketing, so I think that will drive a lot of people to our team.”

This year’s open enrollment period for health coverage extends from Nov. 1 to Jan. 15. “We have a lot of work to do,” Ray said. “But, thankfully, we have a longer enrollment period.” 

Story by Donna Campisano for USF College of Public Health

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The USF College of Public Health’s Florida Covering Kids and Families program recently received a $5,000 grant from the national Protecting Immigrant Families (PIF) campaign. 

PIF comprises hundreds of different organizations and is anchored by the National Immigration Law Center and the Center for Law and Social Policy (CLASP). It partners with community advocates, coalitions, public and private officials, health care service providers and the media to provide education and outreach to immigrant families.

According to Jodi Ray, program director of Florida Covering Kids and Families, an initiative that works to ensure all Florida families have access to affordable health care coverage, the grant money will be used for a variety of endeavors, including:

• Creating education materials in three different languages regarding the Biden administration’s changes to “public charge” regulations. 
  • Public charge is an immigration law term that describes a person who is primarily dependent on the government for support. 
  • Currently, public charge status does not affect things like nutrition and housing assistance programs (SNAP, WIC, Section 8 public housing), community-based services like food banks and emergency-relief assistance, such as COVID-19 related testing, treatment, vaccines and economic impact payments.
• Conducting vaccine outreach to low-wage immigrant and undocumented workers.
• Conducting workshops on ID-related issues and how they impact access to services.
• Providing information and outreach regarding economic-relief programs.

“There have been a lot of challenges for immigrants, including those who are lawfully residing here, to access the benefits they’re entitled to and are eligible for,” Ray said. “There’s a lot of fear [among immigrants] about the public charge rules, and there’s a tendency for some people to not access health care or apply for coverage. What we’re doing is getting information out to people to let them know there are resources available to them regardless of their immigration status. For example, they’re eligible for the COVID vaccine and for COVID treatment. A lot of people don’t know that. They’re not getting this information from the insurance companies.”

Getting the word out won’t be an easy task, but Ray says having ground troops out in the community already advocating for immigrants and their rights will help.

“Our focus has been on enrollment and outreach work, and now we’re expanding into COVID-19 education,” Ray said. “We’re getting out there talking about the safety of the COVID vaccines and encouraging people to get one. A lot won’t seek care, even if they need it, because they’re afraid it will create a financial burden for the family. We’re working to break down the fear and distrust.”

Story by Donna Campisano, USF  College of Public Health

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U.S. President Joseph Biden has opened a special Affordable Care Act enrollment period to run until May 15, and the USF College of Public Health’s (COPH) Florida Covering Kids & Families (FL-CKF) program is ready to assist.

FL-CKF manages the USF State Navigator Program and seven other organizations (collectively referred to as the “Covering Florida” consortium) that provide Navigator services across Florida.

Jodi Ray, director of FL-CKF, says this special open enrollment period (SEP) is open to everyone using the healthcare.gov platform specifically.

“This SEP is in response to the COVID-19 public health emergency, which has left millions facing health problems, uncertainty and exceptional circumstances,” she said. “Consumers who enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection.”

She also says consumers will have 30 days after they submit their application to choose a plan.

“This SEP will not involve any new application questions or require consumers to provide any new information not otherwise needed to determine eligibility and enroll in coverage. Nor will they have to provide any information documenting a qualifying event, which is typically required for a special enrollment period,” Ray said.

Ray and her team of navigators are primarily booking virtual and phone appointments; however, they have adjusted their efforts accordingly to meet consumer needs.

“The reality is not everyone can be served that way,” she said. “We live in a state where there is still a digital divide. Lack of access to broadband and varying levels of both computer literacy and health insurance literacy can make reviewing, for example, 105 plans in Hillsborough County, very difficult. This is especially true when you add in language and cultural differences. Our job is to help everyone who needs help and do it in the way that is best for the individual.”

But, preventing the spread of COVID-19 while attending to those needs has also been on the forefront.

“As public health workers, we understand that we have to take the safety of both the consumer and staff seriously. While the COPH has really helped us with setting up our office safely, we are still trying to give as many consumers as possible those remote appointments,” she said.

Anyone who needs assistance in getting health coverage through the marketplace should call Covering Florida at 877-813-9115 or go on the website (coveringflorida.org) and book directly with a navigator closest to their zip code.

Ray said she anticipates longer enrollment periods in the future, given the change in administration in the White House. She also noted that past enrollment periods had gone down to as little as six weeks during the Trump administration. 

Last year, the project enrolled 2,788 consumers, and the two previous years before that 2,708 and 3,879 consumers.

“Of course, before 2017, the resources for enrollment and outreach were significantly higher, and so were our enrollment numbers,” Ray said. “Compared to just normal SEPs, we are running higher in call volume reflective of the open enrollment period for the same amount time.”

This, she says, is due in part to the pandemic.

“A lot of individuals who have mostly relied on employer coverage for access to health insurance are really having a tough time,” she said. “For example, gig workers and those in the performing arts are really needing help to navigate these programs they have never used. Since the number of individuals like this is growing at a pretty fast rate, this SEP will allow those who might have missed the last open enrollment period because they were unaware of the deadlines to apply and see if they can find an affordable plan, even if for the interim.”

She also noted that for those who already selected a plan during the last enrolment, changes can be made during this special enrollment period.

“This is a good chance to make sure that the plan they signed up for during the fall open enrollment period is still the best fit,” she said. “People might have a better idea of what their income and situations will be like for 2021. They may want to see if the plan they selected will meet their needs.”

Story by Anna Mayor, USF College of Public Health

The post Special open enrollment period reopens the door to health coverage appeared first on College of Public Health News.

While the COVID-19 pandemic sweeps across the nation resulting in loss of employment for many, USF College of Public Health’s Jodi Ray wants the public to know that doesn’t mean they have to lose health care coverage too.

Ray, program director of the COPH’s Florida Covering Kids & Families, says she and her team of health insurance navigators experienced a jump in calls over the past few months from individuals who have been furloughed, laid off, or are self-employed.  

“From the day the person experiences the reason to lose coverage, they have 60 days to apply for a special enrollment period,” Ray said.

A Special Enrollment Period (SEP) is a time outside the yearly open enrollment period where you can sign up for health insurance if you’ve had certain life events, including loss of health coverage, moving, marriage, new baby, or adopting a child. Additionally, a person who was unable to apply during that period due to COVID-19 may be eligible for another SEP.

Enrollment in Medicaid or the Children’s Health Insurance Program (CHIP) may be done any time of the year, whether you qualify for a SEP or not, according to Ray.

Ray said healthcare.gov has also outlined more detailed COVID-19 SEP information, which includes guidance on what options are available for those who lost a job, are experiencing reduced working hours or are now unable to afford their premiums.

“To qualify in terms of insurance being unaffordable, they would look at the cost of the insurance based on household income,” Ray said. “We can also potentially get an SEP if something changed to make them eligible for tax credits, such as a change in household income.”

Ray stressed individuals should be cautious of groups selling short-term plans, which may not cover all COVID-19 services.

“Keep in mind that people are out there selling these short-term plans,” she said. “They are not under the same requirements to cover COVID testing and treatment. People think they are going to get a deal out of some junk plan. They are going to find they aren’t going to have the coverage they expect to have. People have to be careful about that and which is why it’s important to talk to a navigator.”

Ray said there are even Marketplace plans that offer telehealth for little to no co-payments.

“Some people don’t even realize this is an option; they can continue health care without putting their health at risk,” she said.

Despite a drastic decrease in program funding over the last few years, Ray and her team are currently conducting appointments virtually to help those in need across the state.

To speak with a navigator for assistance, visit www.coveringflorida.com or call toll free 877-813-9115.

“Our team will also help with Florida KidCare, which has open-enrollment year-round, and covers children until they turn 19,” she said. “It’s important to get the word out, I think some people they just don’t know where to go for help. We can also help with any other complicated situations with their Marketplace or KidCare coverage. We can also address application issues. We don’t want people out there struggling.”

Story by Anna Mayor, USF College of Public Health

The post USF health insurance navigators address COVID-19 enrollment surge appeared first on College of Public Health News.

The numbers are in and 1.9 million Floridians selected or were re-enrolled in health care plans in 2020 during the Affordable Care Act’s (ACA’s) open enrollment period held from Nov. 1 to Dec. 21.

That’s about a 200,000 increase from last year, despite an 85 percent cut in grant funding, said Jodi Ray, a USF College of Public Health (COPH) instructor II and program director of Florida Covering Kids and Families (FL-CKF).  FL-CKF manages the USF State Navigator Program and nearly a dozen other organizations (collectively referred to as the “Covering Florida” consortium) that provide Navigator services across Florida.

“I’m shocked, but happy,” commented Ray. “Previously we had a marketing budget and all this support to get information about health care coverage out there. But that’s now been cut. And they also cut enrollment assistance. Some states have completely done away with their Navigator Programs—they couldn’t support one on the money they were given. And despite the fact that the number of insured has gone down during this administration, Florida’s enrollment has actually gone up—every single year.”

How was ACA enrollment able to increase when the funding that promoted and facilitated it was cut to the bone?

Key, said Ray, was extending Covering Florida’s reach by teaming with community and government partners.

“We’ve been targeting a lot of vulnerable populations, such as those where English is a second language and those who are re-entering society after jail time,” commented Ray. “We’re also working with the Mexican consulate in Orlando, the Epilepsy Foundation in South Florida, Healthy Start and faith-based and LGBTQ partners—populations that we know are at risk of being uninsured or of not having access to health care. In addition, I work with a lot of elected officials. We’ve really pushed them to use things like social media to get the word out about Covering Florida so their constituents can get the ACA info they need.”

Another factor helping to drive enrollment: offering virtual sign-up sessions.

“We had to look at how we were going to serve the state with so much less in terms of money and personnel,” explained Ray, who noted that the number of state Navigators dwindled from a high of 152 a few years ago to a mere 25 now. “Virtual enrollment has really helped us serve people in an area where we don’t have Navigators on the ground.”

Despite the limitations, Ray said she’s proud of her FL-CKF team’s continued commitment to serving Floridians around the state.

“I’m really impressed with my team and their ability to go with the changes,” said Ray. “I’m so pleased with all that we’ve accomplished and with what we continue to accomplish.”

Story by Donna Campisano, USF College of Public Health

The post ACA enrollment goes up in Florida despite funding being (way) down appeared first on College of Public Health News.