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Therefore, a critical component at the local level is to support not only the mainstream and government systems in enhancing outreach and enrollment efforts, but also to work with community-based organizations that are trusted by vulnerable populations. To this end, The Trust is actively supporting local programs in using the outreach methods that work best in their particular community to reach parents who may be unaware that their children qualify for public coverage or who face other barriers to enrollment. In 2008, The Trust made three-year grants to sites where children and families already have an existing and trusting relationship in their communities. The intent of these resources is to support sites to expand their services and capacity to include outreach and coverage application assistance. Eighteen diverse grantees include after-school programs, clinics, public agencies serving low-income families, a school district, a hospital, an affordable housing provider and county-coordinated collaborations. Yet, even innovative outreach is not sufficient on its own to ensure continuous enrollment in, and retention of, health coverage. It is equally important that policies and systems effectively support this objective. Unfortunately, Colorado's Medicaid and CHP+ processes are cumbersome for all involved, from administrators, to families without coverage who want to determine their children's eligibility, to providers who wish to confirm patient enrollment in coverage. The eligibility processes for Medicaid and CHP+ differ and state staff must work with 65 separate entities (64 county offices for Medicaid and a private vendor for CHP+) to determine eligibility. Although intended to complement each other (CHP+ fills coverage gaps left by Medicaid), the programs were created at different times, with different rules, income thresholds and coverage philosophies. The resulting piecemeal development and inconsistent administration of these programs has created a complicated maze of barriers for Medicaid and CHP+ applicants.
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