As part of his continuing effort to insure children, President Clinton calls for public schools to play a bigger role in enrolling millions of eligible children in two federal health insurance programs -- Medicaid and Children's Health Insurance Program (CHIP).

The President also announced that he would dedicate $9.1 million in research funds to identify effective children's health insurance strategies. The research will attempt to help public insurance programs and health care delivery systems improve the quality of and access to, health care for low-income children.  It is estimated that only 1 million of 11 million eligible children are enrolled in CHIP.  Although the CHIP funding is given to states, Mayors, nationwide, continue to take the lead in enrolling children.

Below are highlights are what some Mayors are doing in their cities:

Spotlight -- Mayor Patrick J. McManus - Lynn, Massachusetts

An aggressive outreach and enrollment campaign initiated last year in Lynn, Massachusetts by Mayor Patrick J. McManus led to the successful enrollment of nearly 1,000 previously uninsured children in Medicaid and MassHealth, the state's new Children's Health Insurance Program. Lynn, a city located nine miles north of Boston with population of 81,245 is an urban manufacturing and commercial center. It is densely populated and culturally diverse and includes large Hispanic and Cambodian populations.

Mayor McManus said he got the idea for the campaign last spring after officials at the US Department of Health and Human Services mentioned to him that the CHIP program "wasn't catching on - mayors hadn't done much on it." State officials estimated at the beginning of 1998 that more than 2,000 children in Lynn were uninsured. In April of 1998, Mayor McManus met with Massachusetts Health and Human Services Secretary William D. O'Leary to address this problem. Within two weeks of this meeting, surveys were sent to the families of 14,000 public school children to find out which children lacked insurance. Impressed by the nearly 50% response rate to these surveys, Governor Celluci visited Lynn in July to announce a $15,000 Enhanced School Health Grant from the Massachusetts Department of Public Health. With this grant money, school nurses were able to complete, evaluate, and record all returned surveys and receive training from Medicaid and MassHealth on the application process so that they could provide direct application assistance during the summer months.

Mayor McManus has made health care for all Lynn children a top-priority. Thanks to his efforts, all new public school students are asked to complete health insurance information forms during registration. Follow-up work similar to that done by the school nurses in the summer of 1998 is now done routinely. Mayor McManus is also working with the Superintendent of Schools on a program for school nurses to visit with parents and their newborns to discuss the importance of proper treatment during the first 18 months of life. Additionally, the mayor linked CHIP outreach efforts to entrance in the Gold Card Program, a program in Lynn that provides teens with free access to after-school programs such as the Boys and Girls Club and the YMCA.

The Lynn Community Health Center also launched its own outreach effort. The Center coordinates Latin Festivals that integrate music, dancing and refreshments with CHIP outreach. These festivals are advertised on the Spanish television channels and on flyers posted throughout the community. The Center works with doctors and local hospitals to ensure that all uninsured patients are referred to them and provides a walk-in clinic with employees fluent in Russian, Spanish, Cambodian, and English where families may directly enroll their children.

Information gathered from: a June 22, 1999 press release from the mayor's office; an April 4, 1999 article written by John Laidler of The Boston Globe; and a phone interview with Frank Mellinger, staff member of Mayor McManus. For more information contact Frank Mellinger, at 781-598-4000.

Spotlight -- Mayor Anthony Williams - Washington, DC

Mayor Anthony Williams has demonstrated that the welfare of children in Washington, DC will be a major focus of his administration. The Mayor has implemented several initiatives to improve the lives of Children in the District. One of these approaches is to actively promote health insurance coverage for all children.

Mayor Williams' continues to lend his leadership to outreach efforts for DC Healthy Families, the District of Columbia's Children's Health Insurance Program. Mayor Williams participated in a press conference to announce the start of enrollment into DC Healthy Families. In early February, the mayor sponsored a poster and poetry contest among junior and senior high school students in the District. Forty students ranging from grades 7-12 participated in the contest, which ran form February 8 through March 12, 1999. The focus of the contest was to demonstrate the importance of keeping families in the District of Columbia healthy by raising awareness, stimulating discussions and illustrating the importance of enrolling children and families in DC Healthy Families. Judging for the contest took place in the Mayor's office. First, second, and third place winners, along with 10 honorable mentions, were selected to attend a lunch with a local radio personality at a popular DC restaurant. The first place poetry and poster winners were honored with a special lunch with Mayor Williams. In an effort to increase awareness around DC Healthy Families and increase student participation in future health campaigns, the District government has arranged an exhibit of the work of poster and poetry winners throughout the District. The first stop on the 'Traveling Art Exhibit' was the Mayor's Office, followed by The Capital Children's Museum.

As part of the on-going outreach and enrollment strategy for DC Healthy Families, the Mayor's Office has been involved in working with faith-based organizations to promote Healthy Families as part of their services. The Council of Churches of Greater Washington, working with the Mayor's office, designated Sunday, September 19, 1999, DC Healthy Families Sunday. Over 200 churches throughout the Washington area will dedicate a special service to the importance of children and family. There will be city employees and volunteers representing DC Healthy Families at each of these churches to announce the program and distribute information. The city hired a consultant firm to assist with the coordination of outreach and enrollment activities around DC Healthy Families and Medicaid. The firm works closely with the Mayor's office and other city departments to promote a multi-level approach to outreach and enrollment. Currently it is working with several local businesses and the Chamber of Commerce to promote health insurance for low to moderate-income employees.

Information was collected from Insight, DC Healthy Families Newsletter and The Capital Spotlight, February 18, 1999.  For more information on outreach activities around DC Healthy Families, contact Artencia Hawkins- Bell, Outreach Coordinator at 301-650-0232.

Spotlight -- Mayor Joseph Ganim - Bridgeport, Connecticut

Under the leadership of Mayor Joseph P. Ganim, the City of Bridgeport's Department of Social Services (BSS) has been working with the state to educate families about Connecticut's Children's Health Insurance Program, known as the HUSKY Plan, throughout Connecticut's Southwest Region. It is estimated that there are 15,000 uninsured children in this region alone. The city's goal is to increase awareness, increase the number of Connecticut children with health insurance, and promote their health and well being. The targeted population includes parents of uninsured children and adolescents who do not have health insurance in the Southwest region of Connecticut, which includes the Bridgeport, Norwalk and Stamford town areas.

In addition to reaching children who are eligible, but not enrolled in HUSKY, outreach activities include outreach for Medicaid, the existing health insurance program for low-income children. Many Connecticut children who are eligible for Medicaid do not benefit because their parents have not applied. Bridgeport's Department of Social Services concentrated its marketing activities through the educational systems, health care delivery systems and employment areas that traditionally do not offer health insurance as part of a benefit package.

The department has been working with the Bridgeport Regional Business Council, Stamford Chamber of Commerce, and Norwalk Chamber of Commerce to create an database of employers in areas that include restaurants, fast-food chains, grocery stores, retail and small businesses. Letters are sent to these employers advising them how their employees can benefit from the HUSKY program which, in turn, will result in a more productive employee. Conducting outreach to employers is considered an effective innovative approach over traditional direct client outreach efforts. In addition, by collaborating with the educational systems in the Bridgeport, Norwalk and Stamford areas, a large percentage of families across three municipalities will be reached. BSS is including colorful pamphlets that are inserted in regularly scheduled mailings to parents. BSS is also conducting a poster contest with the theme "What it means to be Happy and Healthy" to create awareness of the HUSKY program.

BSS understands that a successful outreach campaign requires a collaborative effort involving several social service agencies to maximize the coordination, cost-effectiveness and positive impact of the HUSKY plan. To this end, the department is tailored to effectively conduct this outreach campaign due to its formal and informal relationships with regional, state, and municipal social service agencies, and public service non-profit organizations.

Information was collected from the City of Bridgeport's Department of Social Services. For additional information on outreach activities around HUSKY and Medicaid contact Anne Harrison with the Mayor's Office at 203/576-7201.

Spotlight -- Mayor Richard J. Daly, Jr. - Chicago, Illinois

Under the leadership of Mayor Richard J. Daly, Jr., the City of Chicago is conducting tremendous outreach efforts for KidCare, Illinois' Children's Health Insurance Program. From the Chicago Public Schools, to the Chicago Public Library, to various City departments, enrolling families in KidCare and spreading the word has become a citywide initiative. An aggressive outreach campaign has been launched to reach eligible families throughout the city.

The Chicago Public Schools (CPS) is implementing exciting initiatives to enroll children in KidCare. The CPS first identifies children who are eligible for the free and reduced priced meals from the National School Lunch Program (NSLP). The similarities of the eligibility requirements for NSLP and Medicaid/KidCare allow the programs to coordinate; over 219,000 families with eligible children were identified through the process in October. Using this information, CPS CEO Paul Vallas sent identified families KidCare applications along with informational material and letters urging the families to apply. In another CPS initiative, over 2,000 outreach volunteers (many of whom were school staff members and individuals from local community-based organizations) were trained to provide families with KidCare information and to assist them with filling out applications. Volunteers staffed tables in schools on Report Card Pick-up day, when parents are asked to pick up their children's report cards in person. The volunteers helped interested parents fill out application forms. Over 4,600 KidCare and Medicaid applications were received on Report Card Pick-up day in November.

During the summer months, various festivals and fairs occur every weekend in Chicago. The City takes advantage of these opportunities to increase outreach activity for KidCare. Certified Application Assistants (CAA's) are on location at city events, such as the Chicago Black Expo, Fiesta Del Sol, and the African-American Family Cook-Off. Families attending the fairs are informed about KidCare at booths and can fill out applications on the spot with the help of the CAA's.

Various city departments are joining the KidCare outreach effort as well. KidCare brochures will be available at city buildings including the Health Department, City Hall, Daley Plaza, the Cultural Affairs Office, the Alderman's Office, and the Consumer Affairs building, among others. Families who stop by these buildings for different reasons, whether attending events or just paying bills, can find out about CHIP when they drop in. The Chicago Public Library will also be involved in KidCare outreach. KidCare brochures will soon be available in library branch locations. As a source of health information for city residents, the public library is a prime location for KidCare outreach.

The City also implemented a door-to-door initiative in which certified application assistants go into areas where many uninsured families live. Going from door-to-door in targeted neighborhoods, the CAA's have been signing up families for KidCare and spreading the word in communities. In addition, the Department of Public Health has hired community health assistants for each of the community clinics run by the department to increase KidCare enrollment and outreach.

Information for this article was provided by Sylvia Garrett of the Chicago Department of Public Health and Robyn Gable of the Illinois Maternal and Child Health Coalition. For more information, contact Sylvia Garrett, KidCare Coordinator at the Department of Public Health at (312) 747-8875.

Spotlight -- Mayor Joe Serna, Jr.- Sacramento, California

Sacramento Mayor Joe Serna, Jr. created the Commission on Our Children's Health in April 1999. Since then, the Commission has helped to enroll nearly 200 families in the Healthy Families program and has advertised the program to thousands more. The Commission is a partnership between five regional health systems: Kaiser Permanente, Mercy Healthcare, Shriners Hospitals for Children, Sutter Health and the UC Davis Health System, and Sacramento City Unified School District.

The Commission is one of the first partnerships to match hospital representatives with school sites to increase awareness of the Medi-Cal, Healthy Families and other low cost health insurance programs. As part of this school-based outreach strategy, the Commission hired parents from ten local school districts to assist with outreach efforts at local schools.

This year, the Commission is gearing up for an expanded school outreach effort. Colorful flyers about the program will go out to nearly 70,000 families in school enrollment packets in Sacramento City Unified, Natomas Unified and North Sacramento Unified School Districts. The Commission's outreach staff will then screen school emergency cards for health insurance information and contact parents directly to inform them of the available programs.

The Mayor's Commission also established a local hotline where families can call for information and assistance. Commission hotline staff speak a variety of languages including Spanish, Hmong and Vietnamese and are working with local community organizations, churches, and small businesses to help get the word out about this valuable resource. In addition, the Commission's staff have attended numerous community events handing out thousands of flyers, prescreening families for health insurance, and making appointments for application assistance.

For more information about the Mayor's commission on Our Children's Health, contact Kelly Bennett, Program Manager at (916)-277-3800.

Spotlight -- Mayor Richard J. Riordan - Los Angeles, California

Under the leadership of Mayor Richard J. Riordan, the City of Los Angeles, California continues to encourage health insurance outreach activities aimed at enrolling more children in Medi-Cal and Healthy Kids, the new Children's Health Insurance Program in California. Under Riordan's direction, the Commission for Children, Youth and Families collaborates with City and County health care agencies as well as community based groups to ensure that resources are maximized. For example, the Commission collaborates with the Community Development Department (CDD) in arranging Health Care Insurance Outreach presentations to Welfare-to-Work participants and community forums. The Commission co-facilitates the development of the Child Care Health Consultancy Task Force, a collaboration of health and child care agencies with Crystal Stairs Inc. to address the health and safety needs of children in a child care setting. And, as a member of the Ad Hoc Committee on Welfare Reform, the Commission collaborates with the County's Departments of Public Social Services (DPSS) and Health Services (DHS) in developing and implementing effective policies, outreach campaigns and training strategies to expand enrollment in Medi-Cal and Healthy Families.

Additionally, in a continuing effort to increase health care access, the Commission participates in events such as forums and health fairs. Health Pavilions sponsored by the Commission are scheduled to take place throughout 1999 in various community locations. The Commission also provides a listing of all Child Medi-Cal Enrollment Project Sites to City Council members and council officers to allow them to assist constituents in locating these sites. The Commission also provides data to help community-based organizations target areas where efforts are most needed. On the policy side, the Commission tracks pending legislation affecting children's health insurance, and supports state legislation that allows for simplified access to Medi-Cal and Healthy Families. The Commission has also participated in a collaborative effort with the Immigration and Naturalization Service to disseminate correct information to immigrant families on how enrolling their children in health insurance programs is not likely to interfere with their immigration status.

Information was collected through Mayor Richard Riordan's Office. For more information, contact Robert Sainz, Interim Executive Director in Mayor Riordan's Office at 310/548-7592.