Strategies used by outreach workers to successfully enroll underserved and uninsured California children into low cost health insurance programs such as MediCal and Healthy Families are examined. Otreach workers are particularly effective in enrolling and retaining hard to reach populations, especially immigrant families, in health programs. Skilled in grassroots communications and members of the communities they serve, outreach workers are key to building vital community support. Effective outreach depends on the selection of outreach workers with appropriate personal characteristics and then training them in a number of core competencies. This article analyzes the main avenues used by outreach workers within the First Things First demonstration project: person-to-person contact, utilization of existing of institutions, and public communication strategies. Structural and systemic barriers remain to enrolling children in public health insurance programs that exceed the scope of outreach workers. Thus, effective outreach programs should address both structural issues and staff selection and training.
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