Best Practices & Results

Collaboratives Should Include RSM Staff as Important Link to Health Insurance

By ARIANNE WELDON
and
NAJA WILLIAMSON

Is your local Right from the Start Medicaid (RSM) project staff a member of your Family Connection collaborative?

The answer to this question is critical for providing easy access to health insurance for children in your community. Children-At-Risk Targeted Case Management (TCM) is one of the most important linkages in helping children to maintain health insurance - whether Medicaid, PeachCare for Kids, or other third party payer. Nearly 80 counties include Children-At-Risk TCM in their community strategic plan.

Keeping children up-to-date with their immunizations is important but families must have a way to pay for this Health Check service. The best way to pay is through health insurance. If health insurance coverage lapses, children may "fall through the cracks" of the system designed to keep them covered. This lapse in coverage may occur because children's eligibility reviews were not completed in time, and their enrollment was cancelled.

One way to prevent health insurance cancellation is to talk with a child's parent or guardian on a regular basis during the brief follow-up about the eligibility review, making sure that the family completes the review. Your local RSM project staff is one resource to partner with to assist children in maintaining health insurance coverage.

The mission of RSM is to "identify and certify" pregnant women and children who currently do not receive Medicaid or PeachCare for Kids and to provide easy access to Medicaid or PeachCare for Kids for those who are eligible. To determine what children potentially may qualify for Medicaid, RSM staff use community data of the number of children in the county on the Free and Reduced Lunch program.

If families in your area need assistance in completing the review so that they won't lose coverage, please use your local RSM project staff as a resource. Families may apply for PeachCare or Medicaid by completing the PeachCare Application, available in both English and Spanish, at www.peachcare.org. To locate the RSM staff member in your county, visit www.rsm.dhr.state.ga.us.

Read what some of our counties are saying about their work with the local RSM service provider.

Chattooga County. "Our RSM worker is an active member and an asset to our collaborative. In fact, she has recently started using the Family Connection Resource Center on the first Tuesday of each month to see clients and/or potential clients from our community to enroll them in Medicaid and PeachCare."

Haralson County. "Our local RSM staff member is our Coalition Secretary, serves on our Executive Committee, and is linked with our Family Advocate."

Houston County. "A tremendous resource …our RSM worker goes on home visits with our school nurses, participates in all of our health fairs, and gives us informational brochures to put in each back-to-school package we give kids through Operation Back to School."

Lumpkin County. "Our RSM service provider is an active member of our collaborative. She works closely with our Family Advocates and is very diligent in her efforts to see that families get signed up for the proper coverage."

McDuffie County. "The RSM Project Director is the Secretary for our entire collaborative, which is comprised of six organizations. She is an integral part of our outreach efforts through TCM …and will be involved in our new Utilization of Services grant that we received though the Department of Community Affairs."

Polk County. "RSM is very involved in our collaborative and our Family Support Network."

Ware County. "Our RSM staff person is very active in our collaborative. He works closely with our PeachCare for Kids (Covering Kids) representatives who also are very active in our collaborative."

White County. "Our RSM specialist is a member of our collabrative and is a great participant."

Whitfield County. "We include our bilingual RSM in every activity, resource fair, and community meeting that we can."

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