Happy, Healthy, and Ready to Learn! #InsureAllChildren


Our vision is a country where every child has access to comprehensive, affordable health coverage that is easy to get and easy to keep. Children are our future and must enter school healthy and ready to learn. The role schools must play in student lives is complex and ever-expanding. To ensure students are ready and able to achieve academically, schools must be poised to meet the myriad health, emotional and social needs that can negatively impact student performance. Too many children are uninsured or underinsured, overweight and undernourished, or miss too many school days because of chronic illnesses like asthma or other challenges. Far too many are victims of homelessness and other adverse childhood experiences. Children of color are disproportionately suspended from school, missing valuable learning time.

Your Team


Who Should Be on the Team? Critical to the foundation of the CDF/AASA strategy are the superintendent, the district information technology lead, and the district's coordinator or director of school health.

The buy-in and engagement to the superintendent will facilitate implementation, compliance, and replication of the health insurance initiative. The superintendency is a bully pulpit in your community. It provides an important platform from which to advocate an agenda- in this case, that healthy children are better learners, and so schools have a role in identifying students without health insurance and helping them obtain coverage. The superintendent represents your team's vision for healthy children and can engender support throughout the community.

The key to identifying students without health insurance is asking parents the simple question: "Does your child have health insurance?" Simple question, yes - but it takes the information technology (IT) department to update school databases with the field for health coverage status, make that question part of an annual school district enrollment form, and develop mechanisms to report the results back to the team Check out the AASA/CDF Health insurance Question Template.


Why Build a Team? As a district or school, you have decided to address the challenge of children without health insurance, The next steps are to build a team; identify uninsured children; add a health insurance question to your annual forms; enroll students and/or develop partnerships to enroll students; and develop a plan for sustainability and evaluation of your effort.

It's important to build a team of those:

  • Who have the authority to make decisions or systems changes;
  • Whose function in the school district is related to health and wellness;
  • Who have strong connections to parents and community agencies; and
  • Who can affect school and district policies, and others.

The core team - the worker bees - may interact on a daily basis. Other team members may not be able to participate in all activities, but need to be in on the ground level/planning stages and regularly kept apprised of progress.


How Do You Build Successful Teams? Successful teams regularly reassess to ensure they have the right internal and external mix of people, partnerships, potential and power. They call on their networking skills to get to know "who's in the room" at meetings and conferences, who can be engaged and to whom the team should communicate progress or project needs.

Successful teams also are not only diverse in terms of areas of expertise or influence, but they need to continually seek to educate and expose others in the district and community to the enrollment efforts. Teams can broaden their membership to include community businesses, local and state political representatives, and district union representatives which may prove beneficial for action planning and sustainability. A favorite creative example of getting buy-in from a team with a diverse membership was the "Gilligan's Island Themed Three-Hour Tour" that Mountain view School District (CA) developed to engage team members, district staff, school board members and partners on the issues families face when they seek health coverage in their community. This tour also served to educate and deepen the relationship between the team and community agency partners.

Uninsured Children

Video from beginning to 1:45 Dawn Meyers CHIPRA

“Growing up in the Los Angeles area, I experienced firsthand the difficulties of not always have medical access. For some time, my parents were undocumented, struggled financially and did not always have access to basic services, such as medical care. We did not have preventive care, rather we visited doctors and clinics when something wasn't feeling right and the pain just wouldn't go away.  There were times, where for different circumstances, i.e. lack of transportation, urgent need that made us take drastic measures. For example, I remember walking into someone's garage for dental treatment. That memory stayed with me, as it was something that just didn't look right-it had all of the furnishings but it was inside a garage. Unfortunately, we were not the only family there, others were also visiting and using these services.“


Who Are the Uninsured Children? While our country has made incredible progress expanding health coverage for children, today, nearly 4.5 million children under age 18 (six percent) remain uninsured - that's one in seventeen. School-aged children (ages 6-17) are more likely than younger children to be uninsured, and account for nearl three out of four uninsured children in the nation. Similarly, Hispanic children and children living in families on the brink of poverty are disproportionately uninsured. Children living in the South and in rural areas are also less likely to be insured than those living in other parts of the country.


Why Must You Identify and Enroll Uninsured Children? Health affects every aspect of a child's life - including the ability to grow, learn, play and succeed. Academic achievement and health are closely linked. Children who cannot focus due to a toothache or don't have needed glasses to see the chalkboard or hearing aids to hear their teachers and classmates are less likelu to achieve in the classroom. Children with health insurance are better equipped to handle health-related issues such as chronic illness, hunger and physical or emotional abuse which untreated can lead to poor academic performance 1 (SUPERSCRIPT & LINK TO REFERENCE).


Identifying Uninsured Children in School Settings: CDF and AASA's School-Based Approach

CDF and AASA's tested model provides school districts a basic question to add to their school registration materials: "Does your child have health insurance?" Children whose parents answer "no" and give their permission can then be contacted for application assistance.

How Can Your School District Add the Question to Annual School Forms and Identify Uninsured Children?

Out and Plan Events


Who Does Outreach? As discussed in the BUILD section of the toolkit, it's essential to organize a core team of leaders to conduct child health outreach and enrollment. Each team member complements the job duties and skills of another. when thinking about outreach activities, the logical person to begin coordinating and thinking strategically about spreading the message will likely be one affiliated with the school health office. This person should begin the planning and include the superintendent's office, coaches, teachers, nurses, social workers, and communications department to staff and develop an outreach strategy or campaign. Community partners to consider engaging include your local health care coalition or CHIP/Medicaid?Health Insurance Marketplace navigators or assisters; local media; legislators; local businesses and other community leaders.


Why Do Outreach? Schools are in a powerful position to bring critical information about affordable health insurance so they have access to preventive care and other important health care benefits. The importance of this work canot be overstated. The extensive benefits for everyone involved include better student, teacher and school performance. Perhaps parents benefit most profoundly by seeing their children flourish.

  • Improve Student Outcomes and Graduation Rates - Schools can make an impact in ensuring children are prepared to learn and thrive. Research shows when students have health insurance, they are better able to learn, attend school, graduate, go to college and even become higher income earners as adults. In addition to helping children, the district's graduation rates improve. 1 (SUPERSCRIPT & LINK TO REFERENCE)


How to Conduct Outreach. The AASA/CDF team has identified four key steps to planning your health insurance outreach campaign.

  1. The first step is to clearly clearly determine and define who you want to reach with your campaign. Is there census, school employee or community data that show where the greatest needs are?

    Gaining knowledge about the number of uninsured children living in your school district's boundaries can help team leaders set reasonable goals. In IDENTIFY you read about determining how many students are uninsured in your district. Be sure to visit the TUTORIAL that walks you through the steps on the U.S. Census website. Don't overlook your own school employees whose children may be eligible. Read about how Edinburg Consolidated ISD helped employees. (INSERT DISTRICT SPOTLIGHTS)

and Partner


Who Enrolls Students? As mentioned in the BUILD section of this toolkit, school health professionals are an integral part of the team. Often an employer or trained volunteer will assume responsibilities of school outreach worker. This person is the liaison between the family and other community agencies, helping connect families to health insurance and other services they need. This video clip clearly shows how school outreach workers are caring, compassionate people with a wealth of resources to offer. Words of Advice from School Outreach Workers.


Why Enroll Students at School and With Partners? School districts offer a unique setting for identifying uninsured children and connecting them to affordable health insurance. Many families look at schools as a safe haven for their children and trust the school personnel. Offering assistance, education and resources for children's health insurance enhances the family-school relationship. Depending on what state you live in, enrollment in health insurance occurs differently.


New Applications: Since the implementation of the Affordable Care Act, the process for applying for CHIP and Medicaid has evolved from primarily paper applications to include online applications and the ability to apply over the phone. The chart below describes the cast array of Medicaid enrollment and renewal processes across the 50 states. 2 (SUPERCRIPT & LINK TO REFERENCE)

(INSERT States have implemented an array of modernized Medicaid enrollment and renewal processes graph)

for the Future


Who is Essential to Sustaining Health Outreach and Enrollment?  In order to conceptualize and organize around project goals and objectives it is beneficial to have a sustainability plan in writing that has been sanctioned by your school or district leaders.  This plan provides a roadmap for successful program implementation by the project team and lasting collaboration among project partners.  In the BUILD section of the toolkit, there are important tips about building your team.  We highlight the fact that the superintendent, the district information technology personnel, and the director of school health are critical for implementation, compliance and the sustainability of children’s health insurance enrollment in schools.  Take a moment to visit the BUILD tab and learn more about building your team.  LINK to BUILD. 


Why is Sustainability Important?  Sustainability planning is a critical element of children's health insurance enrollment in schools because it allows a project team to better understand what program components are necessary for long-term success.  Ultimately, the plan will help a team turn big ideas into manageable and actionable steps.  It’s important to remember that you may need to make adjustments along the way.  Your team needs time to assess the current project and determine which activities are working and which aren’t.  This flexibility allows the team to continue to improve on systems and strengthen buy-in.  Having your sustainability plan in writing allows project team members to communicate and even market their efforts to a broader group of school district and community stakeholders.


How to Achieve Sustainability.  There isn’t one way to think about and plan for sustainability. Ultimately, effort committed to planning for sustainability early on provides your district team with a path to follow as you and your partners work toward the goal of insuring children.

Through CDF and AASA’s work in schools, and our systematic approach to program evaluation, we have outlined a way to think about and plan for program sustainability while incorporating concepts shared in research completed at the Center for Public Health Systems Science at Washington University.[1]  One of the first steps while meeting with your project team is to brainstorm answers to this statement: “For this project to successfully continue over time it needs…”  The answers will provide a framework for developing a sustainability plan.

The Children’s Defense Fund Leave No Child Behind® mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities. 

CDF provides a strong, effective and independent voice for all the children of America who cannot vote, lobby or speak for themselves. We pay particular attention to the needs of poor children, children of color and those with disabilities. CDF educates the nation about the needs of children and encourages preventive investments before they get sick, drop out of school, get into trouble or suffer family breakdown. 

CDF began in 1973 and is a private, nonprofit organization supported by individual donations, foundation, corporate and government grants.

AASA, The School Superintendents Association, founded in 1865, is the professional organization for more than 13,000 educational leaders in the United States and throughout the world. AASA’s mission is to support and develop effective school system leaders who are dedicated to the highest quality public education for all children. For more information, visit www.aasa.org.