COD E R E D

provider sites, Asian Health Services and La Clínica, have gained the trust of the communityand are the health care sites of choice of many program enrollees. Concerns do still existamong undocumented immigrants that they may face public charge penalties, but the Allianceand their local partners are working with outreach workers and health care staff to educatethese individuals that they can obtain coverage without public charge concerns.An evaluation of Alliance Family Care conducted by the University of Michigan foundthat Alliance Family Care enrollees used a higher number of preventive services once they wereenrolled than prior to enrollment. In addition, 2003 HEDIS results showed high childimmunization rates for Family Care enrollees and high screening rates for diabetics.EligibilityAlliance Family Care targets uninsured family members with children who are enrolledthrough the Alliance in either Medi-Cal, Healthy Families or Alliance Family Care, and who donot qualify for other public health programs. To be eligible, a family must have an annual incomeno greater than 300% of the FPL, live within Alameda County, and enroll all children in theirhousehold in whichever of the three above-mentioned programs for which they are eligible.When designing the program, the Alliance found that over half of the uninsured immigrants inthe county have at least one family member who is an undocumented immigrant. Thisunderstanding of the mixed immigration status that is common among immigrant families led tothe decision to not make immigration status a qualifying factor for coverage.As of July 1, 2003, just over 7,300 individuals were enrolled in Alliance Family Care and2,500 family members were on a waiting list. As noted above, early enrollment was higher thanestimated, which justified the Alliance’s decision not to implement a formal outreach strategy.Rather, as part of a long-standing, county-wide enrollment program, community clinics andcommunity-based organizations conducted most of the enrollment. Asian Health Services andLa Clínica, in particular, coordinated outreach efforts. At Asian Health Services, four communityhealth workers who speak Cantonese, Mandarin, Vietnamese and Korean conducted outreachin the Asian community. They made presentations on health care coverage options and publiccharge issues at nail salons, sewing factories, churches, etc. La Clínica hired a Spanishspeakingenrollment specialist to enroll individuals. The county also included Alliance FamilyCare in several successful enrollment events and initiatives.In terms of retention, there has been a consistent re-enrollment rate of over 97 percentannually. Enrollment is currently capped and will remain so until the Alliance can tap into anincreased and sustainable funding stream.Benefits and ServicesAlliance Family Care offers coverage for a comprehensive set of health care servicesthat specifically were designed to mirror the Medi-Cal and Healthy Families benefit packagesprovided in Alameda County. This enables enrolled families to have a “seamless” health careexperience whereby all family members can access similar benefits (including vision anddental), use the same providers, and get care in the same locations. In addition, if a familymember becomes ineligible for Medi-Cal, there is an easy transition to Alliance Family Care.Such seamless coverage is particularly important since the Alliance currently has the highestMedi-Cal enrollment in the county (Blue Cross is the only other provider). Families areresponsible for a monthly premium, which varies according to age. Children age 18 or younger(or up to age 23 if a full-time student) pay $10 per month, while adults between 19 and 64 payD-23