RFR - Community Partners

SECTION 1.
OVERVIEW
MassHealth, the Massachusetts Medicaid program, is a joint state-federal program administered by the
Executive Office of Health and Human Services Office of Medicaid (EOHHS), in accordance with Title
XIX of the Social Security Act and federal waivers. MassHealth also comprises the State Children’s
Health Insurance Program (SCHIP, Title XXI of the Social Security Act), CommonHealth (support for
the disabled), and other health benefit programs for specific populations. MassHealth offers health care
coverage for eligible families with children under 19, pregnant women, working people, people
unemployed for over 12 months, individuals with disabilities, eligible individuals living with HIV
disease, and low-income seniors, and provides health care premium assistance for businesses with fewer
than 50 employees. Some members pay a monthly premium depending on income and family size. Nearly
one out of six Massachusetts residents is a MassHealth member.
The Commonwealth Care Health Insurance Program (Commonwealth Care) is an insurance-based
premium assistance program for Massachusetts, administered by the Commonwealth Health Insurance
Connector Authority (the Connector). The program offers health care coverage for uninsured low-income
adults (at or below 300% of the federal poverty level) who are not eligible for MassHealth or Medicare
and who are U.S. citizens or qualified aliens. Some examples of eligible populations include non-working
individuals, self-employed individuals, and working individuals whose employers do not offer health
insurance or who are not eligible for insurance at their place of business, such as part-time workers,
contractors and new employees. While the eligibility criteria for MassHealth and Commonwealth Care
are different, the application process for these health insurance programs is integrated.
The Connector also administers Commonwealth Choice, a program which connects individuals with
commercial health insurance plans, as well as a series of young adult plans for Commonwealth residents
between the ages of 19 and 26. These programs are not income-based, and are available through the
Connector.
EOHHS is issuing this Request for Responses (RFR) to solicit grant proposals from community and
consumer-focused public and private nonprofit organizations for activities directed at reaching and
enrolling Massachusetts residents in MassHealth, Commonwealth Care and Commonwealth Choice.
Grant activities will also be directed at disseminating information about the health care reform law to
potential applicants to any of these programs, including but not limited to the individual mandate,
minimal creditable coverage policies, and assistance with understanding affordability regulations and the
Connector’s affordability tool on the www.MAhealthconnector.org website.
Since October 1, 2006, over 165,000 previously uninsured residents have been insured through
MassHealth and the Connector. The Massachusetts Division of Health Care Finance and Policy’s most
recent uninsured household survey estimated that approximately 6% of Massachusetts residents
(approximately 372,000) are uninsured. Governor Patrick and the Legislature have prioritized the task of
identifying and enrolling individuals who qualify for MassHealth, Commonwealth Care and
Commonwealth Choice but are not yet enrolled. As one means to accomplish this task, the state Fiscal
Year 2008 budget funds enrollment outreach grants to community and consumer-focused public and
private nonprofit organizations. (See Attachment A.)
Funding will be awarded to a number of qualified organizations submitting proposals for traditional
Enrollment, Outreach and Redetermination assistance, in the form of grants ranging between $50,000-
$65,000. Funding will be awarded to qualified organizations statewide, including in places where the
U.S. Census deems there is a high percentage of uninsured individuals and in areas where there is a
limited number of health care providers. Grant-related activities will include education and outreach
activities as well as assistance with eligibility determination and redetermination, provided directly and
indirectly to consumers who may be eligible for MassHealth, Commonwealth Care or Commonwealth
Choice and who may require individualized support due to geography, ethnicity, race, culture,
RFR for MassHealth and Commonwealth Care Enrollment Outreach Grants
FY 2008
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