KEYWORDS:
Hepatitis B immunization, adolescents, primary health care, Medicaid Managed Care, Child Health Plus

BACKGROUND:
The adolescent population historically has not availed itself of primary health care and is a difficult population to reach. The mandated hepatitis B requirement for middle school entry in New York State offered the opportunity to draw this high-risk population into the primary health care system.

OBJECTIVE(S):
Identify adolescents who needed hepatitis B immunization and had no primary care providers. Offer caregivers the opportunity to enroll in Medicaid Managed Care or Child Health Plus at the time of vaccination of the adolescents.

METHOD(S):
In Suffolk County, 20,000 seventh graders were affected by the New York State law requiring hepatitis B vaccination for school entry. Many of these children turned to the local health unit (LHU) for vaccination. Field sites already existed to serve the five-year-old and under population; prior experience supported the concept of immunization field sites as a means of bringing underserved children into the primary health care system. Services at these field sites were expanded to include hepatitis B for uninsured and underinsured seventh graders. During the process of obtaining the immunizations, caregivers were offered the opportunity to speak with facilitated enrollers about Medicaid Managed Care and Child Health Plus. Caregivers could choose to complete the application process at that time. If additional assistance or more information was needed, enrollers were available to make home visits or other arrangements. Community aides were available for additional assistance.

RESULT(S):
The caregivers of 5,000 adolescents chose to enroll in either of the plans offered. Caregivers had the opportunity to enroll other uninsured children within the family. In total, 7,500 children were enrolled.

CONCLUSIONS(S):

LEARNING OBJECTIVES:
Identify a method to offer primary health care services, covered by Medicaid Managed Care or Child Heath Plus, to a specific segment of the adolescent population.