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Noble County Outreach Project

  • Need: To help enroll and retain children and their families in health insurance in Noble County, Indiana.
  • Intervention: A school-based health insurance outreach project focused on connecting children to health insurance.
  • Results: More than 600 individuals have enrolled in health insurance.


Promising (About evidence-level criteria)


Indiana Rural Health Association logo The Indiana Rural Health Association, along with 9 consortium partners, sought to increase enrollment in public health insurance and medical homes in northeast Indiana through the Noble County Outreach Project. Consortium partners included 4 schools, a hospital, a Federally Qualified Health Center (FQHC), and 4 nonprofit organizations. Health insurance options addressed by this project included Medicaid, the Healthy Indiana Plan (HIP), and private Health Insurance Marketplace Plans. Many parents in this area do not have health insurance. Uninsured families usually do not have a medical home; therefore, they miss out on preventive healthcare screenings, continuity of care, and childhood developmental assessments. Poor health affects children's ability to perform well in school.

100% Campaign logo The Noble County Outreach Project developed its outreach and enrollment project after two evidence-based models: All Healthy Children Campaign (formerly called the 100% Campaign) and the Badger Care School Outreach Toolbox. Some resources were modified and many more were created, resulting in the Indiana Healthcare Toolbox.

This project employed an Outreach Enrollment Specialist (OES) certified as a Federal Certified Application Counselor and Indiana Navigator. This person worked closely with schools, the WIC clinic, Parkview Noble Hospital, and other community agencies and businesses. At first a full-time position, the OES is now a part-time position due to changes in funding.

Additionally, the OES offered free education, outreach, and enrollment throughout the community. As part of the 100% Campaign, the OES determined the insurance status of all children enrolled in school by adding two questions to students' annual registration forms: insurance status and permission to release contact information. Similarly, the two questions were also on the athletic departments' emergency contact cards. Nurses and coaches collected the contact information for the uninsured and passed it along to the OES.

The Noble County Outreach Project sought to connect all children with a medical home. To do this, the project promoted the value of medical homes in presentations and handouts and during consumers' application sessions.

The project received support from a 2012-2015 Federal Office of Rural Health Policy (FORHP) Rural Health Care Services Outreach grant.

Services offered

The Outreach Enrollment Specialist:

  • Gave brief outreach presentations about the value of health insurance to parents during athletic meetings
  • Displayed public health insurance materials in gyms and concession stands
  • Included public health insurance flyers with free and reduced lunch applications sent home to parents
  • Provided monthly articles for school newsletters
  • Placed an informational link on school websites
  • Met with school nurses to assess and improve outreach and referral strategies
  • Exhibited at back-to-school registration activities
  • Kept people enrolled in coverage through ongoing outreach related to recertification
  • Provided each applicant a healthcare enrollment folder with coverage information and a magnet to remind them when to recertify their plan

Additionally, the project:

  • Reached out to the primary care providers to increase Medicaid panels and recruit more providers


This project has decreased the rate of uninsured people and has created additional strategies to help communities address healthcare insurance coverage.

  • More than 600 individuals enrolled in health insurance in Noble County during the three-year project.
  • The uninsured rate dropped by at least 6% in the first two and a half years.
  • Outreach flyers, yard signs, posters, business cards, and newspaper ads totaled 11,841 in year one, 38,591 in year two, and 44,795 in year three.
  • 562 enrollment folders covering the basics of health insurance, instructions on how to use their new insurance and report changes, and the importance of having a medical home were distributed.
  • This project has been duplicated in several counties.


Initially, some primary care offices hesitated to refer their self-pay patients for enrollment assistance for fear the patients would be assigned elsewhere. Some additional challenges include:

  • Staff turnovers at the hospital and school and with enrollment staff
  • Tracking Medicaid members to remind them about Medicaid recertification and identifying reliable communication strategies for them
  • Lack of understanding of public health insurance


The Indiana Healthcare Toolbox has resources that other communities can use or adapt to replicate the project.

In order to create a similar project, it is important to:

  • Maintain communication with all stakeholders
  • Establish a local office
  • Have the outreach enrollment specialist develop relationships with other agencies and community leaders through local media and community events
  • Capitalize on relationship-building, trust, and respect, which are key elements to this project
  • Look for opportunities to present the All Healthy Children Campaign to teachers, coaches, and parents
  • Strategically place enrollment events and posters as successful outreach tools

Contact Information

Amanda K. Chappell, Program Manager
Covering Kids & Families of Brightpoint
260.423.3546 Ext. 333

Benefit enrollment and application
Children and youth
Uninsured and underinsured

States served

Date added
September 16, 2015

Date updated or reviewed
October 2, 2019

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.