Health / 2013
Young Leaders For A Healthy LA
Young Invincibles (YI) is an organization that expands opportunities for young adults between the ages of 18 and 34, with a primary focus on health care. YI creates targeted policy, research, and education campaigns that engage young adults and policymakers, and has become the most prominent national youth voice around young adults and health care, with offices and staff in LA and DC. Young adults are a key population to target as CA moves toward implementation of the Affordable Care Act (ACA). This demographic is disproportionately un- and underinsured, and often lacks both health homes and consistent care. YI recognizes the needs of young consumers and the importance of getting “young invincibles” informed and insured. New Exchanges also rely on the participation of the younger, healthier population to succeed and bring down costs for everyone. For many young people, a cell phone is a critical part of everyday life. Connecting with friends, finding directions, getting advice - it all happens on a cell phone. While 25% of smartphone users overall use their phone as their primary Internet access point, 42% of young adults, 38% of African Americans, and 40% of Latinos, go online mostly using their cell phones. In order to reach young adults where they are, YI has developed a free smartphone application, called Health Care Finder – Los Angeles, which easily disseminates health information to young adults in Los Angeles. The application educates users on available health providers, contains FAQ’s about the ACA, and gives information about different health insurance options. The app will also include a direct connection to the new California exchange where low-income youth can get Medi-Cal or subsidies for more affordable coverage, as well as push notification reminders around health services and enrollment. The app is already available on a range of smartphones and is already winning accolades as a true innovation in health care education. In a time, and in a city, in which everything is fast-paced and engaging young people can be difficult, this mobile application is a quick one-stop shop to obtain all of the information needed to help young adults make informed decisions on obtaining health coverage. The application can also help users identify facilities and providers that have been recommended by others in their communities. Since September 2012, YI has strived to improve the app, obtaining feedback from young adult roundtables around LA to ensure that the app is evolving in the most useful and targeted way for the population we serve. YI also continues to promote the mobile app through community events and asks users to provide feedback. However, to truly have an impact in terms of health and coverage for young adults in LA, YI must empower local young people themselves to take a lead role in our education and outreach program. Therefore, YI proposes to develop a base of diverse Young Promoters, ages 18 to 34, that can lead this effort and bring an authentic, trusted voice to their own communities. The Young Promoters will be given training on the ACA, coverage options, and on the use of the mobile app. Promoters will be selected among those that have participated in YI’s ongoing roundtable discussions and have been the most active in providing feedback. The work of these Promoters will result in the following: 1. Outreach and Education in Los Angeles: Young Promoters will be able to easily attend local community/school events and provide information about the mobile application and the importance of getting covered. 2. Train-the-Trainer: After receiving the training, Young Promoters will be given the opportunity to develop their own project in which they will be given a goal to reach 1,000 young adults and educate them about the ACA, how they can enroll, and encourage them to download the app. Young Promoters will receive a stipend of $1,000 when they complete their 6 month individual projects. We anticipate having 20 Young Promoters in year one. 3. Mobile Application Social Media Campaign: Through the base of Young Promoters and the young adults they train and inform, these Promoters will lead a social media campaign in which they will support the use of the free mobile application and will encourage others to continue providing feedback, information on resources that can be included, and most importantly to raise their voice on health care issues in their community. The goal is to ensure that a greater number of young adults are 1) obtaining health coverage and services and 2) that they are voicing their health care needs. Young leaders are the drivers that our communities need to ensure that everyone gets the care they deserve. As many organizations and groups in California are preparing to begin informing and enrolling the community in Covered California, YI and its Young Promoters can be the informational and educational providers and the voice for this population.
What are some of your organization’s most important achievements to date?
Young Invincibles has had notable successes in its health coverage and access program, establishing itself as the national leader on promoting health care and coverage for young adults. In 2011 and 2012, YI led a coalition of over 50 national and local partners around our “Getting Covered” health care education campaign that provided information to millions of young adults on and off-line about how to get covered up to age 26 under the new law. As part of this campaign, YI released and distributed online a health care education toolkit to educate young people on the importance of health coverage, timed around Valentine’s Day, with a reach of over 1.5 million young adults. Already, over 3.1 million uninsured young adults have taken advantage of the dependent coverage provision and gained affordable insurance, far exceeding expectations. In fact, young adults are the only demographic to see uninsurance rates decline during the Recession.
YI has also established expertise on coverage issues for young adults. YI successfully advocated for major improvements to student health plans following the ACA, changes that have helped over 3 million students on college plans see more comprehensive, better coverage. Similarly, YI has worked with the White House and congressional leadership to get national coverage of YI members benefiting from reform, and released the first comprehensive national report and poll on the economic and health challenges facing young adults since the Recession. YI has established itself as the go-to media source for information on young adults and health care, appearing in the LA Times, San Francisco Chronicle, NY Times, Wall Street Journal, NPR, MSNBC, Fox News, and CNN, among other outlets.
Last March, YI launched our National Youth Bus Tour. YI staff visited 43 cities in 20 different states, including 43 campuses and hosted over 100 youth events and roundtables designed to hear the perspective of diverse young adults on the economic, educational and health challenges they face. At our events, we provided state-specific materials on health care needs of young adults and options for coverage. The tour was covered widely, including this feature in the New York Times. The tour expanded our youth networks across the country, and particularly in California.
In LA, YI’s mobile app won LA Social Innovation Fast Pitch’s grand prize of $15,000. Tamika Butler, California Director, pitched at the competition and described plans to expand mobile app in low-income LA communities. Our policy expertise and experience with education campaigns will serve as a strong backbone to this project.
Please identify any partners or collaborators who will work with you on this project.
YI works with coalitions in key target areas, including the California Partnership, LA Access to Health Coverage Coalition, Southside Coalition of Community Health Centers, Community Health Council, and the Cal Endowment Building Healthy Communities Outcome Work Group for South LA. We have talked to a wide variety of health care clinics that serve young people and are excited about our mobile app in particular. We have worked with campuses extensively on the ACA, giving educational presentations to students at USC, UCLA, and CSULA; our networks extend to other campuses as well, where we engage in education trainings around financial aid and student loans; those networks will be brought into our health care outreach as well.
Please explain how you will evaluate your project. How will you measure success?
YI will use the following metrics to evaluate the overall success and impact of the health care outreach and education campaign:
• Number and percentage of YI’s online following in LA receiving and responding to messaging on health coverage and the mobile app; • Number of LA organizations who participate in outreach to members who otherwise would not; • Number of young Angelinos who participate in YI’s on-the-ground events, including trainings, forums and campus health fairs; • Number of young people who take action. For example, who share their story online about how important it is to be covered; the number of young adults who sign up and download materials; • The number of young Angelinos who ultimately enroll in the exchange and through Medi-Cal.
For the Young Promoters, in particular, we will use the following metrics:
• Number of young people we have signing up to become Promoters, receive and pass the training, and complete the program. • Number of young adults educated by each Promoter, including number (1) trained by a Promoter at events on health coverage and the mobile app, (2) that have downloaded the mobile app as a result, and (3) have been contacted by the Promoter via social media on health care and coverage; and (4) have taken an action via social media to share information or the mobile app with their friends. • Pre/Post tests of youth roundtable and training participants on understanding of health care options in their community. • One-on-one interviews with young people served that will cover successful strategies, challenges that they have faced, as well as general overview of feedback being received. • Reports from community health centers, student health centers and community navigators on increased usage of services as a result of Promoters.
How will your project benefit Los Angeles?
Young adults (18-34) continue to go uninsured and without access to basic health care at rates that far exceed the rest of the population. The ACA presents an opportunity to make huge gains for young adults. In CA, there are 3.1 million uninsured young adults, representing 32.8% of all young Californians. Of that 3.1 million, 2.7 million earn under 400% of the federal poverty level and therefore would qualify for either subsidies in the exchange or Medi-Cal. Young adults comprise 42% of the total uninsured population in CA.
California also has a highly diverse young adult population, many of whom are uninsured. In fact, about 42% of young Latinos (18-34) are uninsured. Enrolling these young adults in new exchanges is not only important for the health and financial well-being of this population, but critical for the overall CA insurance market as it spreads risk and can help keep premiums down. These rates are starkest in Los Angeles County where the 39% uninsured rate for young adults surpasses the statewide average of 31%. Both rates exceed the national average.
We want to change this by decreasing the number of young adults of color in Los Angeles who go uninsured. Young Invincibles will utilize our Young Promoters and health care education mobile app and a push text message campaign to complement a broader social media and communications campaign. Our diverse network of 20 Young Promoters will dramatically expand the reach of YI by hosting local youth trainings in their community or on campus, and by promoting the mobile app and health coverage awareness through social media. The mobile app will provide key information about the ACA, places to find local doctors and community health centers, a portal to Covered California, and have the ability to reach the population repeatedly through push text notifications. Using online social media outreach– targeted Facebook promotions, contests, engagement with Twitter influencers– and combining this method with dissemination of our on-the-ground Young Promoters trainings, we can educate young adults on the ACA, facilitate the download of our mobile app, and ultimately reach thousands of uninsured young people. Once these young people have been trained by their peers and downloaded the app, they can be valuable leaders in their own communities.
We will also use social media more broadly to build awareness as major changes occur. During the launch of open enrollment on October 1, 2013 and around special enrollment times like graduation, we will launch highly sharable social media content. For example, we will ask our Young Promoters to post content that contains our enrollment messages to their personal networks and to share a form for friends to get signed up for more information. We will use our own organizational social media platforms, engage with partner social media organizations, and work with social media influencers to push out those messages and drive young adults to the exchange.
What would success look like in the year 2050 regarding your indicator?
In 2050, success in health care would include coverage for everyone that is truly affordable along the entire spectrum of health care. The uninsured rate for 18-34 year olds in the United States is 27%. In California that rate is even higher at 31%. On the local level in Los Angeles, the data is even worse. With 39% of young Angelinos currently lacking insurance, something has to be done.
We think that our organization can make a difference for uninsured young adults in Los Angeles. The ACA has already started impacting the lives of many and it will continue to do so through its full implementation. However, young adults of color are continually left out of education around health care.
We believe that educating young Angelinos in low-income communities of color about the ACA, equipping them with a mobile app to spread the information, and empowering them to lead the change in their communities will dramatically change the uninsured landscape in LA by 2050. In fact, the majority of that 39% of uninsured young Angelinos, should gain access to affordable health coverage either through Medi-Cal or subsidies in the exchange if we are successful. With health insurance, young Angelinos will be more able and willing to seek need medical care, preventive care and treatment for chronic conditions like diabetes and asthma from local hospitals, community health centers, and other providers. Over the long run, young Angelinos will see better health outcomes and greater financial security.
Moreover, as young adults use our app, get engaged, get informed and get insured, we will see increased youth engagement and leadership, particularly in communities of color. The younger generations needs to be informed about health care and need to understand the importance of hearing and voicing the stories of marginalized communities that are too often left when health policy decisions are made. Through the Young Promoter program, and by reaching out to young adults in low-income communities of color in 2013 and 2014, we can help to develop a next generation of leaders in Los Angeles. Together alumni of our Young Promoters and those they have impacted will help to ensure that all young adults can afford quality insurance, and ultimately, lead healthier lives.