Of all the areas that MHP Salud operates in, our agency recognized that there was the greatest need for insurance enrollment assistance in the Rio Grande Valley of Texas. Not only are there many uninsured individuals in the area, but environmental challenges unique to the region create additional challenges for people navigating the often complex insurance process to connect to care.

The Rio Grande Valley has an incredibly large uninsured population; approximately one-third of residents do not have health insurance. Combined, the border’s uninsured population comprises 8.3% that of Texas.

There are unique challenges in the area that prevent people from connecting to insurance coverage and other important resources. Colonias, which are prevalent in the Rio Grande Valley, are unregulated residential areas that often lack basic services such as water, electricity, sewage and garbage removal, street paving and maintenance, police and fire protection, and drainage. These environmental barriers all influence an individual’s daily life and makes accessing needed services and care even more difficult.

The population living in the Rio Grande Valley additionally face barriers relating to language, socio-economic status and education:

• 74% of residents speak a language other than English at home.
• 1% of the population live in poverty and 61.8% are considered low-income.
• 41% of residents aged 25 and older did not graduate high school.

These all affect an individual’s ability to navigate the health insurance process. Luckily, Community Health Workers working as Navigators have helped numerous individuals overcome these barriers and address their insurance-related needs.

MHP Salud’s Navigator program, which began in 2013, provides health insurance information and enrollment assistance to individuals living in Cameron, Hidalgo, Starr and Willacy Counties in the Rio Grande Valley of Texas. Community Health Workers act as certified Health Insurance Navigators, providing one-on-one application assistance as well as community outreach.

Navigator services have addressed common barriers for individuals living in the Rio Grande Valley. Language is often a challenge for people attempting to access insurance information in the Rio Grande Valley. Complex insurance information is often only provided in English. This can be problematic for the large Spanish-speaking population in the Valley and makes an already potentially confusing topic much more difficult to navigate. MHP Salud meets this challenge by employing Community Health Workers that are fluent in both Spanish and English. They commonly translate for those in need, in addition to their Navigator duties.

Our Navigators are readily available to meet the needs of those who need help accessing the insurance marketplace.

In addition to challenges related to language barriers, the Rio Grande Valley is mostly rural and often does not provide public transportation. Considering that a large portion of the community is low-income, transportation options may be limited, which can further impact the ability to access services and resources. Our Community Health Workers operate within the community, in highly accessible and local settings such as libraries, community resource centers, local clinics and community organizations.

 In the four counties that the Navigator program operates, MHP Salud has served individuals who are uninsured, are underinsured, and those who need renewal or post enrollment assistance. People who require assistance are often identified through community outreach. Community Health Workers conduct outreach in many ways: through television and radio ads, presentations at local organizations, and through door-to-door community outreach.

Community Health Workers acting as Navigators help individuals apply for health insurance, but a lot what they do also involves assisting consumers that are already enrolled in coverage. They often resolve issues like application errors, or issues with carriers. Some other common services include: helping consumers obtain an insurance ID card, connecting consumers to Insurance Representatives so that that they can make payments and providing consumers with information on primary care providers.

MHP Salud has also partnered with local organizations to provide additional needed services. For example, for those who don’t qualify for health insurance coverage, Community Health Workers help these individuals receive the care they need by referring them to partner organizations like the Rio Grande Valley Equal Voice Network and other similar local organizations. Working with local partners builds collaborative networks within the community and helps to support long-term and sustainable changes. This investment in sustainability will continue to support improving insurance coverage in the area for years to come.

Over the past 4 years, the Navigator program has had a great deal of success by providing assistance to a large number of people living in the Rio Grande Valley. This success can largely be attributed to the use of Community Health Workers as certified Navigators. Community Health Workers are members of the community who are not only fluent in English and Spanish, but provide insight and deep understanding of local resources, barriers, and history. This perspective supports the development of trust between the Navigator and program participants.

From 2017-2018 the Navigator program has had great success in achieving its goals:

• 8,681 people were reached through outreach
• 1,347 individuals were served

Navigators have provided valuable help for individuals living in the Rio Grande Valley. A few common challenges that Navigators assist individuals with include helping consumers understand their insurance coverage and working with insurance carriers. The many ways that Navigators have assisted these communities from 2017-2018 is illustrated in the graphic below.

*Other includes: Marketplace exemption (3%), Marketplace Tax Forms (1095-A) (2%), State Departments of Insurance (1%), Data Matching Issues (2%), SEP Eligibility (2%), Employer Sponsored Coverage Issues (1%). **APTC/CSR: Advance Premium Tax Credit/Cost Sharing Reduction. ***SHOP: Small Business Health Options Program

MHP Salud is pleased to announce that the organization recently received funding to continue the Navigator program, with expanded services available in additional counties in Texas.

The project described was supported by Funding Opportunity Number CMS-5 NAVCA150270-03-00 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

MHP Salud has over thirty years of experience implementing CHW programs and training organizations looking to start and/or strengthen their own CHW programs. For more information about MHP Salud, our services, and how we can help you, please email us at info@mhpsalud.org